Prevention of hypovitaminosis D in the elderly

McKenna, Malachi J.; Freaney, R.; Meade, Aiden; Muldowney, Francis P.

doi:10.1007/bf02554828

Cited by 40 publications

(15 citation statements)

References 13 publications

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“…In a study with low intakes of vitamin D (800 UI/day) administered to institutionalised older people over 16 months with severe hypovitaminosis D, the dose response curve found was 3.6 ng/ml per each 100 UI/day, nearly 4 times higher than that predicted by the Endocrine Society. Using the IOM's regression equation, the predicted value was 26 ng/ml for an intake of 800 UI/day, similar to that observed, of 31.9 ng/ml, and clearly higher than that predicted by the Endocrine Society rules (an increase of 8 ng/ml) 7,8 . Following this observation, and with the aim of confirming the appropriateness of the rules for the dose-response relationship from the two associations, 41 available works have been studied in which the daily doses administered were lower than 2,000 UI/day, with a duration greater than 3 months and with baseline and final measurements of 25OH vitamin D. The changes in these levels were compared with those predicted by the IOM and Endocrine Society formulae (see above), as well as the regression equation for Vitamin D Supplementation in Older Subjects (ViDOS) (25OHD (nmol/l) = 54.5 + 24.6 x dose/1,000 -2.5 x dose 2 /1,000 2 ) 15 .…”

Section: Rules For the Calculation Of The Replacement Dose For Vitamin Dsupporting

confidence: 79%

“…These recommendations were based on the absence of proven benefits of blood concentrations of 25OH vitamin D above 20 ng/ml and the potential risks -nephrolithiasis and tissue damage -putting an end to the theory "more is better" which prevailed at that time 4 . In terms of the daily necessary intake to reach these sufficient blood levels the IOM indicated a dose response curve between intake and associated blood levels which are summarised in the following formulae 4,7,8 : …”

Section: Recommendations Of the Institute Of Medicine (Iom)mentioning

confidence: 99%

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Recomendaciones sobre cómo administrar la vitamina D: guías internacionales y nacionales

Gimeno

2014

Rev Osteoporos Metab Miner

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Section: Rules For the Calculation Of The Replacement Dose For Vitamin Dsupporting

confidence: 79%

Section: Recommendations Of the Institute Of Medicine (Iom)mentioning

confidence: 99%

Recomendaciones sobre cómo administrar la vitamina D: guías internacionales y nacionales

Gimeno

2014

Rev Osteoporos Metab Miner

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“…[4]). Recent work suggests, however, that vitamin D status may be inadequate or sub-optimal if seasonal fluctuation of parathyroid hormone (PTH) occurs [5], alkaline phosphatase is elevated or at least suppressible with supplemental vitamin D [6], 25(OH)D levels are low enough to limit the production of 1,25(OH) 2 D [7], or Ca absorption fails to meet physiological needs in persons with ample Ca intake. Published laboratory 'normals' based on prevalent values for 25(OH)D extend down to 25-40 nmol/l.…”

Section: Introductionmentioning

confidence: 98%

Vitamin D and its Major Metabolites: Serum Levels after Graded Oral Dosing in Healthy Men

