Center for Bone Diseases, University Hospital of Lausanne, Lausanne, Switzerland.
Osteoporos Int. 2013 Feb;24(2):495-500. doi: 10.1007/s00198-012-1962-5. Epub 2012 Mar 17.
We evaluated the effectiveness of supplementation with high dose of oral vitamin D3 to correct vitamin D insufficiency. We have shown that one or two oral bolus of 300,000 IU of vitamin D3 can correct vitamin D insufficiency in 50% of patients and that the patients who benefited more from supplementation were those with the lowest baseline levels.
Adherence with daily oral supplements of vitamin D3 is suboptimal. We evaluated the effectiveness of a single high dose of oral vitamin D3 (300,000 IU) to correct vitamin D insufficiency in a rheumatologic population.
Over 1 month, 292 patients had levels of 25-OH vitamin D determined. Results were classified as: deficiency <10 ng/ml, insufficiency ≥10 to 30 ng/ml, and normal ≥30 ng/ml. We added a category using the IOM recommended cut-off of 20 ng/ml. Patients with deficient or normal levels were excluded, as well as patients already supplemented with vitamin D3. Selected patients (141) with vitamin D insufficiency (18.5 ng/ml (10.2-29.1) received a prescription for 300,000 IU of oral vitamin D3 and were asked to return after 3 (M3) and 6 months (M6). Patients still insufficient at M3 received a second prescription for 300,000 IU of oral vitamin D3. Relation between changes in 25-OH vitamin D between M3 and M0 and baseline values were assessed.
Patients (124) had a blood test at M3. Two (2%) had deficiency (8.1 ng/ml (7.5-8.7)) and 50 (40%) normal results (36.7 ng/ml (30.5-5.5)). Seventy-two (58%) were insufficient (23.6 ng/ml (13.8-29.8)) and received a second prescription for 300,000 IU of oral vitamin D3. Of the 50/124 patients who had normal results at M3 and did not receive a second prescription, 36 (72%) had a test at M6. Seventeen (47%) had normal results (34.8 ng/ml (30.3-42.8)) and 19 (53%) were insufficient (25.6 ng/ml (15.2-29.9)). Of the 72/124 patients who receive a second prescription, 54 (75%) had a test at M6. Twenty-eight (52%) had insufficiency (23.2 ng/ml (12.8-28.7)) and 26 (48%) had normal results (33.8 ng/ml (30.0-43.7)). At M3, 84% patients achieved a 25-OH vitamin D level >20 ng/ml. The lowest the baseline value, the highest the change after 3 months (negative relation with a correlation coefficient r = -0.3, p = 0.0007).
We have shown that one or two oral bolus of 300,000 IU of vitamin D3 can correct vitamin D insufficiency in 50% of patients.
我们评估了大剂量口服维生素 D3 补充剂纠正维生素 D 不足的效果。我们已经表明，一次或两次口服 300000IU 的维生素 D3 可以使 50%的患者纠正维生素 D 不足，而且从补充中获益更多的患者是那些基线水平最低的患者。
每日口服维生素 D3 补充剂的依从性并不理想。我们评估了单次大剂量口服维生素 D3（300000IU）在风湿患者中纠正维生素 D 不足的效果。
在一个月内，292 名患者测定了 25-羟维生素 D 水平。结果分为：缺乏症<10ng/ml、不足症≥10 至 30ng/ml 和正常≥30ng/ml。我们使用 IOM 推荐的 20ng/ml 截止值增加了一个类别。排除缺乏或正常水平的患者以及已经补充维生素 D3 的患者。选择 141 名维生素 D 不足（18.5ng/ml（10.2-29.1）的患者开具 300000IU 口服维生素 D3 的处方，并在 3 个月（M3）和 6 个月（M6）后要求他们返回。M3 时仍不足的患者再开 300000IU 口服维生素 D3 的处方。评估 M3 和 M0 之间 25-羟维生素 D 变化与基线值之间的关系。
124 名患者在 M3 时进行了血液检查。2 名（2%）患者有缺乏症（8.1ng/ml（7.5-8.7））和 50 名（40%）患者有正常结果（36.7ng/ml（30.5-5.5））。72 名（58%）患者有不足症（23.6ng/ml（13.8-29.8）），并接受了第二次 300000IU 口服维生素 D3 的处方。在 M3 时正常结果且未接受第二次处方的 50/124 名患者中，有 36 名（72%）在 M6 时进行了检查。17 名（47%）有正常结果（34.8ng/ml（30.3-42.8）），19 名（53%）有不足症（25.6ng/ml（15.2-29.9））。在接受第二次处方的 72/124 名患者中，54 名（75%）在 M6 时进行了检查。28 名（52%）有不足症（23.2ng/ml（12.8-28.7）），26 名（48%）有正常结果（33.8ng/ml（30.0-43.7））。在 M3 时，84%的患者达到了 25-羟维生素 D 水平>20ng/ml。基线值越低，3 个月后的变化越大（与相关系数 r=-0.3，p=0.0007 呈负相关）。
我们已经表明，一次或两次口服 300000IU 的维生素 D3 可以使 50%的患者纠正维生素 D 不足。
