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

Chel V, Wijnhoven HA, Smit JH, Ooms M, Lips P - Osteoporos Int (2007)

Bottom Line: Bone turnover markers did not decrease.Calcium supplementation had no effect on serum PTH and bone turnover.Daily vitamin D was more effective than weekly, and monthly administration was the least effective.

View Article: PubMed Central - PubMed

Affiliation: Verpleeghuis Marienhave, Warmond, The Netherlands.

ABSTRACT

Unlabelled: 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.

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Mean (± 1.96 × SD) serum 25(OH)D concentrations at baseline, 2 and 4 months during treatment with vitamin D daily, weekly, or monthly, or placebo
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Fig2: Mean (± 1.96 × SD) serum 25(OH)D concentrations at baseline, 2 and 4 months during treatment with vitamin D daily, weekly, or monthly, or placebo

Mentions: Effects of vitamin D supplementation on serum 25(OH)D in the various treatment groups are shown in Table 2 and Fig. 2. The mean difference in increase of serum 25(OH)D was 38.5 nmol/L (95% confidence interval (CI) 25.6–41.5) in favour of vitamin D when compared to placebo. Daily, weekly and monthly administration of vitamin D resulted in increase of serum 25(OH)D when compared to placebo (P < 0.001). The mean difference in increase of serum 25(OH)D was highest after 4 months with daily administration of vitamin D (mean 47.2 nmol/l) when compared to weekly (mean 40.7 nmol/l, P < 0.01) and monthly (mean 27.6 nmol/l, P < 0.001) administration. Weekly administration of vitamin D resulted in a greater increase of serum 25(OH)D than monthly administration (P < 0.001). The percentage of patients with serum 25(OH)D below cut offs of 25 nmol/l, 50 nmol/l and 75 nmol/l is shown in Table 3. At 4 months, the percentage of patients with serum 25(OH)D < 50 nmol/l was 10.9, 10.6 and 36.4% in the daily, weekly and monthly groups of vitamin D supplementation respectively.Table 2


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

Chel V, Wijnhoven HA, Smit JH, Ooms M, Lips P - Osteoporos Int (2007)

Mean (± 1.96 × SD) serum 25(OH)D concentrations at baseline, 2 and 4 months during treatment with vitamin D daily, weekly, or monthly, or placebo
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2277446&req=5

Fig2: Mean (± 1.96 × SD) serum 25(OH)D concentrations at baseline, 2 and 4 months during treatment with vitamin D daily, weekly, or monthly, or placebo
Mentions: Effects of vitamin D supplementation on serum 25(OH)D in the various treatment groups are shown in Table 2 and Fig. 2. The mean difference in increase of serum 25(OH)D was 38.5 nmol/L (95% confidence interval (CI) 25.6–41.5) in favour of vitamin D when compared to placebo. Daily, weekly and monthly administration of vitamin D resulted in increase of serum 25(OH)D when compared to placebo (P < 0.001). The mean difference in increase of serum 25(OH)D was highest after 4 months with daily administration of vitamin D (mean 47.2 nmol/l) when compared to weekly (mean 40.7 nmol/l, P < 0.01) and monthly (mean 27.6 nmol/l, P < 0.001) administration. Weekly administration of vitamin D resulted in a greater increase of serum 25(OH)D than monthly administration (P < 0.001). The percentage of patients with serum 25(OH)D below cut offs of 25 nmol/l, 50 nmol/l and 75 nmol/l is shown in Table 3. At 4 months, the percentage of patients with serum 25(OH)D < 50 nmol/l was 10.9, 10.6 and 36.4% in the daily, weekly and monthly groups of vitamin D supplementation respectively.Table 2

Bottom Line: Bone turnover markers did not decrease.Calcium supplementation had no effect on serum PTH and bone turnover.Daily vitamin D was more effective than weekly, and monthly administration was the least effective.

View Article: PubMed Central - PubMed

Affiliation: Verpleeghuis Marienhave, Warmond, The Netherlands.

ABSTRACT

Unlabelled: 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.

Show MeSH