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每周 250μg 的维生素 D 剂量与每天 50μg 的剂量对健康成年人同样有效,但每周 4 次、随后每月 1250μg 的方案会增加高钙尿症的风险。

A 250 μg/week dose of vitamin D was as effective as a 50 μg/d dose in healthy adults, but a regimen of four weekly followed by monthly doses of 1250 μg raised the risk of hypercalciuria.

机构信息

Division of Space Life Sciences, Universities Space Research Association, Houston, TX, USA.

出版信息

Br J Nutr. 2013 Nov;110(10):1866-72. doi: 10.1017/S000711451300113X. Epub 2013 Apr 18.

Abstract

The risk of vitamin D insufficiency is increased in persons having limited sunlight exposure and dietary vitamin D. Supplementation compliance might be improved with larger doses taken less often, but this may increase the potential for side effects. The objective of the present study was to determine whether a weekly or weekly/monthly regimen of vitamin D supplementation is as effective as daily supplementation without increasing the risk of side effects. Participants were forty-eight healthy adults who were randomly assigned for 3 months to placebo or one of three supplementation regimens: 50 μg/d (2000 IU/d, analysed dose 70 μg/d), 250 μg/week (10 000 IU/week, analysed dose 331 μg/week) or 1250 μg/week (50 000 IU/week, analysed dose 1544 μg/week) for 4 weeks and then 1250 μg/ month for 2 months. Daily and weekly doses were equally effective at increasing serum 25-hydroxyvitamin D, which was significantly greater than baseline in all the supplemented groups after 30 d of treatment. Subjects in the 1250 μg treatment group, who had a BMI >26 kg/m2, had a steady increase in urinary Ca in the first 3 weeks of supplementation, and, overall, the relative risk of hypercalciuria was higher in the 1250 μg group than in the placebo group (P=0·01). Although vitamin D supplementation remains a controversial issue, these data document that supplementing with ≤ 250 mg/week (≤ 10 000 IU/week) can improve or maintain vitamin D status in healthy populations without the risk of hypercalciuria, but 24 h urinary Ca excretion should be evaluated in healthy persons receiving vitamin D3 supplementation in weekly single doses of 1250 μg (50 000 IU).

摘要

维生素 D 不足的风险在阳光照射和饮食维生素 D 有限的人群中增加。通过减少服用频率但增加剂量,可提高补充剂的依从性,但这可能会增加副作用的风险。本研究的目的是确定每周或每周/每月的维生素 D 补充方案是否与每日补充一样有效,而不会增加副作用的风险。研究对象为 48 名健康成年人,他们被随机分配 3 个月的安慰剂或三种补充方案之一:50μg/d(2000IU/d,分析剂量 70μg/d)、250μg/周(10000IU/周,分析剂量 331μg/周)或 1250μg/周(50000IU/周,分析剂量 1544μg/周),连续 4 周,然后连续 2 个月每月 1250μg。每日和每周剂量在增加血清 25-羟维生素 D 方面同样有效,所有补充组在治疗 30d 后血清 25-羟维生素 D 均显著高于基线。BMI>26kg/m2 的 1250μg 治疗组患者在补充的前 3 周内尿液钙持续增加,总体而言,1250μg 组发生高钙尿症的相对风险高于安慰剂组(P=0.01)。尽管维生素 D 补充仍然存在争议,但这些数据表明,每周补充≤250mg(每周≤10000IU)可改善或维持健康人群的维生素 D 状态,而不会发生高钙尿症,但应评估每周单次剂量为 1250μg(50000IU)接受维生素 D3 补充的健康人 24h 尿钙排泄情况。

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