Searchable abstracts of presentations at key conferences on calcified tissues
Bone Abstracts (2016) 5 SS4.2 | DOI: 10.1530/boneabs.5.S4.2

ECTS2016 Main Symposium East Meets West (3 abstracts)

Relevance of vitamin D to pathogenesis and treatment of osteoporosis

Toshio Matsumoto


Fujii Memorial Institute of Medical Sciences, Tokushima Universicy, Tokushima, Japan.


In order to maintain bone remodeling balance, it is important to keep enough Ca absorption from the intestine. Vitamin D is required to increase Ca absorption from the gut. Because vitamin D acts via activation to 1,25-dihydroxyvitamin D [1,25(OH)2D] in the kidney, native vitamin D cannot exert its full effect when the activation process is disturbed. Renal impairment is the main cause of deterioration of the activation of vitamin D. Aging is associated with the development of chronic kidney disease, causing a reduction in the renal 1,25(OH)2D production and intestinal Ca absorption. Such changes in the elderly cause negative Ca balance, and play a significant role in the pathogenesis of osteoporosis. Therefore, osteoporosis treatment is almost always accompanied by vitamin D and Ca supplementation in the Western countries. However, considering the poor activation of vitamin D in the elderly, it is more plausible to supply with active vitamin D. In addition, Ca supplementation causes a rapid and transient rise in serum Ca, which is associated with an increase in vascular calcification and cardiovascular event. Especially, when Ca supplements are given with active vitamin D, excess amount of Ca is absorbed, causing hypercalcemia, hypercalciuria and renal impairment. Thus, we do not usually recommend Ca supplementation when active vitamin D is given to patients.

Among active vitamin D compounds, eldecalcitol increases bone mass and strength by reducing osteoclast formation and bone resorption with an increase in focal bone minimodeling in animals. A 3-year randomized, double-blind, clinical trial demonstrated that eldecalcitol reduces the incidence of vertebral and wrist fractures more strongly than alfacalcidol. The marked reduction in wrist fractures is suggestive of the effect of eldecalcitol in increasing muscle power and preventing falls. Further studies are needed to clarify its effect on physical function and falls.

Volume 5

43rd Annual European Calcified Tissue Society Congress

Rome, Italy
14 May 2016 - 17 May 2016

European Calcified Tissue Society 

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