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Minimum Required Vitamin D Level for Optimal Increase in Bone Mineral Density with Alendronate Treatment in Osteoporotic Women

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Abstract

Vitamin D insufficiency and deficiency are common in the elderly. Most previous studies using alendronate have used vitamin D supplementation regardless of individual vitamin D status. However, the minimum required vitamin D levels for the efficacy of alendronate treatment of osteoporosis remain unclear. Fifty-two postmenopausal women, diagnosed with osteoporosis, were enrolled in this prospective study, in which they took 5 mg of alendronate daily for 6 months without any supplements. Associations between baseline factors and their changes during the treatment and the change in the lumbar spine bone mineral density (LS-BMD) were examined. The most appropriate cut-off level of 25-hydroxyvitamin D (25[OH]D) for the optimal increase in LS-BMD with alendronate was determined using the Akaike information criterion statistical criterion. Overall, alendronate treatment significantly increased LS-BMD by 4.7%. The basal serum 25(OH)D and change in urinary NTX were significantly associated with the increase in LS-BMD. The increase in LS-BMD between the two groups was not different when comparing those with baseline 25(OH)D above vs. below 30 ng/ml. However, 25(OH)D of 25 ng/ml was determined to be the minimum required vitamin D level for an adequate effect of alendronate. Vitamin D status may affect the increase in LS-BMD with alendronate treatment in individuals being treated for osteoporosis, and a 25(OH)D level >25 ng/ml appears to be required for an optimal LS-BMD response.

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Acknowledgements

We thank Dr. Fumiyo Enomoto, Dr. Mayumi Sawa, Dr. Takaaki Tsuji, and Dr. Masahiko Nozawa for their valuable help in data collection. We give special thanks to Dr. Tokuhide Doi and Ms. Yumiko Sakurai for their excellent help in statistical analysis and secretarial work, respectively. We also express our deep appreciation to Dr. John Eisman for his helpful comments and suggestions. This study was partially supported by a High Technology Research Center Grant from the Ministry of Education, Culture, Sports, Science and Technology of Japan.

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Correspondence to Muneaki Ishijima.

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Ishijima, M., Sakamoto, Y., Yamanaka, M. et al. Minimum Required Vitamin D Level for Optimal Increase in Bone Mineral Density with Alendronate Treatment in Osteoporotic Women. Calcif Tissue Int 85, 398–404 (2009). https://doi.org/10.1007/s00223-009-9295-x

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  • DOI: https://doi.org/10.1007/s00223-009-9295-x

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