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OBJECTIVE To explore the efficacy of alfacalcidol combined with conventional antihypertensive and lipid- lowering drugs on liver and kidney function， serum inflammatory cytokines and renin-angiotensin system（RAS） in hypertensive patients with renal impairment. METHODS A total of 200 hypertensive patients with renal impairment who were treated in the department of nephrology in our hospital from December 2017 to December 2020 were selected and randomly divided into control group and observation group， with 100 cases in each group. Both groups of patients were treated with conventional antihypertensive and lipid-lowering drugs for a total of 14 weeks， patients in the observation group were additionally treated with oral alfacalcidol after 2 weeks of treatment （0.25 μg each time， once a day， for a total of 12 weeks）. The levels of liver function indexes [aspartate aminotransferase （AST）， alanine aminotransferase （ALT）]， renal function indexes [blood calcium， blood phosphorus， blood urea nitrogen （BUN）， cystatin C （Cys-C）， serum creatinine （Scr）， urine microalbumin （mAlb）， β2-microglobulin （β2-MG）， urinary N- acetyl β-D-glucosaminidase （NAG）， 24 h urinary protein]， inflammatory factors [serum interleukin 6 （IL-6）， tumor necrosis factor α （TNF-α）， hypersensitive C-reactive protein （hs-CRP）] and RAS activity indexes [renin， angiotensin Ⅰ（Ang Ⅰ）， Ang Ⅱ and aldosterone] were observed in 2 groups before and after treatment， and the occurrence of adverse drug reactions was recorded during treatment. RESULTS There was no statistical significance in the levels of detection indexes between 2 groups before treatment （P＞0.05）. After treatment， the level of blood calcium in the observation group was significantly higher than before treatment （P＜0.05）， but remained at clinically normal level. Compared with before treatment， the levels of Cys-C， Scr， BUN， urine mAlb， β2-MG， NAG and 24 h urinary protein， hs-CRP， IL-6， TNF-α， renin， Ang Ⅰ， Ang Ⅱ and aldosterone were significantly decreased in the observation group after treatment （P＜0.05）. After treatment， the level of blood calcium in observation group was significantly higher than control group （P＜0.05）. Additionally， the levels of Cys-C， Scr， BUN，urine mAlb， β2-MG， NAG， 24 h urinary protein， hs-CRP， IL-6， TNF-α， renin， Ang Ⅰ， Ang Ⅱ and aldosterone were significantly lower than control group （P＜0.05）. There was no statistical significance in the incidence of adverse drug reactions between 2 groups during treatment （P＞0.05）. CONCLUSIONS Alfacalcidol combined with routine therapy of antihypertensive and lipid-lowering drugs could effectively improve liver and renal functions， inhibit inflammation and RAS activity in hypertensive patients with renal impairment， with a favorable safety.
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OBJECTIVES@#To study the effects of alfacalcidol on serum 25-(OH)D@*METHODS@#A total of 200 children with HSP were prospectively enrolled from June 2018 to June 2020. According to the random number table method, they were divided into an observation group and a control group (@*RESULTS@#After treatment, the observation group showed a significantly higher serum 25-(OH)D@*CONCLUSIONS@#Alfacalcidol can increase the serum 25-(OH)D
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Child , Humans , Hydroxycholecalciferols , Interleukin-6 , Prospective Studies , IgA Vasculitis/drug therapyABSTRACT
Objective To investigate the effect of alendronate combined with calcitriol on bone metabolism in the treatment of postmenopausal osteoporosis patients.Methods66 postmenopausal osteoporosis patients from Cancer Hospital of Hangzhou were selected and randomly divided into the control group and the study group.33 cases in the control group were treated by compound calcium amino acid chelate.33 cases in the study group were treated by compound calcium amino acid chelate, alendronate and alfacalcidol.All patients were taking the drug for 48 weeks.The bone mineral density (BMD) of lumbar vertebrae between 4 and 1, Bone alkaline phosphatase (BALP) and bone metabolism index of left femur (BMD) Type I collagen C end peptide (CTX), acid phosphatase (TRAP), parathyroid hormone (PTH) and clinical curative effect were compared.ResultsAfter treatment, the clinical effective rate of the study group (93.94%) was higher than that of the control group (72.73%), the difference was statistically significant (P<0.05).Compared with the control group,the level of bone mineral density of lumbar spine was increased from 1 to 4, and the level of TRAP, CTX, PTH and BALP were increased,the difference was statistically significant (P<0.05).There was no difference in adverse effects between the two groups.ConclusionThe combination of the application of sodium hyaluronate and the combination of the method can effectively improve the bone mineral density and bone metabolism in postmenopausal women with osteoporosis, and improve the clinical efficacy.
