Randomised controlled trial of vitamin D supplementation on bone density and biochemical indices in preterm infants

Abstract

Aims-To test the hypothesis that a vitamin D dose of 200 IU/kg, maximum 400 IU/day, given to preterm infants will maintain normal vitamin D status and will result in as high a bone mineral density as that attained with the recommended dose of 960 IU/day. Methods-Thirty nine infants of fewer than 33 weeks of gestational age were randomly allocated to receive vitamin D 200 IU/kg of body weight/day up to a maximum of 400 IU/day or 960 IU/day until 3 months old. Vitamin D metabolites, bone mineral content and density were determined by dual energy x-ray absorptiometry, and plasma ionised calcium, plasma alkaline phosphatase, and intact parahormone measurements were used to evaluate outcomes. Results-The 25 hydroxy vitamin D concentrations tended to be higher in infants receiving 960 IU/day, but the diVerences did not reach significance at any age. There was no diVerence between the infants receiving low or high vitamin D dose in bone mineral content nor in bone mineral density at 3 and 6 months corrected age, even after taking potential risk factors into account. Conclusions-A vitamin D dose of 200 IU/kg of body weight/day up to a maximum of 400 IU/day maintains normal vitamin D status and as good a bone mineral accretion as the previously recommended higher dose of 960 IU/day. Vitamin D is a potent hormone which aVects organs other than bone and should not be given in excess to preterm infants.

Fat-soluble vitamins in breast-fed preterm and term infants

“…A rapid increase in plasma 25-OH-vitamin D was observed during the neonatal period, suggesting that a daily supplement of 12.5 mg may be too high. This is in contrast to previous studies (Markestad et al, 1984;Backstrom et al, 1999;Delvin et al, 2005), although our study included smaller and more immature infants. Excessive intake of vitamin D may lead to hypercalcemia and calcification of soft tissues.…”

Calcium and Vitamin D Requirements of Enterally Fed Preterm Infants

“…For VLBW infants, few data are available. Their smaller size may lead to a lower need for vitamin D to achieve adequate 25-OH-D concentrations, 28,29 but further data are needed on this relationship. On the basis of limited data, a vitamin D intake of 200 to 400 IU/day for VLBW infants is recommended.…”

Programming of Skeletal Development in Children: The Role of Vitamin D

“…витамин D регулирует 3% человеческого генома, вклю-чая гены, отвечающие за здоровье кости на протяжении всей жизни человека [9][10][11] определяет вариабельность кости новорожденного ребенка, последующее ее развитие и рост [12][13][14]. в настоящее время убедительно доказано участие витамина D в минерализации скелета и формировании его размеров, процессах костного моделирования и линейного роста ребенка на ранних этапах онтогенеза [15][16][17][18][19].…”