Daily Supplementation with 25 µg Cholecalciferol Does Not Increase Calcium Absorption or Skeletal Retention in Adolescent Girls with Low Serum 25-Hydroxyvitamin D

Park, Clara Yongjoo; Hill, Kenneth; Elble, Ann E; Martin, Berdine R.; DiMeglio, Linda A.; Peacock, Munro; McCabe, George P.; Weaver, Connie M.

doi:10.3945/jn.110.124891

Cited by 43 publications

(34 citation statements)

References 42 publications

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“…In a posthoc analysis, the observed increase in 1,25(OH) 2 (37)(38)(39)(40)(41)(42)(43)(44). Comparisons between those reports and our findings are made difficult by differences in study design that include the ages of the subjects, type and dose of vitamin D administered, duration of vitamin D administration, baseline 25OHD levels, and assays used.…”

Section: Discussionmentioning

confidence: 40%

Randomized Trial Assessing the Effects of Ergocalciferol Administration on Circulating FGF23

Burnett-Bowie

Leder

Henao

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Fibroblast growth factor 23 is a phosphate-and vitamin D-regulating hormone. The objective of this study was to determine the effect of ergocalciferol administration on fibroblast growth factor 23 levels in healthy vitamin D-deficient subjects.Design, setting, participants, & measurements In this 12-week trial conducted in a clinical research center, 18-to 45-year-old subjects (n=90) with 25-hydroxyvitamin D levels #20 ng/ml (by chemiluminescent immunoassay) were randomized to weekly ergocalciferol treatment of 50,000 international units or placebo, while consuming a self-selected diet. Changes in fibroblast growth factor 23, 25-hydroxyvitamin D (by liquid chromatography/ tandem mass spectroscopy), 1,25-dihydroxyvitamin D, parathyroid hormone, and serum phosphate were measured.Results Mean 25-hydroxyvitamin D (P,0.0001), 1,25-dihydroxyvitamin D (P=0.01), and fibroblast growth factor 23 (P=0.003) increased in the treatment versus placebo group. In the treatment group, 25-hydroxyvitamin D increased from 1867 to 40612 ng/ml at week 4 (P,0.0001) and remained stable at 43612 ng/ml at week 12 (P,0.0001); 1,25-dihydroxyvitamin D increased from 42617 to 52618 pg/ml at week 4 (P,0.001) and then remained stable, and fibroblast growth factor 23 increased from 43617 to 60633 pg/ml at week 8 (P=0.001) and 74642 pg/ml at week 12 (P,0.0001). Urinary phosphate excretion increased within the treatment group, but parathyroid hormone and serum phosphate were unchanged.Conclusions Ergocalciferol administration increases circulating fibroblast growth factor 23. When measuring fibroblast growth factor 23, concurrent 25-hydroxyvitamin D measurements should be obtained, because vitamin D deficiency may lower circulating fibroblast growth factor 23 levels.

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Section: Discussionmentioning

confidence: 40%

Randomized Trial Assessing the Effects of Ergocalciferol Administration on Circulating FGF23

Burnett-Bowie

Leder

Henao

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…42,50,75,79,84,108 As shown in Fig 2, none of the arms achieved a group 25(OH)D level .75 nmol/L with the first measurement, and 2 (33%) achieved this target within the first month. A single weekly dosing regimen was identified that enrolled VDD children and performed blood work within 1 month; this study reported an increase in 25(OH)D from 22 to 143 nmol/L with 4 weekly doses of 60 000 IU.…”

Section: Evaluation Of 25(oh)d Response By Dosing Regimenmentioning

confidence: 99%

“…7 Overall, the results strongly advise that this approach will not normalize levels (.75 nmol/L) in a time frame appropriate to potentially benefit acute and critically ill populations. 42,50,75,79,84,108 These findings are important because they will inform future studies and help in the understanding of the results of published RCTs. For example, these findings might call into question the validity of the pediatric RCT by Choudhary and Gupta 114 evaluating the effect of 5 days of vitamin D (1000-2000 IU/day) on recovery from pneumonia.…”