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Objective To understand the skeletal metabolism in glucocorticoids-treated children with kidney diseases and to evaluate the role of Alfacalcidol plus calcium supplements.Methods A retrospective self-controlled study was performed in children with kidney diseases,admitted to Department of Pediatrics,Peking University First Hospital from July 2012 to November 2014,and they conformed to the inclusion and exclusion criteria.Inclusion criteria:children with renal diseases were included when they were administered with glucocorticoids,Alfacalcidol and calcium at the enrollment and follow-up,whose proteinuria was in remission or improved on follow-up,and renal function defined by glomerular filtration rate was more than 80 mL/(min · 1.73 m2),and they were followed up for at least 3 months.Exclusion criteria:whereas on follow-up,children with renal diseases were excluded if glucocorticoids was discontinued,or the follow-up period was less than 3 months,and related parameters were not available at the initial and finial visit.Serum levels of calcium,phosphate,alkaline phosphatase,25-hydroxy-vitamin D (25-OH-VitD) were detected,and bone mineral density at the left radius and mid tibia was measured by using quantitative ultrasound at the initial and finial visit.The levels of calcium,phosphate,alkaline phosphatase,25-OH-VitD and bone mineral density were compared between the initial and finial visit.Results A total of 29 cases (23 male,6 female) were recruited.Their ages at study entry were 2.4 to 14.9 years.Underlying disorders were primary nephrotic syndrome(17 cases),IgA nephropathy (4 cases),lupus nephritis (3 cases),purpura nephritis (2 cases),acute glomerulonephritis (1 case),Sjogren's disease(1 case),and autoimmune disease(1 case).At the time of enrollment,the course of disease was 1 to 69 months (median course of disease was 8 months),the duration of using corticosteroid was 0-60 months (median duration was 5 months),and the follow-up time was 92-409 days.The serum calcium,alkaline phosphatase and 25-OH-VitD levels at finial visit[(2.29 ±0.11) mmol/L,(153.21 ±71.00) U/L,and (40.96 ± 11.40) nmol/L,respectively] were significantly higher as compared with those at initial visit [(2.17 ± 0.16) mmol/L,(114.10 ±64.48) U/L,and (31.64 ± 10.99) nmol/L,respectively],and the differences were significant (all P ＜ 0.01),whereas there was no significant difference in serum level of phosphorate between initial and finial visit[(1.45 ±0.25) mmol/L vs.(1.48 ± 0.25) mmol/L] (t =-0.452,P ＞ 0.05).Meanwhile,there was significant difference in serum level of albumin level between initial and finial visit [(31.41 ± 9.31) g/L vs.(42.09 ± 4.00) g/L,t =-3.670,P ＜ 0.001].Compared with baseline assessment,bone mineral density at the left radius and tibia improved or maintained in 24/29 patients,whereas that of 5/29 patients declined.However,compared with initial and finial visit of bone mineral density in all patients(0.09 ± 1.58 vs.0.22 ± 1.07 at the left radius;0.93 ± 1.13 vs.1.00 ± 1.35 at the mid tibia),there was no significant difference (all P ＞ 0.05).Conclusions Bone loss can be prevented by Alfacalcidol plus calcium supplement in glucocorticoids-treated children with kidney diseases.
