Therapeutic Research

Abstract

Background：The lack of Vitamin D is going to be a serious problem in Japan, that is to say under 30（ng/mL）as insufficiency and under 20（ng/mL）as deficiency, intravenous ivandronate（IBNiv）with concordant use of Vitamin D must be a way to solve the insufficient effect of oral bisphosphonates（BISpo）alone. Methods：①378 osteoporosis patients（350 female, 28 male）22‒92 years of age were investigated for the level of 25OH‒Vitamin D. ②In 134 patients, we compared the change of BMD between before and after a year of the adding Vitamin D. ③68 patients were applied with IBNiv with concordant use of Vitamin D. We investigated the change of bone metabolism markers comparing before and 4 months after bone mineral density （BMD）at 1 year after. Results：①Out of 378 patients, 203 patients were classified as Vitamin D deficiency, 145 as insufficiency, and only 30 as beeing sufficient. ②In the patients whose 25OH‒Vitamin D level was less than 30 （ng/mL）, femoral total BMD changed comparing before and after concordant use of Vitamin D（p＝0.033）. Femoral neck BMD decreased in spite of use of Bispo or SERMs, but it increased 12 months after Vitamin D administration（p＝0.000305）. ③IBNiv with concordant use of Vitamin D seemed to change TRACP‒5b within 4 months（p＜0.001）. After 1 year follow up, Lumbar BMD（p＜0.001）, femoral total BMD（p＝0.000137）and femoral neck BMD（p＝0.01234）each increased significantly. Conclusion：Most Japanese osteoporosis patients are in a lack of Vitamin D, IBNiv with concordant use of Vitamin D must be a way to solve the insufficient effect of BISpo alone.