title: Effects of calcitriol on bone mineral density in patients treated with esomeprazole.
abstract: BACKGROUND
  Proton pump inhibitor (PPI) increases the risk of decrease in bone mineral density (BMD). However, whether calcitrol improves this situation is unknown.
  
  
  OBJECTIVE
  The current study investigates the effects of calcitriol on BMD in patients with esomeprazole therapy.
  
  
  METHODS
  Three hundred and eighty-six participants with gastrointestinal ulcerations were enrolled and randomly assigned into controlled and supplemented groups. Participants in the controlled group were prescribed esomeprazole (20 mg/qd), while the supplemented group was prescribed esomeprazole (20 mg/qd) and calcitriol (2.5 μg/qd). BMD, serum levels of calcium, carboxy-terminal collagen crosslinks (CTX), and alkaline-phosphatase (ALP) were assessed.
  
  
  RESULTS
  (1) No significant between-group difference of age, gender, smoking, previous glucocorticoid use and hemoglobin level was found; (2) after 10.6 ± 0.8 d of PPI therapy, BMD T score in the controlled group was slightly increased compared with initial (-1.25 ± 0.08 versus -1.28 ± 0.06, p = 0.084), while there was no change in the supplemented group (-1.25 ± 0.05 versus -1.26 ± 0.03, p = 0.308); (3) during study termination, calcium level in the supplemented group was slightly higher than the controlled group (2.05 ± 0.03 mmol/L versus 2.01 ± 0.05 mmol/L, p = 0.073), while no significant differences of CTX (366.57 ± 43.71 pg/mL versus 373.15 ± 50.23 pg/mL, p = 0.036) and ALP were found among these two groups (50.47 ± 9.32 U/L versus 52.23 ± 10.45 U/L, p = 0.075).
  
  
  CONCLUSIONS
  Patients with gastrointestinal ulcerations with esomeprazole therapy, calcitriol supplement showed no efficacy on BMD changes.
authors.affiliation: Department of Gastroenterology, the Second Affiliated Hospital of Shantou University , Shantou , China.
authors.forename: Congwu
authors.initials: C
authors.lastname: Huang
authors.forename: Chuan
authors.initials: C
authors.lastname: Cen
authors.forename: Xin
authors.initials: X
authors.lastname: Ding
authors.forename: Haiyong
authors.initials: H
authors.lastname: Zhang
authors.forename: Lingfei
authors.initials: L
authors.lastname: Wu
mesh_terms: D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D002117:Calcitriol / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D064098:Esomeprazole / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000175:diagnosis / Q000188:drug therapy*; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D050071:Bone Density Conservation Agents; D054328:Proton Pump Inhibitors; D002117:Calcitriol; D064098:Esomeprazole
keywords: 1,25-Dihydroxyvitamin D; alkaline phosphatase; bone mineral density; carboxy-terminal collagen crosslinks; duodenal ulceration; gastric ulceration; proton pump inhibitor