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OBJECTIVE:To explore the clinical efficacy and safety of alfacalcidol in the adjuvant treatment of bronchiolitis in children. METHODS:Data of 156 children with bronchiolitis were retrospectively collected and divided into observation group(78 cases) and control group (78 cases) by different medication. All children received oxygen inhalation,relieving asthma,antiviral and other conventional treatment,then control group inhaled Budesonide suspension 0.5-1.0 mg + Salbutamol aerosol 0.25 mL for atomization,bid,10 min every times,7-d was a course. Observation group additionally given Alfacalcidol soft capsule 0.010-0.015μg/(kg·d),3 times a week,3-month was a course. They were treated for 3 months. Clinical efficacy,improvement time of clinical symptoms and signs,levels of 25-(OH)D3 and serum LEP,IgA,IgG,IgM and IgE before and after treatment,and the incidence of adverse reactions in 2 groups were observed and compared. RESULTS:The total effective rate in observation group was signifi-cantly higher than control group,improvement time of cough,asthma,wheezing and moist rale were significantly shorter than con-trol group with statistical significansce (P<0.05) after 7-d treatment;after 3-month treatment,25-(OH)D3,IgA and IgG levels were significantly higher than before,and observation group was higher than control group,LEP and IgE levels were significantly lower than before,and observation group was lower than control group,with statistical significances(P<0.05). There was no sig-nificantly difference of the level of IgM in 2 groups before and after treatment. And there were no severe adverse reactions in 2 groups. CONCLUSIONS:Based on conventional treatment,alfacalcidol shows good efficacy in the adjuvant treatment of bronchiol-itis in children,which can obviously enhance immune function,reduce serum LEP level,then shorten remission time of clinical symptoms and signs,with less adverse reactions and good safety.
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Objective To discuss the curative effects of alfacalcidol combined with losartan potassium tablets in the treatment of early diabetic nephropathy (EDN).Methods 90 EDN patients in our hospital were chosen and randomly divided into the observation group and control group (45 cases in each group).The control group was given losartan potassium tablets treatment,while the observation group was given alfacalcidol combiend with telmisartan treatment.All the two groups were treated for 3 months.Before and after treatment,the fasting blood glucose (FBG), 24h urine trace albumin quantitative (UAER),24h urine protein (24h pro),serum creatinine (SCr),25 -hydroxyl vitamin D [2 5 (OH )D ],blood calcium (Ca2+),potassium (K+),glycosylated hemoglobin (HbA 1 C )and serum inflammatory factors[C-reactive protein (CRP),tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6 )] were observed,and the correlation between 25 (OH)D and UAER,24h pro was analyzed.At the same time,the clinical curative effects and adverse reactions during treatment were evaluated.Results In the observation group,the total effective rate was 93.3%,which was significantly higher than 71.1% in the control group (χ2 =7.601,P0.05).After treatment,Scr,24h pro and UAER in the two groups were all significantly reduced compared with before treatment (P0.331).After treatment,25(OH)D in the observation group decreased significantly compared with before treatment (t=12.000,P0.436).Pearson correlation analysis showed that 25 (OH)D level was negatively correlated with 24h pro and UAER (r=0.483,0.778,all P0.151 ).Conclusion Alfacalcidol combined with losartan potassium tablets can significantly reduce the proteinuria levels of EDN patients and inflammation,which has better clinical curative effects and higher safety.
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Objective To analyze the effect of calcitonin combined with alfacalcidol on clinical outcome,lumbar vertebrae bone mineral density and safety in patients undergoing internal fixation of humeral shaft fracture.Methods 80 patients with humeral shaft fracture treated with internal fixation in Xunwu county people's hospital from June 2010 to June 2016 were selected,and randomly divided into control group and observation group,40 cases in each groups.The control group was given calcium carbonate D3 tablets and functional exercise therapy,the observation group treated calcitonin combined with alfacalcidol on the basis of control group,analysis and comparison the clinical effects,lumbar spine BMD and safety.Results Compared with before treatment,serum calcium level of two groups increased significantly at treatment 2 weeks and 3 weeks(P<0.05);The control group BMD of lumbar spine was significantly increased in treatment 12 weeks(P<0.05),the observation group BMD of lumbar spine was significantly increased in treatment 4 weeks and 12 weeks(P<0.05).Compared with control group,the level of serum calcium in observation group was higher at treatment 2 weeks and 3 weeks (P<0.05),BMD of lumbar spine was higher at treatment 4 weeks and 12 weeks(P<0.05);The total adverse reaction rate of observation group was 10%,the difference was not statistically significant to control group 15%.Conclusion The combination of calcitonin and alfacalcidol treatment of internal fixation of humeral shaft fractures in patients with significant results, can improve serum calcium levels in patients with and improve bone mineral density, and less adverse reactions.
