Publication: D vitamini tedavisinin etkinliği falangeal radyogfrafik absorpsiyometri ile izlenebilir mi?
Abstract
Amaç: Radyografik absorpsiyometri (RA) 2, 3 ve 4. parmakların orta falankslarından kemik mineral yoğunluğu (KMY) ölçümü yapan ucuz ve uygulaması kolay bir tekniktir. Bu çalışmada D vitamini eksikliği bulunan ileri yaştaki hastalarda kısa süreli D vitamini tedavisinin falangeal RA ile izleminin yapılıp yapılamayacağı ve dual enerji x-ışını absorpsiometri (DXA) ile ölçüm sonuçlarının uyumunun karşılaştırılması amaçlanmaktadır. Gereç ve Yöntem: Çalışmaya 65 yaş ve üzerinde D vitamini eksikliği saptanan (<50nmol/l) 57 osteopenik hasta alındı. 30 hastaya günde 1 µg alfakalsidol ve 500 mg elemanter kalsiyum, kontrol grubuna ise günde 500 mg elemanter kalsiyum verildi. Tüm hastaların tedavi başlangıcında ve 6. ayda el falangeal KMY; lomber omurga ve kalça KMY ölçümleri yapıldı. Serumda D vitamini düzeyindeki yüzde değişim ile RA ve DXA sonuçlarının uyumluluğu istatistiksel olarak karşılaştırıldı. Bulgular: Tüm hastaların başlangıçta yapılan DXA KMY ölçümleri ile RA ölçüm sonuçları uyumlu idi. 6 aylık alfakalsidol tedavisi sonucunda D vitamini düzeylerindeki değişim hem DXA hem de RA ile istatistiksel ilgileşim göstermedi. Sonuç: Falangeal radyografik absorpsiyometri güvenilir ve pratik bir yöntem olmakla birlikte D vitamini tedavisinin kısa dönemli takibinde kullanımının sınırlı olacağı düşünülmektedir.
Aim: Radiographic absorptiometry (RA) is a cheap and easily applicable technique for measuring bone mineral density (BMD) of the medium phalanges of fingers 2, 3 and 4. In this trial with elderly patients suffering from vitamin D deficiency, the aim is to investigate whether it is possible to follow short-term vitamin D treatment with phalangeal RA or not and to compare the consistency of measurement results with dual energy x-ray absorptiometry (DXA). Materials and Methods: Fifty-seven patients over 65 years old who had been determined as vitamin D deficiency (<50nmol/l) were included in this trial. Thirty patients received 1 µg of alphacalcidol and 500 mg elemenatry calcium once a day and the control group received 500 mg elementary calcium. Hand phalangeal, lumbar spinal and hip BMD measurements of all patients were performed at the beginning and the 6th month of the treatment. The consistency of percentage change of serum levels of vitamin D with RA and DXA results were statistically compared. Results: Baseline DXA BMD measurements of all of the patients were consistent with the RA measurement values. After 6 months of alphacalcidol and elementary calcium treatment, the difference in the levels of vitamin D was not statistically relevant, neither with DXA nor with RA. Conclusion: Although phalangeal radiographic absorptiometry is a reliable and practical method, its use in the short term follow-up of vitamin D treatment is thought to be limited.
Aim: Radiographic absorptiometry (RA) is a cheap and easily applicable technique for measuring bone mineral density (BMD) of the medium phalanges of fingers 2, 3 and 4. In this trial with elderly patients suffering from vitamin D deficiency, the aim is to investigate whether it is possible to follow short-term vitamin D treatment with phalangeal RA or not and to compare the consistency of measurement results with dual energy x-ray absorptiometry (DXA). Materials and Methods: Fifty-seven patients over 65 years old who had been determined as vitamin D deficiency (<50nmol/l) were included in this trial. Thirty patients received 1 µg of alphacalcidol and 500 mg elemenatry calcium once a day and the control group received 500 mg elementary calcium. Hand phalangeal, lumbar spinal and hip BMD measurements of all patients were performed at the beginning and the 6th month of the treatment. The consistency of percentage change of serum levels of vitamin D with RA and DXA results were statistically compared. Results: Baseline DXA BMD measurements of all of the patients were consistent with the RA measurement values. After 6 months of alphacalcidol and elementary calcium treatment, the difference in the levels of vitamin D was not statistically relevant, neither with DXA nor with RA. Conclusion: Although phalangeal radiographic absorptiometry is a reliable and practical method, its use in the short term follow-up of vitamin D treatment is thought to be limited.