A Predictive Equation to Guide Vitamin D Replacement Dose in Patients

Singh, Gurmukh; Bonham, Aaron J.

doi:10.3122/jabfm.2014.04.130306

Cited by 41 publications

(35 citation statements)

References 74 publications

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“…BMI has been linked to 25(OH)D levels, as well as to the response to oral vitamin D supplementation [30],[31]. Previous studies, as well as our results, suggest that subjects with a higher BMI have lower increase in vitamin D levels and may require higher vitamin D dosing [30]–[32].…”

Section: Discussionsupporting

confidence: 62%

Multiple sclerosis patients have a diminished serologic response to vitamin D supplementation compared to healthy controls

et al. 2015

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Background Vitamin D insufficiency is a risk factor for MS, and patients don’t always show the expected response to vitamin D supplementation. Objective To determine if vitamin D supplementation leads to a similar increase in serum 25-hydroxyvitamin-D (25(OH)D) levels in MS patients and healthy controls (HCs). Methods Participants in this open-label study were female, white, aged 18–60 years, had 25(OH)D levels ≤ 75 nmol/L at screening, and had RRMS or were HCs. Participants received 5,000 IU/day of vitamin D3 for 90 days. Utilizing generalized estimating equations we examined the relationship between the primary outcome (serum 25(OH)D level) and the primary (MS versus HC status) and secondary predictors. Results 27 MS patients and 30 HCs were enrolled. There was no significant difference in baseline 25(OH)D level or demographics except for higher body mass index (BMI) in the MS group (25.3 vs 23.6 kg/m2, p=0.035). 24 MS subjects and 29 HCs completed the study. In a multivariate model accounting for BMI, medication adherence, and oral contraceptive use, MS patients had a 16.7 nmol/L (95%CI: 4.2, 29.2, p=0.008) lower increase in 25(OH)D levels compared to HCs. Conclusions MS patients had a lower increase in 25(OH)D levels with supplementation, even after accounting for putative confounders.

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Section: Discussionsupporting

confidence: 62%

Multiple sclerosis patients have a diminished serologic response to vitamin D supplementation compared to healthy controls

et al. 2015

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“…26,27 A recently reported 3-month dose-response study of African Americans by Ng and colleagues 28 did not consider or report body weight, but the average body mass index of the participants was 31.2 kg/m 2 . Three treatment groups received doses of 1000, 2000, and 4000 IU/day and achieved 25(OH)D concentrations of 29.7 (up 13.5 from this group's baseline), 34.8 (up 20.9), and 45.9 ng/mL (up 30.2 ng/mL), respectively.…”

Section: Figure 1 Probability Of Vitamin D Deficiency By Body Weightmentioning

confidence: 99%

Probability of Vitamin D Deficiency by Body Weight and Race/Ethnicity

Weishaar

Rajan

Keller

2016

The Journal of the American Board of Family Medicine

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Introduction: While most physicians recognize that vitamin D status varies by skin color because darker skin requires more light to synthesize vitamin D than lighter skin, the importance of body weight to vitamin D status is a newer, less recognized, finding. The purpose of this study was to use nationally representative US data to determine the probability of vitamin D deficiency by body weight and skin color.Methods: Using data for individuals age >6 years from the 2001 to 2010 cycles of the US National Health and Nutrition Examination Survey, we calculated the effect of skin color, body weight, and age on vitamin D status. We determined the probability of deficiency within the normal range of body weight for 3 race/ethnicity groups at 3 target levels of 25-hydroxyvitamin D.Results

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“…We compared the supplemented dose of vitamin D3 to the calculated need, using the formula of Singh et al ,. that considers age, body mass index, and albumin levels in addition to the baseline 25(OH)D level.…”

Section: Resultsmentioning

confidence: 99%

Vitamin D deficiency and supplementation in patients with aggressive B‐cell lymphomas treated with immunochemotherapy

et al. 2017

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Vitamin D deficiency has been reported to be a negative prognostic factor in elderly patients with aggressive B‐cell lymphomas. In vitro data suggest that vitamin D supplementation may enhance rituximab‐mediated cytotoxicity. We prospectively assessed 25‐hydroxyvitamin D [25(OH)D] levels at diagnosis in a cohort of 155 patients with aggressive B‐cell lymphomas of whom 128 had diffuse large B‐cell lymphoma (DLBCL) not otherwise specified. 25(OH)D levels were deficient (<20 ng/mL) in 105 (67%), insufficient (20–29 ng/mL) in 32 (21%), and normal (≥30 ng/mL) in 18 (12%) patients with a seasonal variation. Patient characteristics associated with lower 25(OH)D levels were poor performance status, overweight, B‐symptoms, elevated LDH, lower albumin and hemoglobin levels. As a result of a change in practice pattern, 116 patients received vitamin D3 (cholecalciferol) supplementation that included a loading phase with daily replacement and subsequent maintenance phase with a weekly dose of 25,000 IU until end of treatment. This resulted in a significant increase in 25(OH)D levels, with normalization in 56% of patients. We analyzed the impact of 25(OH)D levels on event‐free survival in patients treated with Rituximab‐CHOP. 25(OH)D levels below 20 ng/mL at diagnosis and IPI were independently associated with inferior EFS. Moreover, patients with normalized 25(OH)D levels following supplementation showed better EFS than patients with persistently deficient/insufficient 25(OH)D levels. Our study provides the first evidence that achievement of normal 25(OH)D levels after vitamin D3 supplementation is associated with improved outcome in patients with DLBCL and deficient/insufficient 25(OH)D levels when receiving rituximab‐based treatment.

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A Predictive Equation to Guide Vitamin D Replacement Dose in Patients

Cited by 41 publications

References 74 publications

Multiple sclerosis patients have a diminished serologic response to vitamin D supplementation compared to healthy controls

Multiple sclerosis patients have a diminished serologic response to vitamin D supplementation compared to healthy controls

Probability of Vitamin D Deficiency by Body Weight and Race/Ethnicity

Vitamin D deficiency and supplementation in patients with aggressive B‐cell lymphomas treated with immunochemotherapy

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