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OBJECTIVE:To compare the efficacy and safety of alfacalcidol and strontium ranelate in the treatment of senile menopausal osteoporosis. METHODS:158 elderly menopausal patients with osteoporosis were randomly divided into control group (79 cases)and observation group(79 cases). All patients were orally given 1 Calcium carbonate D3 tablet,once a day. Based on it, control group was given 2 Alfacalcidol soft capsules,once a day. Observation group was additionally given 1 bag of Strontium ranelate dry suspension,orally before bedtime,once a day. The treatment course for both groups was 12 months. L2-4 and BMD of femoral neck,osteocalcin,TPINP and VAS and ADR before and after 6 and 12 months in 2 groups were observed. RESULTS:Before treatment,there were significant differences in the BMD of L2-4 and femoral neck,osteocalcin,TPINP and VAS scores be-tween 2 groups(P>0.05). BMD of L2-4 and femoral neck in control group after 12 months and in observation group after 6 and 12 months were significantly higher than before,and it gradually increased be time in observation,observation group was higher than control group;TPINP and VAS scores in control group after 12 months and in observation group after 6 and 12 months were significantly lower than before,and it gradually decreased be time,observation group was lower than control group,the differenc-es were statistically significant(P0.05). There were no ADR during treatment. CONCLUSIONS:Based on the conventional treatment,the efficacy of alfacal-cidol and strontium ranelate is superior to alfacalcidol alone in the treatment of senile menopausal osteoporosis,with similar safety.
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Objetivos: O desuso pelo repouso no leito, pela imobilização de membros ou por missões espaciais provoca a perda óssea rápida. Fez-se este estudo para investigar os efeitos terapêuticos do ácido zoledrônico (ZOL), isoladamente e em combinação ao alfacalcidol (ALF), em um modelo de rato com osteoporose por desuso. Métodos: Ratos Wistar machos de três meses foram submetidos à imobilização da pata traseira direita (IPTD) por 10 semanas para induzir a osteopenia; em seguida, foram divididos em quatro grupos: 1 – IPTD para controle positivo; 2 – IPTD mais ZOL (50 µg/kg, dose única intravenosa); 3 – IPTD mais ALF (0,5 µg/kg, via oral diariamente); 4 – IPTD mais ALF (0,5 µg/kg, via oral diariamente) mais ZOL (50 µg/kg, dose única intravenosa) por outras 10 semanas. Um grupo de ratos não imobilizados foi usado como controle negativo. No fim do tratamento, os fêmures foram removidos e testaram-se a porosidade do osso e suas propriedades mecânicas, além do peso seco e das cinzas do osso. Resultados: A terapia combinada com ZOL mais ALF foi mais eficaz em reduzir a porosidade do osso do que a monoterapia com um dos fármacos administrado isoladamente em ratos submetidos à IPTD. No que diz respeito à melhoria da resistência mecânica da diáfise femoral média, o tratamento combinado com ZOL mais ALF foi mais eficaz do que a monoterapia com um dos fármacos administrado isoladamente. Além disso, a terapia combinada com ZOL mais ALF foi mais eficaz na melhoria do peso seco e das cinzas do osso do que a monoterapia com ZOL ou ALF em ratos submetidos à IPTD. Conclusões: Esses dados sugerem que a terapia combinada com ZOL mais ALF representa uma opção terapêutica potencialmente útil para o tratamento da osteoporose por desuso. .
Objectives: Disuse by bed rest, limb immobilization or space flight causes rapid bone loss. We conducted the present study to investigate the therapeutic effects of zoledronic acid (ZOL), alone and in combination with alfacalcidol (ALF) in a rat model of disuse osteoporosis. Methods: In the present study, 3-month-old male Wistar rats had their right hind-limb immobilized (RHLI) for 10 weeks to induce osteopenia, then were divided into four groups: 1 – RHLI positive control; 2 – RHLI plus ZOL (50 µg/kg, i.v. single dose); 3 – RHLI plus ALF (0.5 µg/kg, oral gauge daily); 4 – RHLI plus ALF (0.5 µg/kg, oral gauge daily) plus ZOL (50 µg/kg, i.v. single dose) for another 10 weeks. One group of non-immobilized rats was used as negative control. At the end of the treatment, the femurs were removed and tested for bone porosity, bone mechanical properties, and bone dry and ash weight. Results: Combination therapy with ZOL plus ALF was more effective in decreasing bone porosity than each drug administered as monotherapy in RHLI rats. With respect to improvement in the mechanical strength of the femoral mid-shaft, the combination treatment of ZOL plus ALF was more effective than each drug administered as a monotherapy. Moreover, combination therapy using ZOL plus ALF was more effective in improving dry bone and ash weight, than single-drug therapy using ZOL or ALF in RHLI rats. Conclusions: These data suggest that combination therapy with ZOL plus ALF represents a potentially useful therapeutic option for the treatment of disuse osteoporosis. .
