Changes in the vitamin D endocrine system and bone turnover after oral vitamin D3 supplementation in healthy adults: results of a randomised trial

BMC Endocrine Disorders

Lars C Stene²  Cathrine M Lofthus¹  Haakon E Meyer³  Ahmed A Madar³  Kristin Holvik⁴ 

[1] Department of Endocrinology, Oslo University Hospital, Oslo, Norway;Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway;Institute of Health and Society, University of Oslo, Oslo, Norway;Norwegian Institute of Public Health, P.O. Box 4404, Nydalen, 0403, Oslo, Norway

关键词: Bone turnover;    Tartrate-resistant acid phosphatase;    Parathyroid hormone;    1,25-dihydroxyvitamin D;    25-hydroxyvitamin D;    Cholecalciferol;    Vitamin D3;    Randomised trial;    Supplementation;   

Others  :  1086420
DOI  :  10.1186/1472-6823-12-7

 received in 2011-08-01, accepted in 2012-06-13,  发布年份 2012

【 摘 要 】

Background

There is uncertainty as to which intake of vitamin D is needed to suppress PTH and maintain normal bone metabolism throughout winter at northern latitudes. We aimed to investigate whether four weeks’ daily supplementation with 10 μg vitamin D3 from fish oil produced a greater change in serum vitamin D metabolites, parathyroid hormone, and bone turnover in healthy adults compared with solid multivitamin tablets. Furthermore, it was studied whether age, gender, ethnic background, body mass index, or serum concentrations at baseline predicted the magnitude of change in these parameters.

Methods

Healthy adults aged 19–48 years living in Oslo, Norway (59°N) were randomised to receive a daily dose of 10 μg vitamin D3 given as fish oil capsules or multivitamin tablets during four weeks in late winter. Serum samples from baseline and after 28 days were analysed for 25-hydroxyvitamin D (s-25(OH)D), 1,25-dihydroxyvitamin D (s-1,25(OH)₂D), intact parathyroid hormone (s-iPTH), and osteoclast-specific tartrate-resistant acid phosphatase 5b (s-TRACP). Fifty-five eligible participants completed the intervention (74% of those randomised).

Results

S-25(OH)D increased by mean 34.1 (SD 13.1) nmol/l, p < 0.001; s-iPTH decreased by mean 1.2 (SD 2.5) pmol/l, p = 0.001; s-1,25(OH)₂D increased by mean 13 (SD 48) pmol/l, p = 0.057; and s-TRACP increased by mean 0.38 (SD 0.33) U/l, p < 0.001. For all these parameters, there was no difference between fish oil and multivitamin formulation. Baseline concentrations were the only independent predictors of changes in biochemical parameters.

Conclusions

Four weeks of daily supplementation with 10 μg vitamin D3 decreased mean s-iPTH and increased s-TRACP concentration, and this did not differ by mode of administration. Our results suggest an increased bone resorption following vitamin D supplementation in young individuals, despite a decrease in parathyroid hormone levels.

