Faculty of Medicine, University Institute for Primary Care, University of Geneva, Geneva, Switzerland.
Adolescent and Young Adult Clinic, Department of Woman, Child and Adolescent Health, University Hospital of Geneva, Geneva, Switzerland.
Int J Clin Pract. 2021 Dec;75(12):e14989. doi: 10.1111/ijcp.14989. Epub 2021 Nov 8.
To assess the efficacy of an oral high-dose cholecalciferol regimen in correcting vitamin D deficiency (VDD) in adolescents and to explore potential predictive factors on the response to treatment.
This is a retrospective chart review conducted in the Adolescent Outpatient Clinic, Geneva University Hospitals, Switzerland. One hundred-three otherwise healthy vitamin D deficient [serum 25-hydroxyvitamin D, 25(OH)D, level <50 nmol/L] adolescents (mean age 16.6) attending the clinic between 1 January 2016 and 31 December 2018 received 150,000 IU of oral cholecalciferol every month for 3 months (cumulative dose of 450,000 IU). We measured the change in serum 25(OH)D levels pre- and post-treatment and the achievement of serum 25(OH)D level post-treatment ≥75 nmol/L.
The mean serum 25(OH)D level increased by 320%, from 26 nmol/L at baseline to 83 nmol/L at the end of the study (P < .001). The rise was significantly higher for patients initially tested in the winter/spring (mean 65 nmol/L) compared with those initially tested in the summer/autumn (mean 48 nmol/L) (P < .003). No clear relationship was found between the response to treatment and the vitamin D status at baseline. The effect of age, gender, origin and body mass index was not statistically significant.
The present intermittent high-dose regimen is effective in treating VDD in healthy adolescents without significant variations in response between different subgroups.
评估口服大剂量胆钙化醇方案纠正青少年维生素 D 缺乏症（VDD）的疗效，并探讨治疗反应的潜在预测因素。
这是在瑞士日内瓦大学医院青少年门诊进行的回顾性图表研究。2016 年 1 月 1 日至 2018 年 12 月 31 日期间，103 名其他健康的维生素 D 缺乏症（血清 25-羟维生素 D，25（OH）D 水平<50 nmol/L）青少年在门诊接受治疗，他们每月接受 150,000 IU 口服胆钙化醇治疗，共 3 个月（累积剂量为 450,000 IU）。我们测量了治疗前后血清 25（OH）D 水平的变化以及治疗后血清 25（OH）D 水平达到≥75 nmol/L 的情况。
血清 25（OH）D 水平平均增加了 320%，从基线时的 26 nmol/L 增加到研究结束时的 83 nmol/L（P<0.001）。与夏季/秋季（平均 48 nmol/L）相比，最初在冬季/春季检测的患者（平均 65 nmol/L）的上升幅度明显更高（P<0.003）。在治疗反应与基线时的维生素 D 状态之间未发现明显关系。年龄、性别、来源和体重指数的影响无统计学意义。
目前的间歇性大剂量方案在治疗健康青少年的 VDD 方面是有效的，不同亚组之间的治疗反应没有明显差异。