Barger-Lux

Heaney

Dowell

et al. 1998

Osteoporosis International

314

203

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We determined the quantitative relationships between graded oral dosing with vitamin D3, 25(OH)D3, and 1,25(OH)2D3 for short treatment periods and changes in circulating levels of these substances. The subjects were 116 healthy men (mean age, 28 +/- 4 years, with usual milk consumption of < or = 0.47 l/day and mean serum 25(OH)D of 67 +/- 25 nmol/l). They were distributed among nine open-label treatment groups: vitamin D3 (25, 250 or 1250 micrograms/day for 8 weeks), 25(OH)D3 (10, 20 or 50 micrograms/day for 4 weeks) and 1,25(OH)2D3 (0.5, 1.0 or 1.0 microgram/day for 2 weeks). All treatment occurred between January 3 and April 3. We measured fasting serum, calcium, parathyroid hormone, vitamin D3, 25(OH)D and 1,25(OH)2D immediately before and after treatment. In the three groups treated with vitamin D3, mean values for circulating vitamin D3 increased by 13, 137 and 883 nmol/l and serum 25(OH)D increased by 29, 146 and 643 nmol/l for the three dosage groups, respectively. Treatment with 25(OH)D3 increased circulating 25(OH)D by 40, 76 and 206 nmol/l, respectively. Neither compound changed serum 1,25(OH)2D levels. However, treatment with 1,25(OH)2D3 increased circulating 1,25(OH)2D by 10, 46 and 60 pmol/l, respectively. Slopes calculated from these data allow the following estimates of mean treatment effects for typical dosage units in healthy 70-kg adults: an 8-week course of vitamin D3 at 10 micrograms/day (400 IU/day) would raise serum vitamin D by 9 nmol/l and serum 25(OH)D by 11 nmol/l; a 4-week course of 25(OH)D3 at 20 micrograms/day would raise serum 25(OH)D by 94 nmol/l; and a 2-week course of 1,25(OH)2D3 at 0.5 microgram/day would raise serum 1,25(OH)2D by 17 pmol/l.

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“…This results in part from vitamin D insufficiency -vitamin D being a key modulator of intestinal calcium and phosphate absorption [4] -due to a lack of exposure to sunlight combined with reduced vitamin D dietary intake and decreased vitamin D cutaneous synthesis [5][6][7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Combined Calcium and Vitamin D3 Supplementation in Elderly Women: Confirmation of Reversal of Secondary Hyperparathyroidism and Hip Fracture Risk: The Decalyos II Study

Chapuy

Pamphile

Paris³

et al. 2002

Osteoporos Int

490

346

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Vitamin D insufficiency and low calcium intake contribute to increase parathyroid function and bone fragility in elderly people. Calcium and vitamin D supplements can reverse secondary hyperparathyroidism thus preventing hip fractures, as proved by Decalyos I. Decalyos II is a 2-year, multicenter, randomized, double-masked, placebo-controlled confirmatory study. The intention-to-treat population consisted of 583 ambulatory institutionalized women (mean age 85.2 years, SD = 7.1) randomized to the calcium-vitamin D3 fixed combination group (n = 199); the calcium plus vitamin D3 separate combination group (n = 190) and the placebo group (n = 194). Fixed and separate combination groups received the same daily amount of calcium (1200 mg) and vitamin D3 (800 IU), which had similar pharmacodynamic effects. Both types of calcium-vitamin D3 regimens increased serum 25-hydroxyvitamin D and decreased serum intact parathyroid hormone to a similar extent, with levels returning within the normal range after 6 months. In a subgroup of 114 patients, femoral neck bone mineral density (BMD) decreased in the placebo group (mean = -2.36% per year, SD = 4.92), while remaining unchanged in women treated with calcium-vitamin D3 (mean = 0.29% per year, SD = 8.63). The difference between the two groups was 2.65% (95% CI = -0.44, 5.75%) with a trend in favor of the active treatment group. No significant difference between groups was found for changes in distal radius BMD and quantitative ultrasonic parameters at the os calcis. The relative risk (RR) of HF in the placebo group compared with the active treatment group was 1.69 (95% CI = 0.96, 3.0), which is similar to that found in Decalyos I (RR = 1.7; 95% CI = 1.0, 2.8). Thus, these data are in agreement with those of Decalyos I and indicate that calcium and vitamin D3 in combination reverse senile secondary hyperparathyroidism and reduce both hip bone loss and the risk of hip fracture in elderly institutionalized women.

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Prevention of hypovitaminosis D in the elderly

Cited by 40 publications

References 13 publications

Recomendaciones sobre cómo administrar la vitamina D: guías internacionales y nacionales

Recomendaciones sobre cómo administrar la vitamina D: guías internacionales y nacionales

Vitamin D and its Major Metabolites: Serum Levels after Graded Oral Dosing in Healthy Men

Combined Calcium and Vitamin D3 Supplementation in Elderly Women: Confirmation of Reversal of Secondary Hyperparathyroidism and Hip Fracture Risk: The Decalyos II Study

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