Literature DB >> 25572049

Can vitamin D metabolite measurements facilitate a "treat-to-target" paradigm to guide vitamin D supplementation?

N Binkley1, J Lappe, R J Singh, S Khosla, D Krueger, M K Drezner, R D Blank.   

Abstract

UNLABELLED: Substantial variability exists in the serum 25(OH)D increase observed in response to vitamin D supplementation. Measurement of circulating cholecalciferol and 24,25(OH)₂D, as indicators of vitamin D absorption and degradation, respectively, account for approximately half of the variation in serum 25(OH)D observed following supplementation.
INTRODUCTION: Vitamin D supplementation produces a variable response in serum 25(OH)D. This variability likely reflects, in part, differences in vitamin D absorption and/or degradation. Despite this variation in response, virtually all expert recommendations endorse a fixed vitamin D supplementation dose, an approach also used in most prospective studies. Such utilization of a single vitamin D dose does not assure attaining any pre-specified target 25(OH)D level, thereby compromising clinical care and prospective supplementation trials. This study begins addressing this weakness by exploring the feasibility of vitamin D metabolite measurements to predict serum 25(OH)D level attained following supplementation.
METHODS: Ninety-one community-dwelling postmenopausal women with baseline 25(OH)D of 10-30 ng/mL received oral vitamin D₃, 2300 or 2500 IU, daily for 4-6 months. Serum 25(OH)D, cholecalciferol (D₃), and 24,25(OH)₂D were measured before and at the end of supplementation to determine if metabolite concentrations allow prediction of the 25(OH)D level attained.
RESULTS: From baseline and follow-up data, we derived a multiple linear regression model predicting posttreatment 25(OH)D as follows: final 25(OH)D = 8.3 + (1.05*initial 25(OH)D) - (7.7*initial 24,25(OH)₂D) + (0.53*final D₃) + (4.2*final 24,25(OH)₂D). This model has an adjusted R(2) = 0.55, thus accounting for approximately half of the observed variance in the final 25(OH)D level.
CONCLUSIONS: The contributions of circulating cholecalciferol and 24,25(OH)₂D to this predictive model can be considered as indicators of intestinal absorption and clearance, respectively. This paradigm requires further study; it may allow efficient "treat-to-25(OH)D-target" strategies useful in optimizing prospective studies and clinical practice.

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Year:  2015        PMID: 25572049      PMCID: PMC4412341          DOI: 10.1007/s00198-014-3010-0

Source DB:  PubMed          Journal:  Osteoporos Int        ISSN: 0937-941X            Impact factor:   4.507


  18 in total

1.  Intestinal absorption of cholecalciferol and 25-hydroxycholecalciferol in chronic cholestatic liver disease.

Authors:  M D Sitrin; J M Bengoa
Journal:  Am J Clin Nutr       Date:  1987-12       Impact factor: 7.045

2.  Evaluation of ergocalciferol or cholecalciferol dosing, 1,600 IU daily or 50,000 IU monthly in older adults.

Authors:  N Binkley; D Gemar; J Engelke; R Gangnon; R Ramamurthy; D Krueger; M K Drezner
Journal:  J Clin Endocrinol Metab       Date:  2011-02-02       Impact factor: 5.958

3.  Absorption of vitamin D3-3H in control subjects and patients with intestinal malabsorption.

Authors:  G R Thompson; B Lewis; C C Booth
Journal:  J Clin Invest       Date:  1966-01       Impact factor: 14.808

4.  The ratio of serum 24,25-dihydroxyvitamin D(3) to 25-hydroxyvitamin D(3) is predictive of 25-hydroxyvitamin D(3) response to vitamin D(3) supplementation.

Authors:  Dennis Wagner; Heather E Hanwell; Kareena Schnabl; Mehrdad Yazdanpanah; Samantha Kimball; Lei Fu; Gloria Sidhom; Dérick Rousseau; David E C Cole; Reinhold Vieth
Journal:  J Steroid Biochem Mol Biol       Date:  2011-05-13       Impact factor: 4.292

5.  UK Food Standards Agency Workshop Consensus Report: the choice of method for measuring 25-hydroxyvitamin D to estimate vitamin D status for the UK National Diet and Nutrition Survey.

