Magge Sheela N, Prasad Divya, Zemel Babette S, Kelly Andrea
Division of Pediatric Endocrinology, Johns Hopkins University School of Medicine, United States.
Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, United States.
J Clin Transl Endocrinol. 2018 Mar 21;12:1-7. doi: 10.1016/j.jcte.2018.03.001. eCollection 2018 Jun.
Obese, African-American (AA) adolescents are at increased risk for vitamin D deficiency. The primary objective of this pilot study was to examine the effect of vitamin D supplementation upon 25-hydroxy vitamin D (25OHD) levels in obese, AA adolescents.
A randomized, double-blinded, controlled pilot study included 26 obese (BMI ≥ 95%ile), vitamin D deficient (25OHD < 20 ng/mL), pubertal AA adolescents (ages 12-17). Subjects received cholecalciferol 1000 IU or 5000 IU daily for 3 months. Serum 25OHD, vitamin D binding protein, parathyroid hormone, and cardiometabolic risk markers were obtained at baseline and post-treatment.
Of 39 subjects enrolled, 26 (67%) were vitamin D deficient (mean 25OHD 12.0 ± 3.8 ng/mL) at baseline and were randomized, with 22 completing the study. Sex, age, season, pubertal stage, BMI, insulin resistance (HOMA-IR) and 25OHD were similar at baseline between the 1000 IU and 5000 IU groups. Post-treatment, 25OHD increased less in the 1000 IU group (5.6 ng/mL, p = 0.03) vs. the 5000 IU group (15.6 ng/mL, p = 0.002). 83% of the 5000 IU group and 30% of the 1000 IU group reached post-treatment 25OHD ≥ 20 ng/mL (p = 0.01); 50% of the 5000 IU group, but no subject from the 1000 IU group, achieved 25OHD ≥ 30 ng/mL (p = 0.009). We detected no group differences in mineral metabolites or cardiometabolic risk markers following supplementation.
Cholecalciferol dosing in excess of the current Institute of Medicine dietary reference intakes was required to achieve 25OHD levels ≥20 ng/mL in obese, AA adolescents. Supplementation of 5000 IU may be required to achieve the desired goal.
肥胖的非裔美国(AA)青少年维生素D缺乏风险增加。本初步研究的主要目的是检验补充维生素D对肥胖AA青少年25-羟基维生素D(25OHD)水平的影响。
一项随机、双盲、对照的初步研究纳入了26名肥胖(BMI≥95%百分位数)、维生素D缺乏(25OHD<20 ng/mL)的青春期AA青少年(年龄12 - 17岁)。受试者每日接受1000 IU或5000 IU胆钙化醇,持续3个月。在基线和治疗后获取血清25OHD、维生素D结合蛋白、甲状旁腺激素和心脏代谢风险标志物。
在纳入的39名受试者中,26名(67%)在基线时维生素D缺乏(平均25OHD 12.0±3.8 ng/mL)并被随机分组,22名完成了研究。1000 IU组和5000 IU组在基线时的性别、年龄、季节、青春期阶段、BMI、胰岛素抵抗(HOMA-IR)和25OHD相似。治疗后,1000 IU组25OHD的升高幅度(5.6 ng/mL,p = 0.03)小于5000 IU组(15.6 ng/mL,p = 0.002)。5000 IU组的83%和1000 IU组的30%治疗后25OHD≥20 ng/mL(p = 0.01);5000 IU组的50%达到25OHD≥30 ng/mL,但1000 IU组无受试者达到此水平(p = 0.009)。补充后,我们未检测到两组在矿物质代谢物或心脏代谢风险标志物方面的差异。
肥胖的AA青少年需要摄入超过当前医学研究所膳食参考摄入量的胆钙化醇剂量才能使25OHD水平≥20 ng/mL。可能需要补充5000 IU才能达到理想目标。