Trial Registration

ClinicalTrials.gov: NCT01482689

【 授权许可】

   
2012 Holvik et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Brot C, Vestergaard P, Kolthoff N, Gram J, Hermann AP, Sørensen OH: Vitamin D status and its adequacy in healthy Danish perimenopausal women: relationships to dietary intake, sun exposure and serum parathyroid hormone. Br J Nutr 2001, 86(Suppl 1):S97-S103.
• [2]Holick MF, Chen TC: Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr 2008, 87:1080S-1086S.
• [3]Pedersen JI: Vitamin D requirement and setting recommendation levels - current Nordic view. Nutr Rev 2008, 66:S165-S169.
• [4]Doets EL, de Wit LS, Dhonukshe-Rutten RA, Cavelaars AE, Raats MM, Timotijevic L, Brzozowska A, Wijnhoven TM, Pavlovic M, Totland TH, Andersen LF, Ruprich J, Pijls LT, Ashwell M, Lambert JP, Veer P, de Groot LC: Current micronutrient recommendations in Europe: towards understanding their differences and similarities. Eur J Nutr 2008, 47(Suppl 1):17-40.
• [5]Committee to Review Dietary Reference Intakes for Vitamin D and Calcium: Food and Nutrition Board: Dietary Reference Intakes for Calcium and Vitamin D. National Academies Press, Washington D.C; 2011.
• [6]Nordic Council of Ministers: Nordic Nutrition Recommendations. , Copenhagen; 2004.
• [7]Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux M: Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 2003, 77:204-210.
• [8]Viljakainen HT, Väisänen M, Kemi V, Rikkonen T, Kröger H, Laitinen EK, Rita H, Lamberg-Allardt C: Wintertime vitamin D supplementation inhibits seasonal variation of calcitropic hormones and maintains bone turnover in healthy men. J Bone Miner Res 2009, 24:346-352.
• [9]Vieth R: Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr 1999, 69:842-856.
• [10]Björkman M, Sorva A, Tilvis R: Responses of parathyroid hormone to vitamin D supplementation: a systematic review of clinical trials. Arch Gerontol Geriatr 2009, 48:160-166.
• [11]Barnes MS, Robson PJ, Bonham MP, Strain JJ, Wallace JM: Effect of vitamin D supplementation on vitamin D status and bone turnover markers in young adults. Eur J Clin Nutr 2006, 60:727-733.
• [12]Seamans KM, Hill TR, Wallace JM, Horigan G, Lucey AJ, Barnes MS, Taylor N, Bonham MP, Muldowney S, Duffy EM, Strain JJ, Kiely M, Cashman KD: Cholecalciferol supplementation throughout winter does not affect markers of bone turnover in healthy young and elderly adults. J Nutr 2010, 140:454-460.
• [13]Pignotti GA, Genaro PS, Pinheiro MM, Szejnfeld VL, Martini LA: Is a lower dose of vitamin D supplementation enough to increase 25(OH)D status in a sunny country? Eur J Nutr 2010, 49:277-283.
• [14]Holvik K, Madar AA, Meyer HE, Lofthus CM, Stene LC: A randomised comparison of increase in serum 25-hydroxyvitamin D concentration after 4 weeks of daily oral intake of 10 μg cholecalciferol from multivitamin tablets or fish oil capsules in healthy young adults. Br J Nutr 2007, 98:620-625.
• [15]Meyer HE, Holvik K, Lofthus CM, Tennakoon SU: Vitamin D status in Sri Lankans living in Sri Lanka and Norway. Br J Nutr 2008, 99:941-944.
• [16]Wicherts IS, van Schoor NM, Boeke AJ, Visser M, Deeg DJ, Smit J, Knol DL, Lips P: Vitamin D status predicts physical performance and its decline in older persons. J Clin Endocrinol Metab 2007, 92:2058-2065.
• [17]Lips P: Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 2001, 22:477-501.
• [18]Mejborn H, Brot C, Hansen HB, Koch B, Hyldstrup L, Mortensen L, Mosekilde L, Mølgård C, Petersen T, Rasmussen SE, Rasmussen LB: D-vitaminstatus i den danske befolkning bør forbedres (Vitamin D status in the Danish population should be improved). Danish Ministry of Food, Agriculture and Fisheries, Copenhagen; 2004.
• [19]Meyer HE, Brunvand L, Brustad M, Holvik K, Johansson L, Paulsen JE: Tiltak for å sikre en god vitamin D-status i befolkningen (Measures to ensure a good vitamin D status in the population). Norwegian National Nutrition Council, Oslo; 2006.
• [20]Bischoff-Ferrari H: Vitamin D: What is an adequate vitamin D level and how much supplementation is necessary? Best Pract Res Clin Rheumatol 2009, 23:789-795.
• [21]Henriksen K, Tanko LB, Qvist P, Delmas PD, Christiansen C, Karsdal MA: Assessment of osteoclast number and function: application in the development of new and improved treatment modalities for bone diseases. Osteoporos Int 2007, 18:681-685.
• [22]Matkovic V, Jelic T, Wardlaw GM, Ilich JZ, Goel PK, Wright JK, Andon MB, Smith KT, Heaney RP: Timing of peak bone mass in Caucasian females and its implication for the prevention of osteoporosis. Inference from a cross-sectional model. J Clin Invest 1994, 93:799-808.
• [23]Kogawa M, Anderson PH, Findlay DM, Morris HA, Atkins GJ: The metabolism of 25-(OH)vitamin D3 by osteoclasts and their precursors regulates the differentiation of osteoclasts. J Steroid Biochem Mol Biol 2010, 121:277-280.
• [24]Anderson PH, Atkins GJ: The skeleton as an intracrine organ for vitamin D metabolism. Mol Aspects Med 2008, 29:397-406.
• [25]Poulsen RC, Moughan PJ, Kruger MC: Long-chain polyunsaturated fatty acids and the regulation of bone metabolism. Exp Biol Med 2007, 232:1275-1288.
• [26]Salari P, Rezaie A, Larijani B, Abdollahi M: A systematic review of the impact of n-3 fatty acids in bone health and osteoporosis. Med Sci Monit 2008, 14:RA37-RA44.
• [27]Sun D, Krishnan A, Zaman K, Lawrence R, Bhattacharya A, Fernandes G: Dietary n-3 fatty acids decrease osteoclastogenesis and loss of bone mass in ovariectomized mice. J Bone Miner Res 2003, 18:1206-1216.
• [28]Ahmadieh H, Arabi A: Vitamins and bone health: beyond calcium and vitamin D. Nutr Rev 2011, 69:584-598.