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confidence: 99%

Rapid Normalization of Vitamin D Levels: A Meta-Analysis

et al. 2015

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BACKGROUND: Vitamin D deficiency may represent a modifiable risk factor to improve outcome in severe illness. The efficacy of high-dose regimens in rapid normalization of vitamin D levels is uncertain. METHODS:We conducted a systematic review of pediatric clinical trials administering high-dose vitamin D to evaluate 25-hydroxyvitamin D (25[OH]D) response and characteristics associated with final 25(OH)D levels by using Medline, Embase, and the Cochrane Central Register of Controlled Trials, including reference lists of systematic reviews and eligible publications. Uncontrolled and controlled trials reporting 25(OH)D levels after high-dose ($1000 IU) ergocalciferol or cholecalciferol were selected. Two reviewers independently extracted and verified predefined data fields. RESULTS:We identified 88 eligible full-text articles. Two of 6 studies that administered daily doses approximating the Institute of Medicine's Tolerable Upper Intake Level (1000-4000 IU) to vitamin D-deficient populations achieved group 25(OH)D levels .75 nmol/L within 1 month. Nine of 10 studies evaluating loading therapy (.50 000 IU) achieved group 25(OH)D levels .75 nmol/L. In meta-regression, baseline 25(OH)D, regimen type, dose, age, and time factors were associated with final 25(OH)D levels. Adverse event analysis identified increased hypercalcemia risk with doses .400 000 IU, but no increased hypercalcemia or hypercalciuria with loading doses ,400 000 IU (or 10 000 IU/kg). Few studies in adolescents evaluated loading dose regimens .300 000 IU.CONCLUSIONS: Rapid normalization of vitamin D levels is best achieved by using loading therapy that considers disease status, baseline 25(OH)D, and age (or weight). Loading doses .300 000 IU should be avoided until trials are conducted to better evaluate risk and benefit. Dr McNally conceptualized and designed the study, carried out the initial analysis, drafted the initial manuscript, and revised the manuscript for important intellectual content; Mr Iliriani, Dr Pojsupap, and Ms O'Hearn designed the data collection instrument, determined study eligibility, acquired data, and revised the article critically for important intellectual content; Dr Sampson conceptualized and designed the search strategy, acquired data, drafted the initial manuscript, and revised the manuscript for important intellectual content; Drs McIntyre, Fergusson, and Menon conceptualized and designed the study, interpreted the data, and critically revised the manuscript for important intellectual content; and all authors approved the final manuscript as submitted.The systematic review was registered with PROSPERO (identifier CRD42013006677). Normalization of vitamin D status has the potential to speed recovery and improve outcomes in multiple acutely unwell pediatric populations. Most of the guidelines and clinical practice surrounding vitamin D dosing involves a daily intake of ,1000 IU. 6,7 Because these standard dosing strategies target healthy children and require months to restore normal levels, they are not applicab...

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“…This is complicated by the fact that serum 25(OH)D is unrelated or negatively related to calcium absorption or retention, at least in healthy Northern American children (5,46). Vitamin D supplementation at 1,000 IU/day for 4 weeks actually decreased calcium absorption despite increasing serum 25(OH)D (47). The systematic reviews used by the IOM concluded that there is no evidence to link vitamin D status and positive changes in bone health outcomes in young children, and only fair evidence in older children and adolescents (4,48).…”

Section: Childhood and Adolescencementioning

confidence: 99%

2. Vitamin D in Skeletal Growth and Development

Weaver¹,

Lewis²,

Laing³

2011

Translational Endocrinology &Amp; Metabolism: Vitamin D Update

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Vitamin D and calcium are important nutrients in skeletal growth and development. Absorption of calcium, the largest mineral constituent of bone, and the process of bone modeling, which builds and shapes bone during growth, are facilitated by vitamin D-dependent proteins. Thus, deficiency of vitamin D during growth can manifest as skeletal disorders. Rickets in infancy is the classic example. However, calcium can also be absorbed by a vitamin D-independent route, so that sufficient dietary calcium can often overcome vitamin D inadequacy with respect to the skeleton. Furthermore, rickets can occur because of calcium deficiency in the presence of adequate vitamin D status. The interdependence of calcium and vitamin D, and the opportunity to have a sufficient vitamin D supply from cutaneous production without depending on diet, make it difficult to set dietary vitamin D recommendations. The paucity of research studies on vitamin D status during growth has impeded our understanding of the skeletal effects of vitamin D. Moreover, there is increasing interest in the hypothesis that postnatal skeletal growth is influenced by in utero vitamin D status. This chapter evaluates the evidence for vitamin D's role in skeletal health during pregnancy, lactation, childhood, and adolescence. Case 2-1: RicketsA 10-month-old white female presented to the outpatient clinic with mild weight loss, pale skin, and lethargy. The latitude of the area is 43°N and the clinic visit took place in late March. When the patient's parents were queried about concerns, they revealed that the infant recently had a decrease in appetite. The infant's dietary history indicated that breast milk had been her primary source of nutrition to date, along with complementary foods, such as pureed rice, fruits, and vegetables. Infant drops containing 400 international units (IU) of vitamin D had been prescribed at birth, although compliance was poor, and the parents indicated that the infant had not received supplemental vita-

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Daily Supplementation with 25 µg Cholecalciferol Does Not Increase Calcium Absorption or Skeletal Retention in Adolescent Girls with Low Serum 25-Hydroxyvitamin D

Cited by 43 publications

References 42 publications

Randomized Trial Assessing the Effects of Ergocalciferol Administration on Circulating FGF23

Randomized Trial Assessing the Effects of Ergocalciferol Administration on Circulating FGF23

Rapid Normalization of Vitamin D Levels: A Meta-Analysis

2. Vitamin D in Skeletal Growth and Development

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