TY - JOUR
T1 - Effects of cholecalciferol vs. calcifediol on total and free 25-hydroxyvitamin D and parathyroid hormone
AU - Shieh, Albert
AU - Ma, Christina
AU - Chun, Rene F
AU - Witzel, Sten
AU - Rafison, Brandon
AU - Contreras, Hannah Tm
AU - Wittwer-Schegg, Jonas
AU - Swinkels, Leon
AU - Huijs, Tonnie
AU - Hewison, Martin
AU - Adams, John S
PY - 2017/2/10
Y1 - 2017/2/10
N2 - Context:
Vitamin D deficiency (25-hydroxyvitamin D [25D] <20 ng/ml) disproportionately affects non-Caucasian individuals. Controversy persists over: 1) how to best restore low 25D levels; and 2) how to best define vitamin D status (total [protein-bound + free] vs. free 25D).
Objective:
To assess: 1) the effects of vitamin D3 (cholecalciferol, D3) vs. pharmacologic 25-hydroxyvitamin D3 (calcifediol, 25D3) on total and free 25D in a multi-ethnic cohort of adults; and 2) whether change in parathyroid hormone (PTH) is more strongly associated with total vs. free 25D.
Design:
16-week randomized controlled trial. Biochemistries at 0, 4, 8, and 16 weeks.
Intervention:
60 mcg (2,400 IU)/day of D3 or 20 mcg/day of 25D3.
Setting:
Academic medical center.
Participants:
35 adults >18 years with 25D levels <20 ng/ml.
Main Outcome Measures:
Total and free 25D, PTH.
Results:
Baseline total (16.2 + 3.7 vs. 17.0 + 2.5 ng/ml, p=0.4) and free (4.2 + 0.8 vs. 4.7 + 1.0 pg/ml, p=0.2) 25D were similar between D3 and 25D3 groups, respectively. 25D3 increased total (+25.5 vs. +13.8 ng/ml, p=0.001) and free (+6.6 vs. +3.5 pg/ml, p=0.03) 25D more than D3. By 4 weeks, 87.5% of 25D3 participants had total 25D levels >30 ng/ml, compared to 23.1% of D3 participants (p=0.001). These trends were consistent across race/ethnicity. Change in PTH was similarly associated with both total (p=0.01) and free 25D (p=0.04).
Conclusions:
25D3 increased total and free 25D levels more rapidly than D3, regardless of race/ethnicity. Free and total 25D were similarly associated with change in PTH.
AB - Context:
Vitamin D deficiency (25-hydroxyvitamin D [25D] <20 ng/ml) disproportionately affects non-Caucasian individuals. Controversy persists over: 1) how to best restore low 25D levels; and 2) how to best define vitamin D status (total [protein-bound + free] vs. free 25D).
Objective:
To assess: 1) the effects of vitamin D3 (cholecalciferol, D3) vs. pharmacologic 25-hydroxyvitamin D3 (calcifediol, 25D3) on total and free 25D in a multi-ethnic cohort of adults; and 2) whether change in parathyroid hormone (PTH) is more strongly associated with total vs. free 25D.
Design:
16-week randomized controlled trial. Biochemistries at 0, 4, 8, and 16 weeks.
Intervention:
60 mcg (2,400 IU)/day of D3 or 20 mcg/day of 25D3.
Setting:
Academic medical center.
Participants:
35 adults >18 years with 25D levels <20 ng/ml.
Main Outcome Measures:
Total and free 25D, PTH.
Results:
Baseline total (16.2 + 3.7 vs. 17.0 + 2.5 ng/ml, p=0.4) and free (4.2 + 0.8 vs. 4.7 + 1.0 pg/ml, p=0.2) 25D were similar between D3 and 25D3 groups, respectively. 25D3 increased total (+25.5 vs. +13.8 ng/ml, p=0.001) and free (+6.6 vs. +3.5 pg/ml, p=0.03) 25D more than D3. By 4 weeks, 87.5% of 25D3 participants had total 25D levels >30 ng/ml, compared to 23.1% of D3 participants (p=0.001). These trends were consistent across race/ethnicity. Change in PTH was similarly associated with both total (p=0.01) and free 25D (p=0.04).
Conclusions:
25D3 increased total and free 25D levels more rapidly than D3, regardless of race/ethnicity. Free and total 25D were similarly associated with change in PTH.
U2 - 10.1210/jc.2016-3919
DO - 10.1210/jc.2016-3919
M3 - Article
C2 - 28187226
SN - 0021-972X
JO - The Journal of clinical endocrinology and metabolism
JF - The Journal of clinical endocrinology and metabolism
ER -