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Rats , Bone Density Conservation Agents/therapeutic use , Diphosphonates/therapeutic use , Hydroxycholecalciferols/therapeutic use , Imidazoles/therapeutic use , Osteoporosis/drug therapy , Bone Density Conservation Agents/pharmacology , Diphosphonates/pharmacology , Disease Models, Animal , Drug Synergism , Hindlimb Suspension , Hydroxycholecalciferols/pharmacology , Imidazoles/pharmacology , Osteoporosis/etiologyABSTRACT
Objective To observe the effects of alendronate sodium and alfacalcidol on the parameters of atherosclerosis in old women with type 2 diabetes mellitus(T2DM ) complicating osteoporosis .Methods 28 old women with T2DM complicating osteopo-rosis were taken as the osteoporosis group and 25 old women with T2DM and without osteoporosis were taken as the control group .Alendronate sodium(70 mg/week) and alfacalcidol(0 .5 μg/d) were given to the osteoporosis group for 12 month .The pa-rameters of the bone mass density (BMD)of femoral neck and ,T value ,arkle brachial index (ABI) ,cardio-ankle vascular index (CAVI) and carotid artery intima-media thickness(IMT) ,blood fat and glycosylated hemoglobin were observed .Results Com-pared with the control group ,BMD ,T value and ABI in the osteoporosis group were significantly decreased (P<0 .01) ,while CAVI and IMT were obviously increased(P<0 .05) .Compared with before treatment ABI ,CAVI and IMT after 12 month treatment in the osteoporosis group had no significant changes ,but BMD and T value of femoral neck and ward triangle area were significantly increased(P<0 .05) ,the atherosclerosis degree after 12 months in the control group was significantly aggravated (P<0 .05) .BMD and T value had no obvious change .Conclusion Alendronate sodium combined with alfacalcidol for treating T 2DM complicating os-teoporosis can improve the atherosclerosis parameters and has certain role in preventing and treating cardiovascular and cerebrovas-cular diseases .
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PURPOSE: The comparative effects of alendronate and alfacalcidol on bone mineral density (BMD) and bone turnover have already been established in postmenopausal women with osteoporosis. An open-labeled prospective study was conducted to compare the treatment effects of alendronate and alfacalcidol on hip BMD and bone turnover in Japanese men with osteoporosis or osteopenia with clinical risk factors for fractures. MATERIALS AND METHODS: One hundred twelve men with osteoporosis or osteopenia with clinical risk factors for fractures (mean age: 71.4 years) were randomly divided into two groups of 56 patients each: the alendronate (5 mg daily) and alfacalcidol (1 microgram daily) groups. The BMD of the total hip, urinary level of cross-linked N-terminal telopeptides of type I collagen (NTX), and serum levels of bone-specific alkaline phosphatase (BSAP) were measured during the 12-month-treatment period. RESULTS: Forty-five patients in the alendronate group and 42 patients in the alfacalcidol group completed the trial. Alendronate increased BMD (+2.3% at 12 months) following reductions in the urinary level of NTX (-46.4% at 3 months) and serum level of BSAP (-34.1% at 12 months), while alfacalcidol sustained BMD (-1.9% at 12 months) as well as the urinary level of NTX (+13.2% at 3 months) and serum level of BSAP (+1.8% at 12 months). CONCLUSION: The present study confirmed that alendronate has better efficacy than alfacalcidol (active control) in increasing hip BMD and reducing bone turnover in Japanese men with osteoporosis or osteopenia with clinical risk factors for fractures.
