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口服与肌肉注射维生素D补充剂对明显健康的维生素D缺乏成年人的影响。

Effect of oral versus intramuscular Vitamin D replacement in apparently healthy adults with Vitamin D deficiency.

作者信息

Gupta Nitin, Farooqui Khalid J, Batra Chandar M, Marwaha Raman K, Mithal Ambrish

机构信息

Department of Endocrinology, Fortis Escorts Hospital, Amritsar, Punjab, India.

Division of Endocrinology and Diabetes, Medanta the Medicity, Gurgaon, Haryana, India.

出版信息

Indian J Endocrinol Metab. 2017 Jan-Feb;21(1):131-136. doi: 10.4103/2230-8210.196007.

Abstract

CONTEXT

A number of controversies exist regarding appropriate treatment strategy for Vitamin D deficiency.

AIMS

The aim of this study was to investigate the efficacy of equivalent doses of oral cholecalciferol (60,000 IU weekly for 5 weeks) versus intramuscular (IM) cholecalciferol (300,000 IU) in correcting Vitamin D deficiency in apparently healthy volunteers working in a hospital.

SETTINGS AND DESIGN

Prospective randomized open-label single institution study.

SUBJECTS AND METHODS

This study enrolled 40 apparently healthy adults with Vitamin D deficiency into 2 arms. The oral cholecalciferol group ( = 20) received oral cholecalciferol 60,000 IU weekly for 5 weeks while the IM cholecalciferol group ( = 20) received a single injection of cholecalciferol 300,000 IU. The main outcome measure was serum 25-hydroxyvitamin D (25OHD) levels at baseline, 6 and 12 weeks after the intervention.

STATISTICAL ANALYSIS USED

Differences in serum 25OHD and other biochemical parameters at baseline and follow-up were analyzed using general linear model.

RESULTS

Mean 25OHD level at baseline was 5.99 ± 1.07 ng/mL and 7.40 ± 1.13 ng/mL ( = 0.332) in the oral cholecalciferol and IM cholecalciferol group, respectively. In the oral cholecalciferol group, serum 25OHD level was 20.20 ± 1.65 ng/mL at 6 weeks and 16.66 ± 1.36 ng/mL at 12 weeks. The corresponding serum 25OHD levels in the IM cholecalciferol group were 20.74 ± 1.81 ng/mL and 25.46 ± 1.37 ng/mL at 6 and 12 weeks, respectively. At 12 weeks, the mean 25OHD levels in IM cholecalciferol group was higher as compared to the oral cholecalciferol group (25.46 ± 1.37 vs. 16.66 ± 1.36 ng/mL; < 0.001).

CONCLUSIONS

Both oral and IM routes are effective for the treatment of Vitamin D deficiency. 25-hydroxyvitamin D levels in the IM cholecalciferol group showed a sustained increase from baseline.

摘要

背景

关于维生素D缺乏的适当治疗策略存在一些争议。

目的

本研究的目的是调查等量口服胆钙化醇(每周60,000 IU,共5周)与肌肉注射(IM)胆钙化醇(300,000 IU)在纠正一家医院中看似健康的志愿者维生素D缺乏方面的疗效。

设置与设计

前瞻性随机开放标签单机构研究。

对象与方法

本研究将40名患有维生素D缺乏的看似健康的成年人纳入两个组。口服胆钙化醇组(n = 20)每周口服60,000 IU胆钙化醇,共5周,而肌肉注射胆钙化醇组(n = 20)接受单次注射300,000 IU胆钙化醇。主要观察指标是干预前、干预后6周和12周时的血清25-羟基维生素D(25OHD)水平。

所用统计分析方法

使用一般线性模型分析基线和随访时血清25OHD及其他生化参数的差异。

结果

口服胆钙化醇组和肌肉注射胆钙化醇组基线时的平均25OHD水平分别为5.99±1.07 ng/mL和7.40±1.13 ng/mL(P = 0.332)。在口服胆钙化醇组中,6周时血清25OHD水平为20.20±1.65 ng/mL,12周时为16.66±1.36 ng/mL。肌肉注射胆钙化醇组在6周和12周时相应的血清25OHD水平分别为20.74±1.81 ng/mL和25.46±1.37 ng/mL。在12周时,肌肉注射胆钙化醇组的平均25OHD水平高于口服胆钙化醇组(25.46±1.37对16.66±1.36 ng/mL;P < 0.001)。

结论

口服和肌肉注射途径对维生素D缺乏的治疗均有效。肌肉注射胆钙化醇组的25-羟基维生素D水平从基线开始持续升高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2e5/5240054/a740c08ad587/IJEM-21-131-g003.jpg

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