Letter on the article “Supplementation with 80,000 UI vitamin D3/month between November and April corrects vitamin D insufficiency without overdosing: Effect on serum 25-hydroxyvitamin D serum concentrations”

Background: Vitamin D deficiency has been associated with cardiovascular mortality and sudden cardiac death in heart failure patients. Vitamin D may influence parathyroid hormone, the renin-angiotensin axis, natriuretic peptide gene expression, cardiac contractility, and cardiopulmonary function. Heart Failure (HF) studies using vitamin D to date have typically not used adequate repletion doses. Objectives: The primary objectives of this research were to determine if vitamin D repletion over a six month period in New York Heart Association (NYHA) Class II-III HF patients would result in a change in neurohormonal markers, cardiopulmonary exercise parameters, circulating 25- hydroxyvitamin D, and quality of life. Methods: A randomized, double-blinded, placebo-controlled trial assessing adjunctive Vitamin D3 supplementation in the treatment of NYHA Class II-III HF patients was conducted. Patients received 10,000 International Units (IU) per day of vitamin D3 or placebo for 6 months. Inclusion Criteria: 1) 25-hydroxyvitamin D level ≤32 ng/ml 2) stable medical regimen for 3 months. Exclusion Criteria: 1) any clinically unstable medical disorder 2) supplementation of vitamin D3 or D2 of greater than or equal to 2,000 IU/day. Study endpoints were: 1) B-type Natriuretic Peptide (BNP), 2) cardiopulmonary exercise parameters using Shape HF, 3) 25-hydroxyvitamin D, 4) intact parathyroid hormone (PTH), and 5) quality of life with the Kansas City Cardiomyopathy Questionnaire (KCCQ). Statistical analysis included independent samples t-test and multivariate regression. Results: A total of 34 patients completed the study. When adjusted for baseline 25-hydroxyvitamin D, the difference between groups for BNP was significant ([[Unable to Display Character: ∆]]540 ±1928 pg/ml placebo vs [[Unable to Display Character: ∆]] 35 pg/ml ±1054 pg/ml treatment p=0.009). 25-hydroxyvitamin D was [[Unable to Display Character: ∆]]48.9 ±32 ng/ml treatment vs [[Unable to Display Character: ∆]]3.6 ± 9.4 ng/ml placebo, p<0.001 (mean 68 ng/ml treatment vs 23 ng/ml placebo). No toxicity was observed with treatment. PTH and exercise chronotropic response index trended towards improvement in the treatment group vs placebo group, respectively (([[Unable to Display Character: ∆]]-20 ±20 pg/ml vs [[Unable to Display Character: ∆]]7 ±54pg/ml (p=0.06)) and ([[Unable to Display Character: ∆]]0.13±0.26 versus [[Unable to Display Character: ∆]]-0.03 ± 0.23, p=0.12)). KCCQ quality of life total symptom ([[Unable to Display Character: ∆]]16 ±16 treatment vs [[Unable to Display Character: ∆]]-12 ±15 placebo, p< 0.001) and individual scores significantly improved from baseline in the treatment group. Conclusions: Preliminary results show that vitamin D3 treatment of 10,000 IU/day in heart failure patients is safe, results in adequate circulating 25-hydroxyvitamin D levels, and achieves improvement in surrogate endpoint markers of HF outcomes.

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Five salmon dinners per week were not sufficient to prevent the reduction in serum vitamin D in autumn at 60° north latitude: a randomised trial

British Journal Of Nutrition ◽

10.1017/s0007114519002964 ◽

2019 ◽

Vol 123 (4) ◽

pp. 419-427 ◽

Cited By ~ 2

Author(s):

Marianne Bratlie ◽

Ingrid V. Hagen ◽

Anita Helland ◽

Øivind Midttun ◽

Arve Ulvik ◽

...

