This article is more than 5 years old. Information may no longer be current.
High-dose colecalciferol may not alleviate vitamin D deficiency in overweight, obesity
Click Here to Manage Email Alerts
Adults with overweight and obesity treated with a high dose of oral colecalciferol may not achieve sufficient vitamin D levels compared with adults with normal weight, study data show.
“It can take up to 3 months for vitamin D levels to stabilize following oral vitamin D replacement, and hence, it is clinically significant to note much lower 25-[hydroxyvitamin] D levels at 6 months in the overweight and obese cohorts along with far fewer patients maintaining target levels of greater than 75 nmol/L–1 at 6 months in these groups,” the researchers wrote.
Rhodri J. Kong, MD, of the department for endocrinology and diabetes, St. James’ University Hospital in the United Kingdom, and colleagues evaluated 173 adults (mean age, 55 years) who received a 300,000 IU oral loading dose of colecalciferol between 2009 and 2014 to determine the effect of BMI on vitamin D levels. Participants were divided into four groups based on weight: normal weight (20-24.9 kg/m2; n = 38), overweight (25-29.9 kg/m2; n = 73), obese class I (30-34.9 kg/m2; n = 33) or obese class II and above (> 35 kg/m2; n = 29).
The main indications for vitamin D replacement were osteoporosis/osteopenia and symptomatic vitamin D deficiency.
At 6 weeks, all groups had significant increases in total serum 25-(OH)D levels; however, increases were lower in the overweight and obese groups compared with the normal-weight group. Over time, total 25-(OH)D levels fell and did so at a greater rate in the overweight and obese groups compared with the normal-weight group. At 52 weeks, there were no significant differences between the groups for mean total 25-(OH)D levels.
Total 25-(OH)D levels above the recommended target of 75 nmol/L–1 at 6 months was achieved by more participants in the normal-weight group compared with the overweight group (P = .0003), obese class I group (P = .01) and obese class II and above group (P = .001). At 6 months, 6% of the normal-weight group had total 25-(OH)D levels less than 50 nmol/L–1 compared with 32% in the overweight group, 15% in the obese class I group and 35% in the obese class II and above group.
Mean parathyroid hormone levels fell in all participants at 6 weeks, and the highest levels were found in the highest BMI category compared with the normal-weight category.
“In order to minimize the decline in bone density in obese patients following bariatric surgery and thus help reduce fracture risk, correcting vitamin D deficiency and insufficiency preoperatively is important, aiming for total 25-(OH)D levels above 75 nmol/L–1,” the researchers wrote. “High-dose oral colecalciferol has been associated with increased risks of falls and fracture in the elderly, and therefore, combined with the evidence presented here and elsewhere, it may be that an alternative loading regimen, such as 40,000-50,000 IU once per week, would achieve superior results. Further randomized studies are required to determine the optimal replacement dose for obese patients with vitamin D deficiency prebariatric surgery in addition to the most appropriate maintenance regime postoperatively.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts