Hanseul Kim1, Paulette Chandler2, Kimmie Ng3, JoAnn E Manson1,2, Edward Giovannucci4,5,6. 1. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA. 2. Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA. 3. Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, 02215, USA. 4. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA. egiovann@hsph.harvard.edu. 5. Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA. egiovann@hsph.harvard.edu. 6. Department of Nutrition, Harvard T.H. Chan School of Public Health, Building 2, 3rd Floor, 655 Huntington Avenue, Boston, MA, 02115, USA. egiovann@hsph.harvard.edu.
Abstract
PURPOSE: Results from recent clinical trials suggest that vitamin D efficacy against cancer may be influenced by body mass index. As suppression of parathyroid hormone (PTH) is one indicator of vitamin D efficacy, we examined to what extent doses of vitamin D3 supplementation suppress PTH levels in individuals with and without obesity. METHODS: A total of 328 healthy African Americans were randomized into the following four groups and treated for 3 months: placebo, 1,000, 2,000, or 4,000 IU/day of vitamin D3 supplementation. RESULTS: Among the participants, 250 individuals with PTH measurements were included in the analysis. Obese individuals (n = 141) experienced a steep reduction of 3-month PTH from placebo to 1,000 IU/day of vitamin D3 supplementation, but no further reduction at 2,000 or 4,000 IU/day. For non-obese individuals (n = 109), the reduction of 3-month PTH was approximately linear for increasing vitamin D3 doses. At supplementation of 2,000 to 4,000 IU/day, 3-month 25(OH)vitamin D levels were high in both non-obese and obese individuals, but the 3-month PTH levels remained about 10 pg/mL higher in individuals with obesity. CONCLUSION: Our findings suggest that excess adiposity confers resistance to vitamin D efficacy in suppressing PTH levels, even when given at high doses.
RCT Entities:
PURPOSE: Results from recent clinical trials suggest that vitamin D efficacy against cancer may be influenced by body mass index. As suppression of parathyroid hormone (PTH) is one indicator of vitamin D efficacy, we examined to what extent doses of vitamin D3 supplementation suppress PTH levels in individuals with and without obesity. METHODS: A total of 328 healthy African Americans were randomized into the following four groups and treated for 3 months: placebo, 1,000, 2,000, or 4,000 IU/day of vitamin D3 supplementation. RESULTS: Among the participants, 250 individuals with PTH measurements were included in the analysis. Obese individuals (n = 141) experienced a steep reduction of 3-month PTH from placebo to 1,000 IU/day of vitamin D3 supplementation, but no further reduction at 2,000 or 4,000 IU/day. For non-obese individuals (n = 109), the reduction of 3-month PTH was approximately linear for increasing vitamin D3 doses. At supplementation of 2,000 to 4,000 IU/day, 3-month 25(OH)vitamin D levels were high in both non-obese and obese individuals, but the 3-month PTH levels remained about 10 pg/mL higher in individuals with obesity. CONCLUSION: Our findings suggest that excess adiposity confers resistance to vitamin D efficacy in suppressing PTH levels, even when given at high doses.
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Authors: Paulette D Chandler; Wendy Y Chen; Oluremi N Ajala; Aditi Hazra; Nancy Cook; Vadim Bubes; I-Min Lee; Edward L Giovannucci; Walter Willett; Julie E Buring; JoAnn E Manson Journal: JAMA Netw Open Date: 2020-11-02