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Oral Calcidiol Is More Effective Than Cholecalciferol Supplementation to Reach Adequate 25(OH)D Levels in Patients with Autoimmune Diseases Chronically Treated with Low Doses of Glucocorticoids: A "Real-Life" Study.

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Date

2015

Authors

Ortego-Jurado, Miguel
Callejas-Rubio, José-Luis
Ríos-Fernández, Raquel
González-Moreno, Juan
González Ramírez, Amanda Rocío
González-Gay, Miguel A
Ortego-Centeno, Norberto

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Hindawi Publishing Corporation
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Abstract

Glucocorticoids (GCs) are the cornerstone of the therapy in many autoimmune and inflammatory diseases. However, it is well known that their use is a double edged sword, as their beneficial effects are associated almost universally with unwanted effects, as, for example glucocorticoid-induced osteoporosis (GIO). Over the last years, several clinical practice guidelines emphasize the need of preventing bone mass loss and reduce the incidence of fractures associated with GC use. Calcium and vitamin D supplementation, as adjunctive therapy, are included in all the practice guidelines. However, no standard vitamin D dose has been established. Several studies with postmenopausal women show that maintaining the levels above 30-33 ng/mL help improve the response to bisphosphonates. It is unknown if the response is the same in GIO, but in the clinical practice the levels are maintained at around the same values. In this study we demonstrate that patients with autoimmune diseases, undergoing glucocorticoid therapy, often present suboptimal 25(OH)D levels. Patients with higher body mass index and those receiving higher doses of glucocorticoids are at increased risk of having lower levels of 25(OH)D. In these patients, calcidiol supplementations are more effective than cholecalciferol to reach adequate 25(OH)D levels.

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MeSH Terms

Medical Subject Headings::Diseases::Immune System Diseases::Autoimmune Diseases
Medical Subject Headings::Phenomena and Processes::Physiological Phenomena::Body Constitution::Body Weights and Measures::Body Mass Index
Medical Subject Headings::Chemicals and Drugs::Polycyclic Compounds::Steroids::Cholestanes::Cholestenes::Cholecalciferol::Hydroxycholecalciferols::Calcifediol
Medical Subject Headings::Chemicals and Drugs::Inorganic Chemicals::Calcium Compounds::Calcium, Dietary
Medical Subject Headings::Chemicals and Drugs::Polycyclic Compounds::Steroids::Cholestanes::Cholestenes::Cholecalciferol
Medical Subject Headings::Chemicals and Drugs::Organic Chemicals::Organophosphorus Compounds::Diphosphonates
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Diseases::Wounds and Injuries::Fractures, Bone
Medical Subject Headings::Chemicals and Drugs::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormones::Glucocorticoids
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Morbidity::Incidence
Medical Subject Headings::Diseases::Musculoskeletal Diseases::Bone Diseases::Bone Diseases, Metabolic::Osteoporosis
Medical Subject Headings::Phenomena and Processes::Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Climacteric::Menopause::Postmenopause
Medical Subject Headings::Chemicals and Drugs::Polycyclic Compounds::Steroids::Secosteroids::Vitamin D
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Growth Substances::Micronutrients::Vitamins

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Keywords

Enfermedades autoinmunes, Índice de masa corporal, Calcifediol, Calcio en la dieta, Colecalciferol, Difosfonatos, Femenino, Fracturas óseas, Glucocorticoides, Humanos, Incidencia, Posmenopausia, Vitamina D, Vitaminas

Citation

Ortego-Jurado M, Callejas-Rubio JL, Ríos-Fernández R, González-Moreno J, González Ramírez AR, González-Gay MA, et al. Oral Calcidiol Is More Effective Than Cholecalciferol Supplementation to Reach Adequate 25(OH)D Levels in Patients with Autoimmune Diseases Chronically Treated with Low Doses of Glucocorticoids: A "Real-Life" Study. J Osteoporos; 2015:729451