Bian Pingda, Jin Xue, Shou Zhangxuan
Department of Geriatrics, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Clinical Pharmacy Center, Department of Pharmacy, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Int J Endocrinol. 2021 Oct 18;2021:1343913. doi: 10.1155/2021/1343913. eCollection 2021.
Vitamin D deficiency is highly prevalent among the very elderly and is associated with a wide variety of clinical conditions other than musculoskeletal diseases. This study aims to ascertain the efficacy and safety of high-dose intramuscular vitamin D2 in very elderly Chinese patients with vitamin D deficiency.
Very elderly (aged 80 years or over) Chinese patients with vitamin D deficiency were recruited to receive monthly intramuscular injections of 600,000 IU vitamin D2 until their serum 25-hydroxyvitamin D (25(OH)D) reached ≥30 ng/mL. The serum levels of 25(OH)D2, 25(OH)D3, iPTH, BTMs, immune parameters, and other biochemical parameters were measured at baseline and one month after each dose.
Of the 30 very elderly Chinese patients who had been recruited into the study, 27 (90.0%) had their vitamin D deficiency corrected, and 26 (86.7%) reached vitamin D sufficiency. The mean time (±SD) was 3.1 (±1.3) months for vitamin D deficiency to be corrected, and 6.1 (±0.8) months for vitamin D sufficiency to be reached. The mean (±SD) serum level of 25(OH)D2 increased from 0.69 (±1.51) ng/mL to 29.07 (±5.68) ng/mL, while the mean (±SD) serum level of 25(OH)D3 decreased from 9.82 (±2.75) ng/mL to 5.30 (±3.09) ng/mL (both < 0.001). The total T cells in serum remained unchanged ( > 0.05), and the CD4 and B cells (CD19+) were increased significantly (both < 0.05). In addition, no significant change was observed in the serum levels of iPTH and BTMs.
Monthly intramuscular injection of 600,000 IU vitamin D2 is an effective and safe dosing regimen to reach vitamin D sufficiency and enhances immune function in the very elderly Chinese patients with vitamin D deficiency.
维生素D缺乏在高龄人群中极为普遍，且与多种非肌肉骨骼疾病的临床状况相关。本研究旨在确定大剂量肌肉注射维生素D2对高龄中国维生素D缺乏患者的疗效和安全性。
招募高龄（80岁及以上）中国维生素D缺乏患者，每月肌肉注射60万IU维生素D2，直至其血清25-羟基维生素D（25(OH)D）达到≥30 ng/mL。在基线以及每次给药后1个月测量血清25(OH)D2、25(OH)D3、iPTH、骨转换标志物（BTMs）、免疫参数及其他生化参数。
纳入本研究的30例高龄中国患者中，27例（90.0%）维生素D缺乏得到纠正，26例（86.7%）达到维生素D充足。维生素D缺乏得到纠正的平均时间（±标准差）为3.1（±1.3）个月，达到维生素D充足的平均时间为6.1（±0.8）个月。25(OH)D2的平均（±标准差）血清水平从0.69（±1.51）ng/mL升至29.07（±5.68）ng/mL，而25(OH)D3的平均（±标准差）血清水平从9.82（±2.75）ng/mL降至5.30（±3.09）ng/mL（均P<0.001）。血清总T细胞保持不变（P>0.05），CD4和B细胞（CD19+）显著增加（均P<0.05）。此外，iPTH和BTMs的血清水平未观察到显著变化。
每月肌肉注射60万IU维生素D2是使高龄中国维生素D缺乏患者达到维生素D充足并增强免疫功能的有效且安全的给药方案。
