The effect of Vitamin D(3)addition on bone mineral density in postmenopausal hormone replacement / 대한산부인과학회잡지

OBJECTIVE: To determine the effect of the addition of Vit. D3 (1,25-Dihydroxychole calciferol D3) to the conventional postmenopausal hormone replacement therapy on bone mineral density(BMD) DESIGN: A 2-year retrospective , randomized study Setting : Department of Obstetrics and Gynecology of Catholic university hospital Patients : 388 postmenopausal women were recruited and divided into 5 groups according to treatment regimen; A: conjugated estrogens only treated group(n=146), B : conjugated estrogens and progesterone treated group(n=103), C : conjugated estrogens and Vit.D3 treated group (n=36), D : conjugated estrogens, progesterone and Vit.D3 treated group (n=41), E : control group (n=60). METHODS: The bone mineral density of the lumbar spines and femoral neck were determined by dual-energy X-ray absorptiometry(DEXA) every 2 years. STATISTICS: The difference between before and after treatment was determined by paired t-test. The comparison among the groups were determined by one way ANOVA test and student's t-test. RESULTS: The addition of progesterone to estrogen showed insignificant increase in the lumbar and femoral neck BMD. The addition of Vit. D3 compared with conventional hormone replacement therapy insignificantly influened bone density in women with initially normal BMD, but definitely increase in women with initially osteopenic and osteoporotic BMD of femoral neck rather than lumar spine(p<0.05). CONCLUSIONS: The use of Vit. D3 combined with postmenopausal estrogen replacement effects the increase of BMD in low bone density than normal bone density, especially femoral neck.

The Effect of Steroid Therapy on Growth and Bone Density in Children with Nephrotic Syndrome

PURPOSE: Long-term steroid therapy for various glomerular disorders in children has been known to decrease serum Vit D3 level and develop osteomalacia. The aim of this study was to observe the effect of long-term steroid therapy on growth and bone density in children with nephrotic syndrome. METHODS: Bone density of 17 steroid-treated nephrotic syndrome was compared with that of 17 similar aged healthy children by biochemical measurement, bone age and bone mineral density. Serum Vit D3, calcium, phosphorus and alkaline phosphatase were measured and bone mineral content was measured in the lumbar vertebra by dual energy X-ray absorptiometry (HOLOGIC QDR 2000 X-Ray Bone densitometer). RESULTS: There was no significant difference in height ,weight and bone age between the two groups. The mean bone density was significantly lower in children receiving steroid (0.58 +/- 0.04g/cm2) than in the control group (0.65 +/- 0.07g/cm2) (P<0.001). There was no significant correlation between duration of steroid therapy and decrement of bone density. Serum Vit D3 level was significantly lower in the group receiving steroid (16.7 +/- 6.1pg/ml) than in the control group (31.0 +/- 5.8pg/ml) (P<0.001). CONCLUSION: we conclude that alternate-day steroid therapy doesn't affect growth but may lead to decrement of serum Vit D3 level and bone mineral density in children with nephrotic syndrome.