Authors:  Anne de la Hunty; A Michael Wallace; Sigrid Gibson; Heli Viljakainen; Christel Lamberg-Allardt; Margaret Ashwell
Journal:  Br J Nutr       Date:  2010-08       Impact factor: 3.718

6.  Circulating 25-hydroxyvitamin D and risk of pancreatic cancer: Cohort Consortium Vitamin D Pooling Project of Rarer Cancers.

Authors:  Rachael Z Stolzenberg-Solomon; Eric J Jacobs; Alan A Arslan; Dai Qi; Alpa V Patel; Kathy J Helzlsouer; Stephanie J Weinstein; Marjorie L McCullough; Mark P Purdue; Xiao-Ou Shu; Kirk Snyder; Jarmo Virtamo; Lynn R Wilkins; Kai Yu; Anne Zeleniuch-Jacquotte; Wei Zheng; Demetrius Albanes; Qiuyin Cai; Chinonye Harvey; Richard Hayes; Sandra Clipp; Ronald L Horst; Lonn Irish; Karen Koenig; Loic Le Marchand; Laurence N Kolonel
Journal:  Am J Epidemiol       Date:  2010-06-18       Impact factor: 4.897

7.  Comparative absorption of vitamin D3 and 25-hydroxyvitamin D3 in intestinal disease.

Authors:  M Davies; E B Mawer; E L Krawitt
Journal:  Gut       Date:  1980-04       Impact factor: 23.059

8.  Intestinal absorption of cholecalciferol and 25-hydroxycholecalciferol in patients with both Crohn's disease and intestinal resection.

Authors:  G A Leichtmann; J M Bengoa; M J Bolt; M D Sitrin
Journal:  Am J Clin Nutr       Date:  1991-09       Impact factor: 7.045

9.  Dose response to vitamin D supplementation among postmenopausal African American women.

Authors:  Sonia A Talwar; John F Aloia; Simcha Pollack; James K Yeh
Journal:  Am J Clin Nutr       Date:  2007-12       Impact factor: 7.045

10.  Vitamin D intake to attain a desired serum 25-hydroxyvitamin D concentration.

Authors:  John F Aloia; Manish Patel; Rhett Dimaano; Melissa Li-Ng; Sonia A Talwar; Mageda Mikhail; Simcha Pollack; James K Yeh
Journal:  Am J Clin Nutr       Date:  2008-06       Impact factor: 7.045

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  4 in total

1.  Ancestry-specific polygenic scores and SNP heritability of 25(OH)D in African- and European-ancestry populations.

Authors:  Kathryn E Hatchell; Qiongshi Lu; Scott J Hebbring; Erin D Michos; Alexis C Wood; Corinne D Engelman
Journal:  Hum Genet       Date:  2019-07-24       Impact factor: 4.132

2.  Serum 25-hydroxyvitamin D levels and incident falls in older women.

Authors:  K Uusi-Rasi; R Patil; S Karinkanta; K Tokola; P Kannus; C Lamberg-Allardt; H Sievänen
Journal:  Osteoporos Int       Date:  2018-09-25       Impact factor: 4.507

3.  Chemotyping the distribution of vitamin D metabolites in human serum.

Authors:  Miriam J Müller; Caroline S Stokes; Frank Lammert; Dietrich A Volmer
Journal:  Sci Rep       Date:  2016-02-11       Impact factor: 4.379

4.  Vitamin D Metabolic Ratio and Risks of Death and CKD Progression.

Authors:  Nisha Bansal; Ronit Katz; Lawrence Appel; Michelle Denburg; Harold Feldman; Alan S Go; Jiang He; Andrew Hoofnagle; Tamara Isakova; Bryan Kestenbaum; John Kusek; James Lash; Mary Leonard; Mahboob Rahman; Cassianne Robinson-Cohen; Myles Wolf; Dawei Xie; Leila Zelnick; Ian H de Boer
Journal:  Kidney Int Rep       Date:  2019-08-30
  4 in total

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