Download PDF
Horm Metab Res 2018; 50(10): 747-753
DOI: 10.1055/a-0746-5031
Endocrine Care
© Georg Thieme Verlag KG Stuttgart · New York

Effects of Stratified Vitamin D Supplementation in Middle-Aged and Elderly Individuals with Vitamin D Insufficiency

Yanhui Lu   *
1   Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
,
Xiaomin Fu   *
1   Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
,
Lili Zhang
1   Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
,
Minyan Liu
1   Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
,
Xiaoling Cheng
1   Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
,
Shuangtong Yan
1   Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
,
Nan Li
1   Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
,
Xinyu Miao
1   Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
,
Banruo Sun
1   Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
,
Chunlin Li
1   Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, China
› Author Affiliations
Further Information

Publication History

received  15 April 2018

accepted 11 September 2018

Publication Date:
12 October 2018 (online)

Also available at
    Permissions and Reprints

Abstract

The incidence of vitamin D deficiency is high globally, and vitamin D supplementation draws particular attention. The objective of this study was to investigate the effects of stratified vitamin D supplementation in middle-aged and elderly individuals with vitamin D insufficiency in Beijing. A total of 448 subjects aged over 40 years old were selected from a community in Beijing. Among them, 100 middle-aged and elderly people with vitamin D insufficiency were randomly selected on a voluntary basis. They were further divided into control group and intervention group. The control group received health education and lifestyle guidance, and the intervention group received lifestyle guidance and vitamin D supplementation for nine months. The doses were stratified as follows: for vitamin D insufficiency, oral vitamin D3 supplement was given at 5000 IU/w; for mild vitamin D deficiency, oral vitamin D3 supplement was given at 10 000 IU/w; for severe vitamin D deficiency, oral vitamin D3 supplement was given at 15 000 IU/w. Safety evaluation was conducted after three-month treatment. The intervention group consisted of 8%, 62%, and 30% of cases who had vitamin D insufficiency, mild vitamin D deficiency, and severe vitamin D deficiency, respectively, which were similar with the control group. It showed that the blood 25(OH)D level increased significantly in the intervention group, from 14.30±4.30 ng/ml to 33.62±6.99 ng/ml (p<0.001), in contrast to insignificant change in the control group. Stratified vitamin D supplementation effectively increased the blood 25(OH)D level, as well as the number of cases with corrected vitamin D insufficiency or deficiency.

Key words

middle-aged and elderly people - stratified vitamin D supplementation - vitamin D insufficiency - safety - effect

* Yanhui Lu and Xiaomin Fu contributed equally to this work


 

