Association of Body Weight With Response to Vitamin D Supplementation and Metabolism
Tobias DK, Luttmann-Gibson H, Mora S, Danik J, Bubes V, Copeland T, LeBoff MS, Cook NR, Lee IM, Buring JE, Manson JE
JAMA network open · 105 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 Heart, Lung, and Blood Institute
- Government
- National Cancer Institute
- Government
- National Institute of Arthritis and Musculoskeletal and Skin Diseases
- Government
- National Center for Complementary and Integrative Health
- Government
- NIAMS NIH HHS
- Government
- NHLBI NIH HHS
- Government
- NCI NIH HHS
- Government
- NCCIH NIH HHS
- Grants
- National Cancer Institute (R01 CA138962); National Cancer Institute (U01CA138962); National Heart, Lung, and Blood Institute (K24HL136852); National Center for Complementary and Integrative Health (R01 AT011729); National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR059775); National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 AR070854)
Based on 8 listed funder(s).
Publication
- Published
- 2023-01-17 · JAMA Netw Open · vol. 6 · issue 1 · p. e2250681
- Publisher
- American Medical Association
- Cited
- 226 citations · more than 100% of similar papers · 38.5× the field average
- Impact
- Top 10% most cited in its field
- References
- 35 works
- Access
- Open access (journal) · CC-BY
- Research areas
- Vitamin D Research Studies · Nutrition, Genetics, and Disease · Nutritional Studies and Diet
- Keywords
- Vitamin D and neurology, Medicine, Body mass index, Internal medicine, Placebo, Vitamin, Cholecalciferol, vitamin D deficiency, Calcifediol, Parathyroid hormone, Cohort, Vitamin D-binding protein, Randomized controlled trial, Endocrinology, Physiology, Gastroenterology, Calcium
- MeSH
- humans, obesity, calcium, parathyroid hormone, vitamins, vitamin d, cohort studies, dietary supplements, aged, middle aged, female, male, overweight, biomarkers
11 authors
From US
- Deirdre Kay Tobias · correspondingBrigham and Women's Hospital; Harvard University
- Heike Luttmann‐GibsonBrigham and Women's Hospital; Harvard University
- Samia MoraBrigham and Women's Hospital; Harvard University
- Jacqueline Suk DanikHarvard University; Massachusetts General Hospital
- Vadim Y. BubesBrigham and Women's Hospital; Harvard University
- Trisha CopelandBrigham and Women's Hospital; Harvard University
Abstract
Importance
In the Vitamin D and Omega-3 Trial (VITAL), the effects of randomized vitamin D supplementation (cholecalciferol), 2000 IU/d, reduced the risk of several health outcomes among participants with normal, but not elevated, body weights. It was unclear whether weight had any association with the outcomes of the supplementation.
Objective
To investigate whether baseline body mass index (BMI) modifies vitamin D metabolism and response to supplementation.
Design, setting, and participants
VITAL is a completed randomized, double-blind, placebo-controlled trial for the primary prevention of cancer and cardiovascular disease. In the present cohort study, an analysis was conducted in a subset of VITAL participants who provided a blood sample at baseline and a subset with a repeated sample at 2 years' follow-up. VITAL was conducted from July 1, 2010, to November 10, 2018; data analysis for the present study was conducted from August 1, 2021, to November 9, 2021.
Interventions
Treatment outcomes of vitamin D, 2000 IU/d, supplementation vs placebo associated with clinical and novel vitamin D-related biomarkers by BMI category adjusted for other factors associated with vitamin D status.
Main outcomes and measures
Multivariable-adjusted means (SE) or 95% CIs of vitamin D-related serum biomarkers at baseline and follow-up: total 25-hydroxyvitamin D (25-OHD), 25-OHD3, free vitamin D (FVD), bioavailable vitamin D (BioD), vitamin D-binding protein (VDBP), albumin, parathyroid hormone (PTH), and calcium, and log-transformed as needed.
Results
A total of 16 515 participants (mean [SD] age, 67.7 [7.0] years; 8371 women [50.7%]; 12420 non-Hispanic White [76.9%]) were analyzed at baseline, including 2742 with a follow-up blood sample. Before randomization, serum total 25-OHD levels were incrementally lower at higher BMI categories (adjusted mean [SE]: underweight, 32.3 [0.7] ng/mL; normal weight, 32.3 [0.1] ng/mL; overweight, 30.5 [0.1] ng/mL; obesity class I, 29.0 [0.2] ng/mL; and obesity class II, 28.0 [0.2] ng/mL; P < .001 for linear trend). Similarly, baseline 25-OHD3, FVD, BioD, VDBP, albumin, and calcium levels were lower with higher BMI, while PTH level was higher (all P < .001 for linear trend). Compared with placebo, randomization to vitamin D supplementation was associated with an increase in total 25-OHD, 25-OHD3, FVD, and BioD levels compared with placebo at 2 years' follow-up, but increases were significantly lower at higher BMI categories (all treatment effect interactions P < .001). Supplementation did not substantially change VDBP, albumin, PTH, or calcium levels.
Conclusions and relevance
In this randomized cohort study, vitamin D supplementation increased serum vitamin D-related biomarkers, with a blunted response observed for participants with overweight or obesity at baseline. These longitudinal findings suggest that BMI may be associated with modified response to vitamin D supplementation and may in part explain the observed diminished outcomes of supplementation for various health outcomes among individuals with higher BMI.
Abstract via Europe PMC. Copyright remains with the authors or publisher (CC BY).
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