Vitamin D3 in the evolution of osteoporosis
The pathological basis of osteoporosis is the decoupling of bone resorption and bone formation, resulting in low bone mass. Vitamin D3 is an important hormone in the regulation of bone metabolism, which can regulate the expression of multiple target genes in osteoblasts and promote the proliferation and differentiation of osteoblasts. Osteoblasts express vitamin D receptors (VDR). Vitamin D3 can promote osteoblast proliferation and improve osteoblast activity; regulate calcium and phosphorus metabolism; accelerate bone mineralization and promote bone matrix formation. Vitamin D3 deficiency results in low proliferation and differentiation of osteoblasts and reduced bone formation.
Lack or insufficiency of vitamin D3 can lead to secondary hyperparathyroidism, intermittent low-dose PTH promotes bone formation, and continuous high-dose PTH promotes bone resorption and accelerates bone turnover. Vitamin D3 deficiency is a risk factor for osteoporosis and a risk factor for osteoporotic fractures.
Clinical application of vitamin D3 in the treatment of osteoporosis
(1) Basic measures: Vitamin D3 is an essential basic drug for the prevention and treatment of osteoporosis. Vitamin D3 required by the human body is mainly synthesized by the skin after receiving sunlight, and a very small amount comes from food. For lack of sunshine and insufficient absorption of vitamin D3, vitamin D3 deficiency or even deficiency often occurs, and sufficient vitamin D3 needs to be supplemented for the prevention and treatment of osteoporosis.
Basic measures apply to the basic measures for the prevention and treatment of osteoporosis in the general population; long-term adherence is required, and should run through the entire process of osteoporosis prevention and treatment; it is also applicable during osteoporosis drug treatment and rehabilitation treatment.
(2) Combination of vitamin D3: throughout the entire treatment process. Vitamin D3 can be used in combination with bone resorption inhibitors, in combination with bone formation promoters, and calcium.
(3) The clinical significance of vitamin D3 supplementation: relieve clinical symptoms, increase bone density, increase muscle strength, reduce the incidence of falls, reduce the incidence of osteoporotic fractures, and promote fracture healing.
(4) Precautions for supplementing calcium and vitamin D3 preparations: As basic health supplements for the prevention and treatment of osteoporosis, calcium and vitamin D3 should generally be taken for a long time. The long-term application of the recommended dose is generally safe, and the blood and urine calcium levels can be measured to make adjustments if necessary. Vitamin D3 and calcium should be used in combination with other anti-osteoporotic drugs on a long-term basis. It should be used with caution in patients with abnormal calcium metabolism, kidney stones, etc., and a discretionary decision should be made after testing blood and urine calcium levels. When using ordinary vitamin D3, the nutritional status of vitamin D3 can be known by measuring 25( OH) D3 in blood to adjust the dose. When active vitamin D3 and its analogs are used, the nutritional status of vitamin D3 cannot be assessed by measuring blood 25(OH)D3 levels.
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