Cora M Best1,2, Leila R Zelnick2,3, Kenneth E Thummel4, Simon Hsu2,3, Christine Limonte2,3, Ravi Thadhani5, Howard D Sesso6,7, JoAnn E Manson6,7, Julie E Buring6,7, Samia Mora6, I-Min Lee6,7, Nancy R Cook6,7, Georgina Friedenberg6, Heike Luttmann-Gibson6, Ian H de Boer2,3,8, Andrew N Hoofnagle1,2,3. 1. Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA. 2. Kidney Research Institute, University of Washington, Seattle, WA, USA. 3. Department of Medicine, University of Washington, Seattle, WA, USA. 4. Department of Pharmaceutics, University of Washington, Seattle, WA, USA. 5. Mass General Brigham, Harvard Medical School, Boston, MA, USA. 6. Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 7. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 8. Puget Sound VA Healthcare System, Seattle, WA, USA.
Abstract
CONTEXT: The effect of daily vitamin D supplementation on the serum concentration of vitamin D (the parent compound) may offer insight into vitamin D disposition. OBJECTIVE: To assess the total serum vitamin D response to vitamin D3 supplementation and whether it varies according to participant characteristics. To compare results with corresponding results for total serum 25-hydroxyvitamin D [25(OH)D], which is used clinically and measured in supplementation trials. DESIGN: Exploratory study within a randomized trial. INTERVENTION: 2000 International Units of vitamin D3 per day (or matching placebo). SETTING: Community-based. PARTICIPANTS: 161 adults (mean ± SD age 70 ± 6 years; 66% males) with type 2 diabetes. MAIN OUTCOME MEASURES: Changes in total serum vitamin D and total serum 25(OH)D concentrations from baseline to year 2. RESULTS: At baseline, there was a positive, nonlinear relation between total serum vitamin D and total serum 25(OH)D concentrations. Adjusted effects of supplementation were a 29.2 (95% CI: 24.3, 34.1) nmol/L increase in serum vitamin D and a 33.4 (95% CI: 27.7, 39.2) nmol/L increase in serum 25(OH)D. Among those with baseline 25(OH)D < 50 compared with ≥ 50 nmol/L, the serum vitamin D response to supplementation was attenuated (15.7 vs 31.2 nmol/L; interaction P-value = 0.02), whereas the serum 25(OH)D response was augmented (47.9 vs 30.7 nmol/L; interaction P-value = 0.05). CONCLUSIONS: Vitamin D3 supplementation increases total serum vitamin D and 25(OH)D concentrations with variation according to baseline 25(OH)D, which suggests that 25-hydroxylation of vitamin D3 is more efficient when serum 25(OH)D concentration is low.
CONTEXT: The effect of daily vitamin D supplementation on the serum concentration of vitamin D (the parent compound) may offer insight into vitamin D disposition. OBJECTIVE: To assess the total serum vitamin D response to vitamin D3 supplementation and whether it varies according to participant characteristics. To compare results with corresponding results for total serum 25-hydroxyvitamin D [25(OH)D], which is used clinically and measured in supplementation trials. DESIGN: Exploratory study within a randomized trial. INTERVENTION: 2000 International Units of vitamin D3 per day (or matching placebo). SETTING: Community-based. PARTICIPANTS: 161 adults (mean ± SD age 70 ± 6 years; 66% males) with type 2 diabetes. MAIN OUTCOME MEASURES: Changes in total serum vitamin D and total serum 25(OH)D concentrations from baseline to year 2. RESULTS: At baseline, there was a positive, nonlinear relation between total serum vitamin D and total serum 25(OH)D concentrations. Adjusted effects of supplementation were a 29.2 (95% CI: 24.3, 34.1) nmol/L increase in serum vitamin D and a 33.4 (95% CI: 27.7, 39.2) nmol/L increase in serum 25(OH)D. Among those with baseline 25(OH)D < 50 compared with ≥ 50 nmol/L, the serum vitamin D response to supplementation was attenuated (15.7 vs 31.2 nmol/L; interaction P-value = 0.02), whereas the serum 25(OH)D response was augmented (47.9 vs 30.7 nmol/L; interaction P-value = 0.05). CONCLUSIONS: Vitamin D3 supplementation increases total serum vitamin D and 25(OH)D concentrations with variation according to baseline 25(OH)D, which suggests that 25-hydroxylation of vitamin D3 is more efficient when serum 25(OH)D concentration is low.
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Authors: Cora M Best; Leila R Zelnick; Kenneth E Thummel; Simon Hsu; Christine Limonte; Ravi Thadhani; Howard D Sesso; JoAnn E Manson; Julie E Buring; Samia Mora; I-Min Lee; Nancy R Cook; Georgina Friedenberg; Heike Luttmann-Gibson; Ian H de Boer; Andrew N Hoofnagle Journal: J Clin Endocrinol Metab Date: 2022-01-18 Impact factor: 6.134