维生素D3补充：疗效与维生素D3代谢产物预测指标的随机对照试验
2016年4月，欧洲肠外肠内营养学会（ESPEN）官方期刊《临床营养》发表了德国马丁路德大学、挪威卑尔根大学的随机安慰剂对照试验，发现经过12周每天补充20μg维生素D3者，冬季期间25(OH)D3水平显著升高平均41nmol/L（P＜0.001），而未补充者25(OH)D3水平显著降低（P＜0.01）；补充维生素D3者，25(OH)D3水平≥50nmol/L占94%，≥75nmol/L占46%；25(OH)D3水平升高程度取决于25(OH)D3基线水平、年龄、体重和甘油三酯水平；24,25(OH)2D3水平升高程度仅取决于24,25(OH)2D3基线水平和年龄，可以考虑作为疗效预测指标进一步研究。
Clin Nutr. 2016 Apr;35(2):351-8.
Vitamin D3 supplementation: Response and predictors of vitamin D3 metabolites - A randomized controlled trial.
Lehmann U, Riedel A, Hirche F, Brandsch C, Girndt M, Ulrich C, Seibert E, Henning C, Glomb MA, Dierkes J, Stangl GI.
Martin Luther University Halle-Wittenberg, Germany.
University of Bergen, Norway.
BACKGROUND & AIMS: Large parts of the population are insufficiently supplied with vitamin D, in particular when endogenous synthesis is absent. Therefore many health care providers recommend the use of vitamin D supplements. The current study aimed to investigate the efficacy of an once-daily oral dose of 20 μg vitamin D3 to improve the vitamin D status and to evaluate predictors of response.
METHODS: The study was conducted as a double-blind, randomized, placebo-controlled parallel trial from January till April 2013. In total, 105 subjects (20-71 years) were allocated to receive either a vitamin D3 supplement (20 μg/d) or a placebo for 12 weeks. Circulating levels of vitamin D3 metabolites such as the 25(OH)D3 and the 24,25(OH)2D3, and biomarkers of calcium and phosphate metabolism were quantified.
RESULTS: The 25(OH)D3 serum concentrations in the placebo group decreased from 38 ± 15 nmol/L at baseline to 32 ± 14 nmol/L and 32 ± 13 nmol/L at weeks 8 and 12 of the study, respectively (p < 0.01). In the vitamin D3 group, the serum 25(OH)D3 concentration increased from 38 ± 14 nmol/L at baseline to 70 ± 15 nmol/L and 73 ± 16 nmol/L at weeks 8 and 12 of vitamin D3 supplementation (p < 0.001), respectively. As a result, 94% of the vitamin D3-supplemented participants reached 25(OH)D3 concentrations of ≥50 nmol/L and thereof 46% attained 25(OH)D3 levels of ≥75 nmol/L until the end of the study. The extent of the 25(OH)D3 increase upon vitamin D3 supplementation depended on 25(OH)D3 baseline levels, age, body weight and circulating levels of triglycerides. In contrast to 25(OH)D3, the response of 24,25(OH)2D3 to the vitamin D3 treatment was affected only by baseline levels of 24,25(OH)2D3 and age.
CONCLUSIONS: The average improvement of 25(OH)D3 levels in individuals who received 20 μg vitamin D3 per day during the winter months was 41 nmol/L compared to individuals without supplementation. As a result almost all participants with the vitamin D3 supplementation attained 25(OH)D3 concentrations of 50 nmol/L and higher. The suitability of 24,25(OH)2D3 as a marker of vitamin D status needs further investigation. Clinical trial registration number at clinicaltrails.gov: NCT01711905.
PMID: 26037521
DOI: 10.1016/j.clnu.2015.04.021
