口服维生素 D2 与维生素 D3 对维生素 D 代谢的影响差异：一项随机对照试验。
Differential Effects of Oral Boluses of Vitamin D2 vs Vitamin D3 on Vitamin D Metabolism: A Randomized Controlled Trial.
机构信息
Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.
Department of Pharmaceutics, University of Washington, Seattle, Washington.
出版信息
J Clin Endocrinol Metab. 2019 Dec 1;104(12):5831-5839. doi: 10.1210/jc.2019-00207.
CONTEXT
Vitamin D2 and vitamin D3 have been hypothesized to exert differential effects on vitamin D metabolism.
OBJECTIVE
To compare the influence of administering vitamin D2 vs vitamin D3 on metabolism of vitamin D3.
METHODS
We measured baseline and 4-month serum concentrations of vitamin D3, 25-hydroxyvitamin D3 [25(OH)D3], 25-hydroxyvitamin D2, 24R,25-dihydroxyvitamin D3 [24R,25(OH)2D3], 1α,25-dihydroxyvitamin D3 [1α,25(OH)2D3], and 4β,25-dihydroxyvitamin D3 [4β,25(OH)2D3] in 52 adults randomized to receive a total of four oral bolus doses of 2.5 mg vitamin D2 (n = 28) or vitamin D3 (n = 24) over four months. Metabolite-to-parent compound ratios were calculated to estimate hydroxylase activity. Pairwise before vs after comparisons were made to evaluate effects of vitamin D2 and vitamin D3 on metabolism of vitamin D. Mean postsupplementation metabolite-to-parent ratios were then compared between groups.
RESULTS
Vitamin D2 was less effective than vitamin D3 in elevating total serum 25(OH)D concentration. Vitamin D2 suppressed mean four-month serum concentrations of 25(OH)D3, 24R,25(OH)2D3, 1α,25(OH)2D3, and 4β,25(OH)2D3 and mean ratios of 25(OH)D3 to D3 and 1α,25(OH)2D3 to 25(OH)D3, while increasing the mean ratio of 24R,25(OH)2D3 to 25(OH)D3. Vitamin D3 increased mean four-month serum concentrations of 25(OH)D3, 24R,25(OH)2D3, 1α,25(OH)2D3, and 4β,25(OH)2D3 and the mean ratio of 24R,25(OH)2D3 to 25(OH)D3. Participants receiving vitamin D2 had lower mean postsupplementation ratios of 25(OH)D3 to vitamin D3 and 1α,25(OH)2D3 to 25(OH)D3 than those receiving vitamin D3. Mean postsupplementation ratios of 24R,25(OH)2D3 to 25(OH)D3 and 4β,25(OH)2D3 to 25(OH)D3 did not differ between groups.
CONCLUSIONS
Bolus-dose vitamin D2 is less effective than bolus-dose vitamin D3 in elevating total serum 25(OH)D concentration. Administration of vitamin D2 reduces 25-hydroxylation of vitamin D3 and 1-α hydroxylation of 25(OH)D3, while increasing 24R-hydroxylation of 25(OH)D3.
背景
维生素 D2 和维生素 D3 被假设对维生素 D 代谢有不同的影响。
目的
比较给予维生素 D2 与维生素 D3 对维生素 D3 代谢的影响。
方法
我们测量了 52 名成年人在四个月内的基线和血清维生素 D3、25-羟维生素 D3 [25(OH)D3]、25-羟维生素 D2、24R,25-二羟维生素 D3 [24R,25(OH)2D3]、1α,25-二羟维生素 D3 [1α,25(OH)2D3]和 4β,25-二羟维生素 D3 [4β,25(OH)2D3]的浓度，这些成年人被随机分为两组，每组 28 人，共接受四剂 2.5 毫克维生素 D2 或 24 人接受四剂维生素 D3 的口服冲击剂量，共四个月。计算代谢物与母体化合物的比值，以估计羟化酶活性。进行了前后比较，以评估维生素 D2 和维生素 D3 对维生素 D 代谢的影响。然后比较两组之间补充后的平均代谢物与母体比值。
结果
维生素 D2 升高血清总 25(OH)D 浓度的效果不如维生素 D3。维生素 D2 抑制了四个月时血清 25(OH)D3、24R,25(OH)2D3、1α,25(OH)2D3 和 4β,25(OH)2D3 的平均浓度，以及 25(OH)D3 与 D3 和 1α,25(OH)2D3 与 25(OH)D3 的平均比值，同时增加了 24R,25(OH)2D3 与 25(OH)D3 的平均比值。维生素 D3 增加了四个月时血清 25(OH)D3、24R,25(OH)2D3、1α,25(OH)2D3 和 4β,25(OH)2D3 的平均浓度，以及 24R,25(OH)2D3 与 25(OH)D3 的平均比值。与服用维生素 D3 的患者相比，服用维生素 D2 的患者补充后的 25(OH)D3 与维生素 D3 和 1α,25(OH)2D3 与 25(OH)D3 的平均比值较低。24R,25(OH)2D3 与 25(OH)D3 和 4β,25(OH)2D3 与 25(OH)D3 的平均比值在两组之间无差异。
结论
冲击剂量的维生素 D2 升高血清总 25(OH)D 浓度的效果不如冲击剂量的维生素 D3。给予维生素 D2 可减少维生素 D3 的 25-羟化和 25(OH)D3 的 1-α羟化，同时增加 25(OH)D3 的 24R-羟化。
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