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-hydroxyvitamin D3 in elderly patients with Parkinson's disease
a Department of
Neurology, Futase Social Insurance Hospital, Iizuka, Japan, b First
Department of Internal Medicine, Kurume University School of Medicine,
Kurume, Japan
Correspondence to: Dr Yoshihiro Sato, Department of Neurology, Kurume University Medical Center, 155-1 Kokubumachi, Kurume 839-0863, Japan. Telephone 0081 942 22 6111; fax 0081 942 22 6533; email y-sato{at}ktarn.or.jp
Received 6 January
1998 and in revised form 26 June 1998;
Accepted 29 June
1998
OBJECTIVES
A high
prevalence of hip and other fractures in elderly patients with
Parkinson's disease has been linked to reduced bone mass arising from
a defect of renal synthesis of 1, 25-dihydroxyvitamin D (1, 25-[OH]2D). Treatment with 1
-hydroxyvitamin D3
(1(OH)D3; an active form of vitamin D) was evaluated for maintaining
bone mass and reducing the incidence of hip and other non-vertebral fractures in patients with Parkinson's disease.
METHODSIn a double
blind, randomised trial, 86 elderly patients with Parkinson's disease
(mean Hoehn and Yahr stage, 3; mean age 70.6 years) were randomised to
receive either 1 µg 1(OH)D3 daily (treatment group,
n=43) or a placebo (n=43) for 18 months. Bone mineral densities in the
second metacarpals were determined by computed radiographic
densitometry. Serum bone turnover indices were measured serially, and
incidence of non-vertebral fractures was recorded.
RESULTSBone mineral
densities decreased 1.2% in the treatment group compared with 6.7% in
the placebo group during 18 months (p<0.0001). At baseline in both
groups, the serum concentration of 1, 25-[OH]2D was
reduced. Parathyroid hormone was abnormally increased in 15 patients
(17%) and correlated negatively with serum 25-hydroxyvitamin D,
indicating compensatory hyperparathyroidism. Eight patients sustained
fractures (six at the hip and two at other sites) in the placebo group,
and one hip fracture occurred among treated patients (odds ratio 9.8;
p=0.0028).
CONCLUSIONBy
increasing serum 1, 25-[OH]2D concentrations, treatment
with 1(OH)D3 can reduce the risk of hip and other non-vertebral fractures in osteoporotic elderly patients with Parkinson's disease by
slowing the loss of bone mineral densities.
This article has been cited by other articles:
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  Y. Sato, Y. Honda, and J. Iwamoto Risedronate and ergocalciferol prevent hip fracture in elderly men with Parkinson disease Neurology, March 20, 2007; 68(12): 911 - 915. [Abstract] [Full Text] [PDF]
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 Y. Sato, J. Iwamoto, T. Kanoko, and K. Satoh Risedronate Sodium Therapy for Prevention of Hip Fracture in Men 65 Years or Older After Stroke Arch Intern Med, August 8, 2005; 165(15): 1743 - 1748. [Abstract] [Full Text] [PDF]
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Y. Sato, J. Iwamoto, T. Kanoko, and K. Satoh Risedronate therapy for prevention of hip fracture after stroke in elderly women Neurology, March 8, 2005; 64(5): 811 - 816. [Abstract] [Full Text] [PDF]
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Y. Sato, M. Kaji, N. Metoki, K. Satoh, and J. Iwamoto Does compensatory hyperparathyroidism predispose to ischemic stroke? Neurology, February 25, 2003; 60(4): 626 - 629. [Abstract] [Full Text] [PDF]
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 Y. Sato, T. Asoh, I. Kondo, and K. Satoh Vitamin D Deficiency and Risk of Hip Fractures Among Disabled Elderly Stroke Patients Stroke, July 1, 2001; 32(7): 1673 - 1677. [Abstract] [Full Text] [PDF]
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