Levels of serum sclerostin, FGF-23, and intact parathyroid hormone in postmenopausal women treated with calcitriol

Abstract

ObjectiveThis study aimed to determine the effect of calcitriol on serum concentrations of fibroblast growth factor-23 (FGF-23), sclerostin, intact parathyroid hormone (PTH), and handgrip strength in postmenopausal women with low bone mass.MethodsA randomized, double-blind controlled trial was carried out among 141 postmenopausal women with low bone mass. Participants were randomized into two groups: 75 participants received calcitriol 0.5 µg/day and 66 participants received a placebo for 12 weeks.ResultsAfter 12-week calcitriol treatment, significant decreases in serum intact PTH (P=0.035) and sclerostin (P=0.039), as well as significant increases in serum creatinine (P=0.027), uric acid (P=0.032), 24-hour urinary calcium (P=0.0026), and left handgrip strength (P=0.03), were observed, compared to placebo group. Level of serum sclerostin was weakly but significantly positively correlated with serum PTH (r=0.277; P=0.01) and negatively correlated with 24-hour urinary calcium (r=−0.221; P=0.04) and left handgrip strength (r=−0.338; P=0.03) after calcitriol treatment. Multiple regression analysis demonstrated that decrease in serum sclerostin was associated with decrease in PTH serum level after calcitriol treatment (OR, 7.90; 95% CI, 2.28–27.42; P=0.002). However, no significant change in FGF-23 level was observed after calcitriol treatment.ConclusionCalcitriol treatment yields a considerable decrease in serum sclerostin and significant increase of handgrip strength, and the change in serum sclerostin is regulated by serum PTH and by muscle strength.

The effects of vitamin D supplementation on muscle strength and mobility in postmenopausal women: a systematic review and meta‐analysis of randomised controlled trials

“…The included studies were published between 2000 and 2019. Studies were conducted in the USA , Thailand , China , Switzerland , Australia , Brazil , Japan , Netherland , Denmark , Turkey , Norway , UK , Belgium , Finland and Indonesia . None of the studies were of an international multicentre type.…”

“…Four studies used alpha‐hydroxy vitamin D3 (alfacalcidol) in daily doses of 0.25 , 0.5 and 1 µg . In two studies, 1,25 dihydroxyvitamin D (calcitriol) was administrated in doses of 125 IU and 0.25 and 0.5 µg day –1 . Eldecalcitol, an analogue of active vitamin D3 was used in one study .…”

“…One study was conducted on subjects with type 2 diabetes , five studies were conducted on women with osteoporosis or osteopenia , two studies were conducted on obese or overweight subjects and 13 of the selected studies were conducted on women with vitamin D insufficiency or deficiency .…”

“…Vitamin D was administrated as the only supplement in 15 studies , whereas, in 12 other trials, participants received vitamin D or placebo combined with calcium from supplements or dietary sources . In one study, participants received vitamin D in combination with a lifestyle‐based weight loss intervention .…”

“…Of the 29 included studies in the systematic review, 18 studies reported that supplementation with vitamin D with or without calcium did not enhance muscle strength or mobility outcomes or both and 10 studies concluded that vitamin D had beneficial effects on muscle strength or mobility or both However, only in one study did vitamin D supplementation result in the deterioration of muscle strength compared to placebo .…”