  • References

  • 1 Hossein-nezhad A, Holick MF. Vitamin D for health: a global perspective. Mayo Clin Proc 2013; 88: 720-755
    CrossrefPubMedSearch in Google Scholar
  • 2 Kamimura M, Uchiyama S, Nakamura Y, Ikegami S, Mukaiyama K, Kato H. Short-term bisphosphonate treatment reduces serum 25(OH) vitamin D3 and alters values of parathyroid hormone, pentosidine, and bone metabolic markers.Therap Clin. Risk Manage 2017; 13: 161-168
    PubMedSearch in Google Scholar
  • 3 Holick MF. Vitamin D deficiency. . N Eng J Med 2007; 357: 266-281
    CrossrefPubMedSearch in Google Scholar
  • 4 Haq A, Svobodova J, Imran S, Stanford C, Razzaque MS. Vitamin D deficiency: A single centre analysis of patients from 136 countries. J Steroid Biochem Mol Biol 2016; 164: 209-213
    CrossrefPubMedSearch in Google Scholar
  • 5 Holick MF, Siris ES, Binkley N, Beard MK, Khan A, Katzer JT, Petruschke RA, Chen E, de Papp AE. Prevalence of Vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. J Clin Endocrinol Metab 2005; 90: 3215-3224
    CrossrefPubMedSearch in Google Scholar
  • 6 Wacker M, Holick MF. Sunlight and Vitamin D: A global perspective for health. Dermatoendocrinology 2013; 5: 51-108
    CrossrefPubMedSearch in Google Scholar
  • 7 Bouillon R. Comparative analysis of nutritional guidelines for vitamin D. Nat Rev Endocrinol 2017; 13: 466-479
    CrossrefPubMedSearch in Google Scholar
  • 8 Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Eng J Med 1992; 327: 1637-1642
    CrossrefPubMedSearch in Google Scholar
  • 9 Vaes AMM, Tieland M, de Regt MF, Wittwer J, van Loon LJC, de Groot LCPGM. Dose-response effects of supplementation with calcifediol on serum 25-hydroxyvitamin D status and its metabolites: A randomized controlled trial in older adults. Clin Nutr 2017; 37: 808-814
    PubMedSearch in Google Scholar
  • 10 Julian C, Mouratidou T, Vicente-Rodriguez G, Gracia-Marco L, Valtueña J, González-Gross M, Ferrari M, Gottrand F, Manios Y, de la OA, Widhalm K, Molnár D, Kafatos A, Sjöström M, Kersting M, Gunter MJ, De Henauw S, Moreno LA, Huybrechts I. Dietary sources and sociodemographic and lifestyle factors affecting vitamin D and calcium intakes in European adolescents: The Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) Study. Pub Health Nutr 2017; 20: 1593-1601
    CrossrefPubMedSearch in Google Scholar
  • 11 Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM. Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96: 1911-1930
    CrossrefPubMedSearch in Google Scholar
  • 12 Sun X, Cao ZB, Tanisawa K, Ito T, Oshima S, Higuchi M. Vitamin D supplementation reduces insulin resistance in Japanese adults: A secondary analysis of a double-blind, randomized, placebo-controlled trial. Nutr Res 2016; 36: 1121-1129
    CrossrefPubMedSearch in Google Scholar
  • 13 Wimalawansa SJ. Associations of vitamin D with insulin resistance, obesity, type 2 diabetes, and metabolic syndrome. J Steroid Biochem Mol Biol 2018; 175: 177-189
    CrossrefPubMedSearch in Google Scholar
  • 14 Wagner H, Alvarsson M, Mannheimer B, Degerblad M, Ostenson G. No effect of high-dose vitamin d treatment on beta-cell function, insulin sensitivity, or glucose homeostasis in subjects with abnormal glucose tolerance: A randomized clinical trial. Diabetes Care 2016; 39: 345-352
    CrossrefPubMedSearch in Google Scholar
  • 15 Holick MF, Chen TC. Vitamin D deficiency: A worldwide problem with health consequences. Am J Clin Nutr 2008; 87: 1080S-1086S
    CrossrefPubMedSearch in Google Scholar
  • 16 Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux MJ. Human serum 25–hydroxy–cholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 2003; 77: 204-210
    CrossrefPubMedSearch in Google Scholar
  • 17 Rizzoli R, Boonen S, Brandi ML, Bruyere O, Cooper C, Kanis JA. Vitamin D supplementation in elderly or postmenopausal women: A 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Curr Med Res Opin 2013; 29: 305-313
    CrossrefPubMedSearch in Google Scholar
  • 18 Cianferotti L, Cricelli C, Kanis JA, Nuti R, Reginster JY, Ringe JD, Rizzoli R, Brandi ML. The clinical use of vitamin D metabolites and their potential developments: A position statement from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the International Osteoporosis Foundation (IOF). Endocrine 2015; 50: 12-26
    CrossrefPubMedSearch in Google Scholar
  • 19 Cosman F, de Beur SJ, LeBoff MS, Lewiecki EM, Tanner B, Randall S, Lindsay R. Clinician's Guide to Prevention and Treatment of Osteoporosis [J]. Osteoporosis Int 2014; 25: 2359-2381
    CrossrefPubMedSearch in Google Scholar
  • 20 Bea JW, Jurutka PW, Hibler EA, Lance P, Martínez ME, Roe DJ, Sardo Molmenti CL, Thompson PA, Jacobs ET. Concentrations of the vitamin D metabolite 1,25(OH)2D and odds of metabolic syndrome and its components. Metabolism 2015; 64: 447-459
    CrossrefPubMedSearch in Google Scholar
  • 21 Rosen CJ, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Manson JE, Mayne ST, Ross AC, Shapses SA, Taylor CL. IOM committee members respond to Endocrine Society vitamin D guideline. J Clin Endocrinol Metab 2012; 97: 1146-1152
    CrossrefPubMedSearch in Google Scholar
  • 22 Pietras SM, Obayan BK, Cai MH, Holick MF. Vitamin D2 treatment for vitamin D deficiency and insufficiency for up to 6 years. Arch Inter Med 2009; 169: 1806-1808
    PubMedSearch in Google Scholar
  • 23 Ekwaru JP, Zwicker JD, Holick MF, Giovannucci E, Veugelers PJ. The importance of body weight for the dose response relationship of oral Vitamin D supplementation and serum 25-Hydroxyvitamin D in healthy volunteers. Plos One 2014; 9: e111265
    CrossrefPubMedSearch in Google Scholar
  • 24 Chacko SA, Song Y, Manson JE, Horn LV, Eaton C, Martin LW, McTiernan A, Curb JD, Wylie-Rosett J, Phillips LS, Plodkowski RA, Liu S. Serum 25-hydroxyvitamin D concentrations in relation to cardiometabolic risk factors and metabolic syndrome in postmenopausal women. Am J Clin Nutr 2011; 94: 209-217
    CrossrefPubMedSearch in Google Scholar
  • 25 Jungert A, Roth HJ, Neuhauser-Berthold M. Associations of serum 25-hydroxycholecalciferol and parathyroid hormone with serum lipids differ by sex and vitamin D status. Pub Health Nutr 2015; 18: 1684-1691
    CrossrefPubMedSearch in Google Scholar
  • 26 Takeuchi Y. Current Topics on Vitamin D. Treatment of osteoporosis with eldecalcitol: Its therapeutic efficacy and adverse effect on renal function. Clin Calcium 2015; 25: 425-432
    PubMedSearch in Google Scholar