Sunlight exposure or vitamin D supplementation for vitamin D-deficient non-western immigrants: a randomized clinical trial.

Autor:	Wicherts, I. S., Boeke, A. J. P., van der Meer, I. M., van Schoor, N. M., Knol, D. L., Lips, P.
Předmět:	HYPERPARATHYROIDISM VITAMIN D deficiency VITAMIN deficiency ANALYSIS of variance BLOOD testing CLINICAL trials DOSE-response relationship in biochemistry HEALTH outcome assessment PAIN PARATHYROID hormone REGRESSION analysis STATISTICAL sampling SUNSHINE VITAMIN D LOGISTIC regression analysis EQUIPMENT & supplies TREATMENT effectiveness PREVENTION THERAPEUTICS
Zdroj:	Osteoporosis International; Mar2011, Vol. 22 Issue 3, p873-882, 10p, 1 Diagram, 2 Charts, 1 Graph
Abstrakt:	Summary: Vitamin D deficiency is very common in non-western immigrants. In this randomized clinical trial, vitamin D 800 IU/day or 100,000 IU/3 months were compared with advised sunlight exposure. Vitamin D supplementation was more effective than advised sunlight exposure in improving vitamin D status and lowering parathyroid hormone levels. Introduction: Vitamin D deficiency (25-hydroxyvitamin D [25(OH)D] < 25 nmol/l) is common among non-western immigrants. It can be treated with vitamin D supplementation or sunlight exposure. Methods: To determine whether the effect of vitamin D supplementation (daily 800 IU or 100,000 IU/3 months) or sunlight exposure advice is similar with regard to serum 25(OH)D and parathyroid hormone (PTH) concentrations. Randomized clinical trial in 11 general practices in The Netherlands. Non-western immigrants, aged 18-65 years ( n = 232) and serum 25(OH)D < 25 nmol/l were randomly assigned to supplementation (daily 800 IU or 100,000 IU/3 months) or advice for sunlight exposure for 6 months (March-September). Blood samples were collected at baseline, during treatment (3 months, 6 months), and at follow-up (12 months). Statistical analysis was performed with multilevel regression modelling. Results: The intention-to-treat analysis included 211 persons. Baseline serum 25(OH)D was 22.5 ± 11.1 nmol/l. After 6 months, mean serum 25(OH)D increased to 53 nmol/l with 800 IU/day, to 50.5 nmol/l with 100,000 IU/3 months, and to 29.1 nmol/l with advised sunlight exposure (supplementation vs sunshine p < 0.001). Serum PTH decreased significantly in all groups after 3 months, more in the supplementation groups than in the advised sunlight group ( p < 0.05). There was no significant effect on physical performance and functional limitations. Conclusion: Vitamin D supplementation is more effective than advised sunlight exposure for treating vitamin D deficiency in non-western immigrants. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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