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Aged , Aged, 80 and over , Humans , Male , Middle Aged , Alendronate/pharmacology , Asian People , Bone Density/drug effects , Bone Density Conservation Agents/pharmacology , Bone Diseases, Metabolic/drug therapy , Fractures, Bone/prevention & control , Hip Joint/drug effects , Hydroxycholecalciferols/pharmacology , Osteoporosis/drug therapy , Treatment OutcomeABSTRACT
PURPOSE: The comparative effects of alendronate and alfacalcidol on bone mineral density (BMD) and bone turnover have already been established in postmenopausal women with osteoporosis. An open-labeled prospective study was conducted to compare the treatment effects of alendronate and alfacalcidol on hip BMD and bone turnover in Japanese men with osteoporosis or osteopenia with clinical risk factors for fractures. MATERIALS AND METHODS: One hundred twelve men with osteoporosis or osteopenia with clinical risk factors for fractures (mean age: 71.4 years) were randomly divided into two groups of 56 patients each: the alendronate (5 mg daily) and alfacalcidol (1 microgram daily) groups. The BMD of the total hip, urinary level of cross-linked N-terminal telopeptides of type I collagen (NTX), and serum levels of bone-specific alkaline phosphatase (BSAP) were measured during the 12-month-treatment period. RESULTS: Forty-five patients in the alendronate group and 42 patients in the alfacalcidol group completed the trial. Alendronate increased BMD (+2.3% at 12 months) following reductions in the urinary level of NTX (-46.4% at 3 months) and serum level of BSAP (-34.1% at 12 months), while alfacalcidol sustained BMD (-1.9% at 12 months) as well as the urinary level of NTX (+13.2% at 3 months) and serum level of BSAP (+1.8% at 12 months). CONCLUSION: The present study confirmed that alendronate has better efficacy than alfacalcidol (active control) in increasing hip BMD and reducing bone turnover in Japanese men with osteoporosis or osteopenia with clinical risk factors for fractures.
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Aged , Aged, 80 and over , Humans , Male , Middle Aged , Alendronate/pharmacology , Asian People , Bone Density/drug effects , Bone Density Conservation Agents/pharmacology , Bone Diseases, Metabolic/drug therapy , Fractures, Bone/prevention & control , Hip Joint/drug effects , Hydroxycholecalciferols/pharmacology , Osteoporosis/drug therapy , Treatment OutcomeABSTRACT
Kearns-Sayre Syndrome (KSS) is rare mitochondrial disorder characterized by chronic progressive external ophthalmoplegia, atypical retinal pigmentation and complete heart block. It is occasionally combined endocrinologic symptoms such as hypoparathyroidism, short stature, diabetes mellitus and hypothyroidism. We reported the effect of Coenzyme Q10 on total serum calcium concentration in 17 years old girl with KSS and hypoparathyroidism. The patients was treated with alfacalcidol (1alpha-OHD3), Coenzyme Q10 and oral calcium agent. Total serum calcium concentration had even remained within normal range and hypercalcemia was developed suddenly after treatment of combination of Coenzyme Q10 and alfacalcidol (1alpha-OHD3). After stop of all medication, her total calcium concentration was decreased to 7.6 mg/dL and remained in normal range with oral calcium (2 g/day) and Coenzyme Q10 (150 mcg/day) daily. The action of Coenzyme Q10 is not clearly defined but, we could explain Coenzyme Q10 activates the capacity of the patient to produce the active form of Vitamin D, 1alpha-OHD3.
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Adolescent , Female , Humans , Calcium , Diabetes Mellitus , Heart Block , Hypercalcemia , Hypoparathyroidism , Hypothyroidism , Kearns-Sayre Syndrome , Mitochondrial Diseases , Ophthalmoplegia, Chronic Progressive External , Pigmentation , Reference Values , Retinaldehyde , Vitamin DABSTRACT
OBJECTIVE:To investigate the curative effects of alfacalcidol soft capsules combined with calaium carbonate tablet on secondary hyperparathyroidism(SHPT)associated with chronic renal failure(CRF).METHODS:55patients were assigned to dialysis group(28cases)and non-dialysis group(27cases),both groups had taken oral alfacalcidol soft capsules in combination with calcium carbonate tablet continuously for3months.Then the changes in serum Ca 2+ ,P 3- ,PTH,AKP and Cr levels were observed.RESULTS:After treatment,serum Ca 2+ concentration was significantly increased(P