Efficacy of different doses and time intervals of oral vitamin D supplementation with or without calcium in elderly nursing home residents

被引:141
作者
Chel V. [1 ,2 ]
Wijnhoven H.A.H. [2 ]
Smit J.H. [3 ]
Ooms M. [2 ]
Lips P. [2 ,4 ]
机构
[1] Verpleeghuis Marienhave, Warmond
[2] EMGO Institute, VU University Medical Center, Amsterdam
[3] Department of Psychiatry, VU University Medical Center, Amsterdam
[4] Department of Endocrinology, VU University Medical Center, Amsterdam 1007 MB
关键词
Calcium supplementation; Secondary hyperparathyroidism; Vitamin D deficiency; Vitamin D supplementation;
D O I
10.1007/s00198-007-0465-2
中图分类号
学科分类号
摘要
Summary: The effect of equivalent oral doses of vitamin D3 600 IU/day, 4200 IU/week and 18,000 IU/month on vitamin D status was compared in a randomized clinical trial in nursing home residents. A daily dose was more effective than a weekly dose, and a monthly dose was the least effective. Introduction: It is assumed that equivalent daily, weekly or monthly doses of vitamin D3 equally influence vitamin D status. This was investigated in a randomized clinical trial in nursing home residents. Methods: The study was performed in ten nursing homes including 338 subjects (76 male and 262 female), with a mean age of 84 (± SD 6.3 years). They received oral vitamin D3 either 600 IU/day, or 4200 IU/week, or 18,000 IU/month or placebo. After 4 months, calcium was added during 2 weeks, 320 mg/day or 640 mg/day or placebo. Outcome: serum levels of 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH) and bone turnover markers. Statistical approach: linear multilevel analysis. Results: At baseline, mean serum 25(OH)D was 25.0 nmol/L (SD 10.9), and in 98%, it was lower than 50 nmol/L. After 4 months, mean serum 25(OH)D levels increased to 62.5 nmol/L (after daily vitamin D3 69.9 nmol/L, weekly 67.2 nmol/L and monthly 53.1 nmol/L, P<0.001 between groups). Median serum PTH levels decreased by 23% (p<0.001). Bone turnover markers did not decrease. Calcium supplementation had no effect on serum PTH and bone turnover. Conclusion: Daily vitamin D was more effective than weekly, and monthly administration was the least effective. © 2007 International Osteoporosis Foundation and National Osteoporosis Foundation.
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页码:663 / 671
页数:8
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