Comparison of the Effects of Native Vitamin D and Eldecalcitol on Muscular Strength and Dynamic Balance in Patients with Postmenopausal Osteoporosis

Abstract

Objectives: Previous studies have suggested that the effects of vitamin D in preventing osteoporotic fractures result in part from its influence on fall prevention. However, the effects of vitamin D on dynamic balance as a contributor to fall prevention have not been fully evaluated. Moreover, few studies have compared the effects of native and active forms of vitamin D. The objective of this preliminary randomized prospective study was to compare the effects of native vitamin D and eldecalcitol on muscular strength and dynamic balance in postmenopausal patients undergoing denosumab treatment for osteoporosis. Methods: A total of 30 women with postmenopausal osteoporosis were randomly assigned to a native D group (administered denosumab and native vitamin D with calcium) or an ELD group (administered denosumab and eldecalcitol) and were followed up for 6 months. The following parameters were compared: the strengths of the back extensor and lower extremity muscles; static balance evaluated using the one-leg standing test; and dynamic balance evaluated using the 10-m walk test, the functional reach test, the timed up and go test, and the total length of the trajectory of the center of gravity (LNG) measured using a dynamic sitting balance measurement device. Results: Compared to baseline measurements, back extensor and knee extensor strengths had significantly increased after 6 months of treatment in the native D group (P<0.05) but not in the ELD group. In contrast, LNG significantly improved in both groups after 6 months (P<0.05). No significant differences between the two groups were seen in any of these measured parameters after treatment. Conclusions: Both native vitamin D + denosumab and eldecalcitol + denosumab were effective for improving dynamic sitting balance in postmenopausal women with osteoporosis.

Effects of active vitamin D analogues on muscle strength and falls in elderly people: an updated meta-analysis

“…We contacted the authors of those studies and obtained the required data for one of the studies ( 13 ). Five of them were changed to mean and variance for further analysis according to medium, range, or mid-quartile range and the sample size ( 14 , 15 , 17 , 19 , 20 ). Finally, we identified 12 RCTs in which active vitamin D analogues (calcitriol ( 12 , 13 , 15 , 16 , 21 ): n=5, alfacalcidol ( 14 , 17 , 18 , 22 ): n=4, eldecalcitol ( 19 , 20 , 39 ): n=3) were used ( Figure 1 ).…”

“…Three of the included trials reported results of falls ( 19 , 21 , 22 ). Ten of the included trials reported results of muscle strength ( 12 – 20 , 39 ). One of the included trials reported results of both of falls and muscle strength ( 19 ).…”

“…In the majority of the selected trials ( 12 – 17 , 21 , 22 ), participants received treatment with active vitamin D analogues alone. In four of 12 included trials, participants received treatment of vitamin D analogues combined with bisphosphonates or denosumab ( 18 – 20 , 39 ). In 8 trials ( 12 , 14 , 16 – 18 , 20 – 22 ), participants received treatment with calcitriol or eldecalcitol combined with calcium supplement.…”

“…In four of 12 included trials, participants received treatment of vitamin D analogues combined with bisphosphonates or denosumab ( 18 – 20 , 39 ). In 8 trials ( 12 , 14 , 16 – 18 , 20 – 22 ), participants received treatment with calcitriol or eldecalcitol combined with calcium supplement. In 1 trial ( 13 ), participants received alfacalcidol alone.…”

“…( 19 ) reported its positive effects on improving quadriceps muscle strength and back extensor strength, but not on hand grip strength. Another clinical trial showed that eldecalcitol does not increase the strength of back extensor and knee extensor after 6 months of treatment ( 20 ). Regarding the effect of active vitamin analogues on falls, it has been shown that supplementation with calcitriol ( 21 ) or alfacalcidol ( 22 ) reduces the incidence rate and cumulative number of falls in older adults.…”