Objectives: To compare 3 different treatment regimens for vitamin D deficiency in minority adolescents and to explore factors that impact treatment efficacy.
Study Design: We conducted an 8-week, prospective, open-label, randomized clinical trial in an urban, academic, children's hospital. A total of 183 vitamin D-deficient adolescents, mean 25-hydroxyvitamin D or 25(OH)D 13.7 ± 3.9 ng/mL; mean age 16.6 ± 2.2 years, were randomized into 3 vitamin D3 (cholecalciferol) treatment arms: 50,000 IU/wk; 5000 IU/d; and 1000 IU/d. Serum 25(OH)D and vitamin D binding protein (VDBP) levels were measured pre-and posttreatment; 122 (67%) participants completed posttreatment measures. Complete-case and multiple-imputation, intention-to-treat analyses were performed.
Results: Mean change in 25(OH)D level posttreatment was significantly different among the 3 arms, 24.9 ± 15.1 vs 21.0 ± 15.2 vs 6.2 ± 6.5 ng/mL, for 50,000 IU, 5000 IU, and 1000 IU doses, respectively, P < .001. Both high-dose treatments were effective in increasing the 25(OH)D level out of deficiency range (≥ 20 ng/mL) in more than 80% of participants, and 60% remained deficient after low-dose treatment. Only 72%, 56%, and 2% achieved vitamin D sufficiency (>30 ng/mL) with 50,000 IU, 5000 IU, and 1000 IU doses, respectively, P < .001. Obese participants had substantially less mean change in 25(OH)D level after treatment than normal-weight participants, 13.7 ± 10.7 vs 21.9 ± 16.9 ng/mL, P < .001. Mean baseline VDBP level was almost twice as high in Hispanic compared with black participants (P < .001) and did not alter treatment response or change with treatment.
Conclusions: Adult-sized adolescents require 8 weeks of high-dose cholecalciferol, at least 5000 IU/d, to correct deficiency. Obese adolescents have poorer response to treatment and may need higher doses than nonobese youth. Hispanic and black adolescents have different VDBP levels but similar treatment responses.
Trial Registration: ClinicalTrials.gov: NCT01784029.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769970 | PMC |
| http://dx.doi.org/10.1016/j.jpeds.2015.11.025 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The Relationship Between Novel Inflammatory Markers and Serum 25-Hydroxyvitamin D Among US Adults.
Immun Inflamm Dis
January 2025
Department of Cardiology, Anqing First People's Hospital of Anhui Medical University, Anqing, China.
Background: Vitamin D is the focus of extensive medical research globally. Recent studies have investigated the correlation between serum 25-hydroxyvitamin D (25(OH)D) and common inflammatory markers. However, few studies have incorporated novel inflammatory markers such as the platelet-to-lymphocyte ratio (PLR), platelet-to-high density lipoprotein cholesterol ratio (PHR), systemic inflammatory index (SII), neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory response (SIRI), and neutrophil-to-high-density lipoprotein cholesterol ratio (NHR).
View Article and Find Full Text PDFCombined 25-hydroxyvitamin D concentrations and physical activity on mortality in US stroke survivors: findings from the NHANES.
Nutr J
January 2025
Department of Neurology, Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Nanjing, 210029, China.
Background: 25-hydroxyvitamin D [25(OH)D] concentrations and physical activity (PA) are linked and both are associated with changes in mortality. We examined the association of 25(OH)D and PA with all-cause or cause-specific mortality risk in stroke survivors.
Methods: The analysis included 677 stroke survivors from National Health and Nutrition Examination Survey (NHANES) 2007-2008 to 2017-2018.
Low serum 25-hydroxyvitamin D levels in migraine are not related to headache frequency: A case-control study in patients with high-frequency/chronic migraine.
Headache
January 2025
Service of Neurology, University Hospital Marqués de Valdecilla, Universidad de Cantabria and Valdecilla Research Institute (IDIVAL), Santander, Spain.
Background: Serum 25-hydroxyvitamin D (25[OH]D) concentrations have been shown to be low in patients with migraine, but results are controversial regarding the current role of vitamin D in migraine severity. Using a case-control design, we aimed to evaluate serum 25(OH)D levels in a group of females with high-frequency episodic migraine/chronic migraine (HF/CM) and analyze its association with headache frequency and serum calcitonin gene-related peptide (CGRP) levels.
Methods: Serum 25(OH)D levels were measured in 97 females with HF/CM (age 48.
Vitamin D, C-Reactive Protein, and Increased Fall Risk: A Genetic Epidemiological Study.
Nutrients
December 2024
Australian Centre for Precision Health, Unit of Clinical and Health Sciences, University of South Australia, Adelaide, SA 5000, Australia.
: Falls are a major public health concern. Daily vitamin D supplementation is a proposed fall prevention strategy; however, safety concerns have arisen from some clinical trials showing increased fall risk when using higher vitamin D dosing methods. The relationship between vitamin D and falls may be influenced by factors, such as inflammation, which can alter the balance of essential nutrients like vitamin D and retinol, potentially affecting motor function.
View Article and Find Full Text PDFCommutability assessment of new standard reference materials (SRMs) for determining serum total 25-hydroxyvitamin D using ligand binding and liquid chromatography-tandem mass spectrometry (LC-MS/MS) assays.
Anal Bioanal Chem
January 2025
Chemical Sciences Division, National Institute of Standards and Technology (NIST), Gaithersburg, MD, 20899, USA.
Commutability is where the measurement response for a reference material (RM) is the same as for an individual patient sample with the same concentration of analyte measured using two or more measurement systems. Assessment of commutability is essential when the RM is used in a calibration hierarchy or to ensure that clinical measurements are comparable across different measurement procedures and at different times. The commutability of three new Standard Reference Materials (SRMs) for determining serum total 25-hydroxyvitamin D [25(OH)D], defined as the sum of 25-hydroxyvitamin D [25(OH)D] and 25-hydroxyvitamin D [25(OH)D], was assessed through an interlaboratory study.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!