补充骨化二醇对健康成年人25-羟基维生素D、甲状旁腺激素和1,25-二羟基维生素D水平的疗效、安全性和剂量反应效应:一项开放标签的介入性试点研究。

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY Accounts of Chemical Research Pub Date : 2023-09-01 DOI:10.4103/ijp.ijp_873_22
Liza Das, Michael F Holick, Naresh Sachdeva, Sanjay Kumar Bhadada, Shallu Singhmar, Neetika Thakur, Pinaki Dutta, Raman Kumar Marwaha
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引用次数: 0

摘要

背景:维生素D缺乏症(VDD)在全球范围内非常普遍。在相当大比例的补充个体中,胆钙化醇(维生素D3)未能达到足够的25-羟基维生素D(25(OH)D)血清浓度。降钙二醇(25-羟基维生素D3)在健康成年人中的研究较少,其在较高剂量下对25(OH)D、甲状旁腺激素(PTH)和1,25-二羟基维生素D(1,25(OH)2D)的影响尚不清楚。材料和方法:该研究是一项开放标签的介入性试验,招募了连续的VDD参与者,他们被分配接受2粒(50μg组)或1粒(25μg组。基线评估包括临床形态参数、膳食钙、血钙(钙、无机磷酸盐、白蛋白、碱性磷酸酶、尿斑钙/肌酐)和激素参数(25(OH)D、PTH和1,25(OH)2D)。参与者在第4周和第8周接受随访,并对血钙和激素参数进行重复评估。结果:共有64名参与者,35名(50μg组)和29名(25μg组。50μg组97.1%的参与者(4周和8周时)和25μg组93.1%(4周时)、96.5%(8周时。4周时,50μg组和25μg组的平均血清25(OH)D分别为84.0±27.7 ng/ml和58.0±23.6 ng/ml,8周时分别升至94.3±21.8 ng/ml和76.0±16.4 ng/ml。PTH水平在两个时间点都有所下降。1,25(OH)2D在4周和8周时在两组中均显著升高,但两组之间没有显著差异。没有发生高钙血症或症状性肾结石的病例。结论:骨化醇是一种安全有效的年轻人口服补充维生素D的替代品。25(OH)D水平的增加是快速和剂量依赖性的。
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Efficacy, safety, and dose-response effects of calcifediol supplementation on 25-hydroxyvitamin D, parathyroid hormone, and 1,25-dihydroxyvitamin D levels in healthy adults: An open-label, interventional pilot study.

Background: Vitamin D deficiency (VDD) is highly prevalent across the globe. Cholecalciferol (Vitamin D3) fails to attain sufficient serum concentrations of 25-hydroxyvitamin D (25(OH)D) in a significant proportion of supplemented individuals. Calcifediol (25-hydroxyvitamin D3) is less studied in healthy adults and its effects on 25(OH)D, parathyroid hormone (PTH), and 1,25-dihydroxyvitamin D (1,25(OH)2D) at higher doses are not well known.

Materials and methods: The study was an open-label, interventional trial recruiting consecutive participants with VDD who were allocated to receive either 2 capsules (50 μg-group) or 1 capsule (25 μg-group) daily doses of calcifediol. Baseline assessment included clinicodemographic parameters, dietary calcium, calcemic (calcium, inorganic phosphate, albumin, alkaline phosphatase, urine spot calcium/creatinine), and hormonal parameters (25(OH)D, PTH, and 1,25(OH)2D). Participants were followed up at 4 and 8 weeks with repeat assessments of calcemic and hormonal parameters.

Results: There were 64 participants, 35 (50 μg-group) and 29 (25 μg-group), without any significant difference in any of the baseline parameters. 97.1% participants in the 50 μg-group (at 4 and 8 weeks) and 93.1% (at 4 weeks) and 96.5% (at 8 weeks) in the 25 μg-group attained 25(OH)D sufficiency (≥30 ng/ml) with calcifediol. The mean serum 25(OH)D was 84.0 ± 27.7 ng/ml in the 50 μg-group and 58.0 ± 23.6 ng/ml in the 25 μg-group group at 4 weeks, which later rose to 94.3 ± 21.8 ng/ml and 76.0 ± 16.4 ng/ml, respectively, at 8 weeks. PTH levels decreased in both groups at both time points. 1,25(OH)2D rose significantly in both groups at 4 and 8 weeks but was not significantly different between both groups. There was no case of incident hypercalcemia or symptomatic nephrolithiasis.

Conclusion: Calcifediol is a safe and efficacious alternative for oral Vitamin D supplementation in young adults. Increment in 25(OH)D levels is rapid and dose-dependent.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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