单次“超大肌肉注射剂量”维生素D对血清25羟维生素D及甲状旁腺激素水平的影响

Response of a single 'mega intramuscular dose' of vitamin D on serum 25OHD and parathyroid hormone levels.

作者信息

Khan Aysha Habib, Rohra Dileep K, Saghir Shakil A, Udani Shamsa K, Wood Richard, Jabbar Abdul

机构信息

Department of Pathology and Microbiology, The Aga Khan University Hospital, Karachi.

出版信息

J Coll Physicians Surg Pak. 2012 Apr;22(4):207-12.

PMID:22482374

Abstract

OBJECTIVE

To determine the changes produced in serum 25OHD and iPTH levels after 600,000 IU of injection cholecalciferol in volunteers.

STUDY DESIGN

Interventional study.

PLACE AND DURATION OF STUDY

Section of Chemical Pathology, Department of Pathology and Microbiology, the Aga Khan University Hospital, Karachi, from June 2009 - June 2010.

METHODOLOGY

Volunteers of either gender aged 18-40 years with known 25OHD, calcium (Ca), creatinine (Cr) and phosphorous (P) levels were included in the study. Subjects on therapy like vitamin D and calcium supplements, corticosteroids or anti-epileptic medicines, primary hyperparathyroidism and hypercalcaemia, with co-morbidity like renal failure, liver disease and history of malabsorption, diarrhea or hyperthyroidism were excluded. All volunteers were given an intramuscular injection of vitamin D3 (cholecalciferol, 600,000 IU). After 8 weeks, serum 25OHD, iPTH, Ca and P levels were determined again. For 25OHD level, cut-off of ² 50 nmol/l was defined as deficient, 50-75 nmol/l as insufficient and ³ 75 as optimal level.

RESULTS

Mean 25OHD and iPTH levels were 35.06 ± 16.6 nmol/l and 81.15 ± 76.78 pg/ml respectively at baseline. Seventeen volunteers were 25OHD deficient. Five had high iPTH levels (25%) (mean 156 ± 123.7 pg/ml). 25OHD and iPTH showed a significant inverse correlation at baseline (< 0.01). After 8 weeks of injection vitamin D 25OHD levels became optimal in 6 subjects (35%) [mean 92.9 ± 16.6 nmol/l]. It remained low in 5 volunteers (25%) [mean 41.6 ± 9.6 nmol/l] while insufficient levels were seen in 9 volunteers (40%) [mean 63.3±5.8 nmol/l]. Follow-up mean Ca, P and iPTH were 2.25 mmol/l (± 0.09), 1.1 (± 0.1) and 47.52 pg/ml (± 22.56) respectively. A significant increase in mean 25OHD level was seen at follow-up (p < 0.01), while the change in PTH was insignificant (p=0.05).

CONCLUSION

Single mega-dose of cholecalciferol achieved optimal levels of 25OHD in 35% of subjects after eight weeks of supplementation.

摘要

目的

确定60万国际单位注射用胆钙化醇对志愿者血清25羟维生素D（25OHD）和全段甲状旁腺激素（iPTH）水平产生的变化。

研究设计

干预性研究。

研究地点及时间

2009年6月至2010年6月，卡拉奇阿迦汗大学医院病理与微生物学系化学病理学组。

方法

纳入年龄在18 - 40岁、已知25OHD、钙（Ca）、肌酐（Cr）和磷（P）水平的男女志愿者。排除正在接受维生素D和钙补充剂、皮质类固醇或抗癫痫药物治疗的受试者，以及患有原发性甲状旁腺功能亢进和高钙血症、伴有肾衰竭及肝脏疾病、有吸收不良、腹泻或甲状腺功能亢进病史的受试者。所有志愿者均接受维生素D3（胆钙化醇，60万国际单位）肌肉注射。8周后，再次测定血清25OHD、iPTH、Ca和P水平。对于25OHD水平，低于50 nmol/l定义为缺乏，50 - 75 nmol/l为不足，≥75 nmol/l为最佳水平。

结果

基线时25OHD和iPTH的平均水平分别为35.06±16.6 nmol/l和81.15±76.78 pg/ml。17名志愿者存在25OHD缺乏。5名志愿者iPTH水平较高（25%）（平均156±123.7 pg/ml）。基线时25OHD和iPTH呈显著负相关（<0.01）。注射维生素D 8周后，6名受试者（35%）的25OHD水平达到最佳[平均92.9±16.6 nmol/l]。5名志愿者（25%）的水平仍较低[平均41.6±9.6 nmol/l]，9名志愿者（40%）的水平不足[平均63.3±5.8 nmol/l]。随访时Ca、P和iPTH的平均水平分别为2.25 mmol/l（±0.09）、1.1（±0.1）和47.52 pg/ml（±22.56）。随访时25OHD平均水平显著升高（p < 0.01），而甲状旁腺激素的变化不显著（p = 0.05）。