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High-dose, low-dose vitamin D confer similar bone benefits in older adults with overweight
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Healthy, older adults with overweight who are deficient in serum 25-hydroxyvitamin D assigned to a large, weekly dose of vitamin D in addition to daily supplementation saw the same gains in bone mineral density as those assigned to daily supplementation plus a weekly placebo dose, according to findings from a randomized controlled trial.
“At the time this study was launched, and until today, the adequate dose of vitamin D supplementation to minimize age-related bone loss in the elderly has been unclear,” Ghada El-Hajj Fuleihan, MD, MPH, of the WHO Collaborating Center for Metabolic Bone Disorders at the American University of Beirut Medical Center, Lebanon, and colleagues wrote. “Our findings reveal that there is little benefit in increasing vitamin D supplementation above 600 IU/day, both on BMD and bone markers.”
Fuleihan and colleagues analyzed data from 222 adults without chronic disease aged at least 65 years with BMI at least 25 kg/m² and serum 25-(OH)D level between 10 ng/mL and 30 ng/mL at baseline from 2011 to July 2013 (mean age, 71 years; 55% women; mean baseline BMI, 30.2 kg/m²; mean 25-(OH)D level, 20.4 ng/mL). All participants received 1,000 mg daily elemental calcium and 500 IU daily vitamin D3; researchers also randomly assigned patients to one weekly 10,000-IU dose of vitamin D3 (n = 129; high-dose group) or weekly placebo (n = 128; low-dose group) for 12 months. Participants returned every 3 months for follow-up, which included measurements of the spine, hip, forearm and total body composition via DXA and assessment of calciotropic hormones and bone remodeling markers. Primary outcomes were BMD and bone remodeling at 12 months.
At 12 months, mean serum 25-(OH)D levels increased from 20.9 ng/mL to 36 ng/mL in the high-dose group and from 20 ng/mL to 25.9 ng/mL in the low-dose group. In repeated-measure analysis of variance (ANOVA) models, there were no between-group differences for any mean hormonal values at 6 and 12 months, apart from parathyroid hormone and 1,25-(OH)D levels that gradually decreased in the low-dose arm, according to the researchers.
Researchers also observed no between-group differences for percent change in BMD at the femoral neck, total hip or lumbar spine. In contrast, mean percent change in subtotal body BMD was higher in the high-dose compared with the low-dose group, they noted.
“Our study findings are relevant to the growing literature on the adequate dose of vitamin D to prevent bone loss in overweight non-frail elderly with similar characteristics from the region and worldwide,” the researchers wrote. “They provide further evidence for the lack of additional skeletal benefits in vitamin D doses that exceed 600 IU/day in such populations.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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