Effects of High-Dose Vitamin D2 Versus D3 on Total and Free 25-Hydroxyvitamin D and Markers of Calcium Balance
Shieh A, Chun RF, Ma C, Witzel S, Meyer B, Rafison B, Swinkels L, Huijs T, Pepkowitz S, Holmquist B, Hewison M, Adams JS
The Journal of clinical endocrinology and metabolism · 70 citations
How it was studied
- Design
- Randomized controlled trial (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Independent funding
- Government
- National Institute of Arthritis and Musculoskeletal and Skin Diseases
- Government
- National Center for Advancing Translational Sciences
- Government
- NIAMS NIH HHS
- Government
- NCATS NIH HHS
- Grants
- National Center for Advancing Translational Sciences (UL-1TR000124); National Institute of Arthritis and Musculoskeletal and Skin Diseases (P50AR063020); National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR063910)
Based on 4 listed funder(s).
Publication
- Published
- 2016-05-18 · J Clin Endocrinol Metab · vol. 101 · issue 8 · pp. 3070–3078
- Publisher
- Oxford University Press
- Cited
- 98 citations · more than 98% of similar papers · 8.7× the field average
- Impact
- Top 10% most cited in its field
- References
- 53 works
- Access
- Open access (repository copy)
- Research areas
- Vitamin D Research Studies · Bone health and osteoporosis research · Parathyroid Disorders and Treatments
- Keywords
- Internal medicine, Vitamin D and neurology, Endocrinology, Medicine, Vitamin, Creatinine, Ergocalciferol, Calcium, Vitamin D-binding protein, Cholecalciferol, vitamin D deficiency
- MeSH
- humans, vitamin d deficiency, calcium, cholecalciferol, ergocalciferols, parathyroid hormone, vitamin d, hormone replacement therapy, case-control studies, homeostasis, dose-response relationship, drug, adult, aged, middle aged, biomarkers
12 authors
From US, NL, GB
- Albert Shieh · correspondingUniversity of California, Los Angeles
- Rene F. ChunUniversity of California, Los Angeles
- Christina MaUniversity of California, Los Angeles
- Sten de Boom WitzelUniversity of California, Los Angeles
- Briana P. MeyerUniversity of California, Los Angeles
- Brandon RafisonUniversity of California, Los Angeles
Abstract
Context
Controversy persists over: 1) how best to restore low serum 25-hydroxyvitamin D (25D) levels (vitamin D2 [D2] vs vitamin D3 [D3]); 2) how best to define vitamin D status (total [protein-bound + free] vs free 25D); and 3) how best to assess the bioactivity of free 25D.
Objective
To assess: 1) the effects of D2 vs D3 on serum total and free 25D; and 2) whether change in intact PTH (iPTH) is more strongly associated with change in total vs free 25D.
Design
Participants previously enrolled in a D2 vs D3 trial were matched for age, body mass index, and race/ethnicity. Participants received 50 000 IU of D2 or D3 twice weekly for 5 weeks, followed by a 5-week equilibration period. Biochemical assessment was performed at baseline and at 10 weeks.
Setting and participants
Thirty-eight adults (19 D2 and 19 D3) ≥18 years of age with baseline 25D levels <30 ng/mL were recruited from an academic ambulatory osteoporosis clinic.
Outcome measures
Serum measures were total 25D, free 25D (directly measured), 1,25-dihydroxyvitamin D, calcium, and iPTH. Urine measure was fasting calcium:creatinine ratio.
Results
Baseline total (22.2 ± 3.3 vs 23.3 ± 7.2 ng/mL; P = .5) and free (5.4 ± 0.8 vs 5.3 ± 1.7 pg/mL; P = .8) 25D levels were similar between D2 and D3 groups. Increases in total (+27.6 vs +12.2 ng/mL; P = .001) and free (+3.6 vs +6.2 pg/mL; P = .02) 25D levels were greater with D3 vs D2. Percentage change in iPTH was significantly associated with change in free (but not total) 25D, without and with adjustment for supplementation regimen, change in 1,25-dihydroxyvitamin D, and change in calcium.
Conclusions
D3 increased total and free 25D levels to a greater extent than D2. Free 25D may be superior to total 25D as a marker of vitamin D bioactivity.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
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