25-OHD response to vitamin D supplementation in children: effect of dose but not GC haplotype

in European Journal of Endocrinology
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  • 1 Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
  • | 2 Veterans Administration Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, Connecticut, USA
  • | 3 Department of Chronic Diseases, Metabolism and Ageing, Laboratory of Clinical and Experimental Endocrinology, Katholieke Universiteit Leuven, Belgium
  • | 4 Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
  • | 5 Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • | 6 Departments of Laboratory Medicine and Pathobiology, Medicine, and Genetics, University of Toronto, and Sunnybrook Health Center, Toronto, Ontario, Canada
  • | 7 Department of Pediatrics (Endocrinology), Yale University School of Medicine, New Haven, Connecticut, USA

Correspondence should be addressed to T O Carpenter Email thomas.carpenter@yale.edu
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Objective

GC/DBP effects on response to vitamin D supplementation have not been well-studied. Thus we assessed free and total 25-OHD after vitamin D treatment across the six common GC haplotypes.

Design

This double-blind, randomized study compared two vitamin D3 doses in healthy, urban-dwelling 6-month to 10-year-old children at-risk for vitamin D deficiency. Randomization was stratified by GC haplotype.

Methods

Children were randomized to receive 2800 or 7000 International Units of vitamin D3 weekly. 25-OHD and 1,25(OH)2D were sampled at baseline and after 1–6 months of supplementation.

Results and conclusions

One hundred ninety-two of 225 enrolled subjects completed the study. After one month, total 25-OHD increased with both doses and were higher with 7000 IU/week (85.5 ± 22.8 nmol/L) compared to 2800 IU/week (76.8 ± 18.0 nmol/L), despite equivalent baseline levels. No further significant increase occurred at 6 months (89.8 ± 35.5 and 74.3 ± 18.3 nmol/L, respectively). Free 25-OHD similarly changed. 25-OHD differed among GC groups at baseline. Although no significant effects of individual GC haplotypes on incremental changes were evident, a trend toward an effect of combined 'at risk' GC alleles on response was evident (P = 0.06). Total 1,25(OH)2D showed modest increases, moreso with the larger dose. In urban-dwelling children at-risk for vitamin D deficiency, 1 month of vitamin D3 2800 IU/week increased 25-OHD across all GC haplotype groups, and somewhat enhanced with 7000 IU/week with no further significant increases after 6 months of supplementation. Free 25-OHD measures offer no monitoring advantage over total 25-OHD.

Supplementary Materials

    • supplemental figure 1

 

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