Other causes of secondary osteoporosis were excluded, including hyperparathyroidism or hypoparathyroidism, hyperthyroidism or hypothyroidism, hypocalcemia, rheumatoid arthritis, Paget's disease, osteomalacia, and serum creatinine greater than 1.7 mg/dL. Exclusion criteria included the use of bisphosphonates within the previous 12 months or fluoride within the previous 24 months tibolone, parathyroid hormone or any derivative, or systemic glucocorticoids (more than 5 mg of prednisone equivalent daily for more than 10 days) inhaled glucocorticoids (more than 2000 μg daily for more than 10 days) anabolic steroids or testosterone within 6 months and estrogens, selective estrogen receptor modulators, calcitonin, or calcitriol within 3 months of enrollment. Postmenopausal women aged over 65 years were eligible for the study when both of the following criteria were met: a) a bone mineral density (BMD) T score of -1.0 or less at the lumbar spine (meaning that fractures did not involve more than two lumbar vertebrae) and the anatomical structures were suitable for DXA scanning or femoral neck, and b) body mass index (BMI) between 18 and 30 kg/m 2. Volunteers were recruited through notices posted in the communities surrounding the three centers. In this randomized, multi-center, open-label, placebo-controlled clinical trial, the effects of 12 months of treatment with Rocaltrol plus Caltrate D or Caltrate D alone on bone mass, muscle function and balance have been investigated in elderly Chinese women. Calcitriol has been advocated for treatment of osteoporosis, but its effects in such use are inconsistent 8, 9.
Calcitriol has been thought to play an important role in promoting bone formation, since it increases osteocalcin production by osteoblasts 7. Metabolites of vitamin D not only can increase the intestinal absorption of calcium but also possess other cellular effects 6. Vitamin D insufficiency may progress to a clinical deficiency, which is associated with severe muscle weakness in elderly adults and often results in a marked disability 4, 5 that can be ameliorated within several weeks of vitamin D supplementation. If untreated, it leads to bone loss and consequently to an increased risk of fracture. Vitamin D insufficiency is common in older people 3. Many age-related factors contribute to osteoporosis, such as a decline of gonadal function, a reduction in intestinal calcium absorption, vitamin D insufficiency, decreased production of 1,25(OH) 2D 3 and secondary hyperparathyroidism 2. Osteoporosis, a common disease among aging people, is characterized by decreased bone mass and microarchitecture deterioration of bone tissue, leading to increased bone fragility and fracture 1.
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