Keyword(s):

Vitamin D ◽

Fish Intake ◽

Control Group ◽

Serum Concentrations ◽

Hydroxyvitamin D ◽

Western Norway ◽

Increased Risk ◽

25 Hydroxyvitamin D ◽

High Fish ◽

North Latitude

AbstractLow serum concentrations of several vitamins have been linked to increased risk of diseases including insulin resistance and type 2 diabetes (T2D). Fish is a good source of several vitamins, and the prevalence of T2D is low in populations with high fish intake. The aim of the present study was to investigate the effects of high fish intake on vitamins in serum from adults in autumn in South-Western Norway at 60° north latitude. In this randomised clinical trial, sixty-three healthy participants with overweight/obesity consumed 750 g/week of either cod (n 22) or salmon (n 22) as five weekly dinners or were instructed to continue their normal eating habits but avoid fish intake (Control group, n 19) for 8 weeks. The estimated vitamin D intake was significantly increased in the Salmon group when compared with the Cod group (P = 6·3 × 10−4) and with the Control group (P = 3·5 × 10−6), with no differences between groups for estimated intake of vitamins A, B1, B2, B3, B6, B9, C and E. Serum 25-hydroxyvitamin D3 concentration was decreased in all groups after 8 weeks; however, the reduction in the Salmon group was significantly smaller compared with the Cod group (P = 0·013) and the Control group (P = 0·0060). Cod and salmon intake did not affect serum concentrations of the other measured vitamins. The findings suggest that 750 g/week of salmon was not sufficient to prevent a decrease in serum 25-hydroxyvitamin D3 in autumn in South-Western Norway in adults with overweight/obesity.

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Vitamin D Status in Japanese Adults: Relationship of Serum 25-Hydroxyvitamin D with Simultaneously Measured Dietary Vitamin D Intake and Ultraviolet Ray Exposure

Nutrients ◽

10.3390/nu12030743 ◽

2020 ◽

Vol 12 (3) ◽

pp. 743 ◽

Cited By ~ 2

Author(s):

Keiko Asakura ◽

Norihito Etoh ◽

Haruhiko Imamura ◽

Takehiro Michikawa ◽

Takahiro Nakamura ◽

...

Keyword(s):

Vitamin D ◽

Exposure Time ◽

Serum Vitamin ◽

Vitamin D Insufficiency ◽

Uv Exposure ◽

Dietary Vitamin ◽

Hydroxyvitamin D ◽

Vitamin D Intake ◽

25 Hydroxyvitamin D ◽

Ultraviolet Ray

Vitamin D insufficiency/deficiency is prevalent worldwide. We investigated the effect of vitamin D intake and ultraviolet ray (UV) exposure on serum vitamin D concentration in Japan. A total of 107 healthy adult participants were recruited from Hokkaido (43° N) and Kumamoto (33° N) prefectures. All participants undertook surveys in both summer and winter. Serum 25-hydroxyvitamin D (25(OH)D3) was examined, and vitamin D intake was assessed with a diet history questionnaire. UV exposure was measured with a wearable UV dosimeter. Regression analysis was performed to investigate the relationship between these factors, with covariates such as sun avoidance behavior. The prevalence of vitamin D insufficiency (serum 25(OH)D3; 12 ng/mL (30 nmol/L) ≤ and <20 ng/mL (50 nmol/L))/deficiency (<12 ng/mL) was 47.7% in summer and 82.2% in winter. UV exposure time was short in Kumamoto (the urban area), at 11.6 min in summer and 14.9 min in winter. In Hokkaido (the rural area), UV exposure time was 58.3 min in summer and 22.5 min in winter. Vitamin D intake was significantly associated with serum 25(OH)D3, and a 1 μg/1000kcal increase in intake was necessary to increase 25(OH)D3 by 0.88 ng/mL in summer and by 1.7 ng/mL in winter. UV exposure time was significantly associated with serum 25(OH)D3 in summer, and a 10 min increase in UV exposure time was necessary to increase 25(OH)D3 by 0.47 ng/mL. Although consideration of personal occupation and lifestyle is necessary, most Japanese may need to increase both vitamin D intake and UV exposure.

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Prediction of Bone Mass Density Variation by Bone Remodeling Markers in Postmenopausal Women with Vitamin D Insufficiency Treated with Calcium and Vitamin D Supplementation

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2002-021968 ◽

2003 ◽

Vol 88 (11) ◽

pp. 5175-5179 ◽

Cited By ~ 49

Author(s):

Franck Grados ◽

Michel Brazier ◽

Saïd Kamel ◽

Marc Mathieu ◽

Nathalie Hurtebize ◽

...

Keyword(s):

Vitamin D ◽

Bone Remodeling ◽

Elderly Women ◽

Vitamin D Insufficiency ◽

Vitamin D Supplementation ◽

Hydroxyvitamin D ◽

Bone Remodeling Markers ◽

25 Hydroxyvitamin D ◽

Total Body

Abstract The aim of this study was to determine whether early changes in bone markers could predict long-term response in bone mineral density (BMD) after calcium (500 mg) and vitamin D (400 IU) supplementation twice daily in ambulatory elderly women with vitamin D insufficiency (25-hydroxyvitamin D, <12 ng/ml). One hundred and ninety-two women (mean age, 75 ± 7 yr) were randomized to receive either the supplementation (n = 95) or a placebo (n = 97) in a double-blind, controlled clinical trial for 1 yr. In comparison with the placebo group, supplementation significantly increased BMD, normalized 25-hydroxyvitamin D and significantly decreased intact PTH and bone remodeling markers. The initial values of telopeptide cross-links were correlated with improvement in total body BMD [urinary N-telopeptides (NTX), r = 0.38; C-telopeptides (CTX), r = 0.32; serum CTX, r = 0.28], and the 3-month changes in the same markers were correlated with improvement in total body (urinary N-telopeptides, r = −0.29; serum CTX, r = −0.26) and vertebral BMD (CTX, r = −0.26; all P < 0.05). We concluded that short-term changes in bone resorption markers can predict long-term variations in BMD in elderly women with vitamin D insufficiency receiving calcium and vitamin D supplementation.

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Very high rates of vitamin D insufficiency in women of child-bearing age living in Beijing and Hong Kong

British Journal Of Nutrition ◽

10.1017/s0007114507844382 ◽

2008 ◽

Vol 99 (6) ◽

pp. 1330-1334 ◽

Cited By ~ 43

Author(s):

Jean Woo ◽

Christopher W. K. Lam ◽

Jason Leung ◽

Winny Y. Lau ◽

Edith Lau ◽

...

Keyword(s):

Vitamin D ◽

Hong Kong ◽

Pregnant Women ◽

Vitamin D Deficiency ◽

Vitamin D Insufficiency ◽

Dietary Intakes ◽

Hydroxyvitamin D ◽

The North ◽

25 Hydroxyvitamin D ◽

The Relationship

We aimed to describe the vitamin D status of young women living in two Chinese cities in the spring – Beijing in the north (latitude 39° north) and Hong Kong (latitude 22° north) in the south. We also examined the relationship between serum 25-hydroxyvitamin D and parathyroid hormone (PTH) concentrations to determine a threshold for serum 25-hydroxyvitamin D above which there is no further suppression of PTH. Finally, we examined whether dietary Ca intake influences this relationship. Non-pregnant women aged 18–40 years (n 441) were recruited between February and June. Fasting blood was collected and dietary intakes were assessed using 5 d food records. Mean serum 25-hydroxyvitamin D concentration was lower in Beijing than Hong Kong women (29 v. 34 nmol/l; P < 0·001). Vitamin D deficiency ( ≤ 25 nmol/l) was indicated in 40 % of Beijing and 18 % of Hong Kong women, and over 90 % of women in both cities were insufficient ( ≤ 50 nmol/l). Mean Ca and vitamin D intakes were 478 mg/d and 2·0 μg/d, respectively. The relationship between 25-hydroxyvitamin D concentration and PTH was linear throughout the range with a slope of − 0·36 (different from 0; P < 0·001; R 0·26), with no apparent threshold. There was no influence of Ca intake on the relationship between 25-hydroxyvitamin D and PTH concentration. Vitamin D deficiency is common and insufficiency is very common in non-pregnant women in Hong Kong and Beijing during spring. Serum 25-hydroxyvitamin D was inversely associated with PTH with no apparent threshold. Strategies such as vitamin D fortification or supplementation may be required.

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