T1150 Efficacy of Two Different Weekly Doses of Vitamin D (400 Iu and 50,000 Iu) in Patients with Crohn's Disease in Improving Vitamin D Nutritional Status
| Autor: | James M. Becker, Kleanthis Dendrinos, Michael F. Holick, Alpdogan Kantarci, Tai C. Chen, Francis A. Farraye, Amanda Blackwood, Jeffrey S. Mathieu, Kristen N. Bushell, Timothy Heeren, Arthur F. Stucchi |
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| Rok vydání: | 2008 |
| Předmět: |
Vitamin
Crohn's disease medicine.medical_specialty Malabsorption Randomization Hepatology medicine.diagnostic_test business.industry Gastroenterology Hematocrit medicine.disease vitamin D deficiency Diarrhea chemistry.chemical_compound chemistry Internal medicine medicine Vitamin D and neurology medicine.symptom business |
| Zdroj: | Gastroenterology. 134:A-495 |
| ISSN: | 0016-5085 |
| Popis: | Background: Vitamin D deficiency is prevalent among patients with Crohn's disease (CD). Factors predisposing to hypovitaminosis D in these patients may include lack of adequate vitamin D intake or supplementation and malabsorption. Since these factors have been poorly described in patients with CD, the aims of this study were to assess baseline serum vitamin D status and the efficacy of a standard pharmacologic dose of vitamin D in improving serum 25(OH)D levels.Methods: Consecutive adult patients with CD presenting for routine office visits to Boston Medical Center participated in the study from April 2007 to November 2007. Baseline serum 25(OH)D levels were measured by HPLC in 21 consecutive patients after which patients were randomized to receive either 50,000 IU (n = 14) or 400 IU (n = 7) of vitamin D2 q week for seven weeks. At the end of the study, changes in serum 25(OH)D from baseline were compared. As secondary endpoints, changes from baseline in serum calcium, hematocrit, ESR, CRP were measured. In addition, changes in serum levels of 12 cytokines (GMCSF, IFN-gamma, IL-10, IL-1beta, IL-s, IL-4, IL-5, IL-6, IL-8, MCP-1, MIP-1alpha, TNF-alpha) were evaluated by using multi-analyte profiling beads (Luminex, Toronto, ON). Results: Baseline serum levels of 25(OH)D were not significantly different between treatment arms (21.3 vs. 26.1 ng/ml). Both treatment arms significantly increased serum 25(OH)D levels over baseline. Those patients receiving 50,000 IU of vitamin D weekly had a mean increase of 25(OH)D of 61% (26.1 to 37 ng/ml, p=0.007) while those receiving 400 IU of vitamin D weekly had a mean increase of 25(OH)of 128% (21.3 to 41.6 ng/ml, p=0.035). There was no significant difference in end serum levels of 25(OH)D between the treatment arms (41.6 vs. 37.8 ng/ml). Neither a significant increase in serum 25(OH)D levels nor randomization to the 50,000 IU per week arm of the study had an effect any laboratory markers of disease activity (ESR, CRP, Hct) nor on serum cytokine levels. One patient in the high dose group discontinued the study medication after 4 doses secondary to increased diarrhea. Conclusions: 50,000 IU of vitamin D given once a week for 7 weeks was no more effective than 400 IU of vitamin D given once a week for 7 weeks in raising serum 25(OH)D levels. Hence, other variables that affect serum vitamin D levels such as sun exposure due to seasonal variation over the course of the study may be responsible for the significant increase in serum 25(OH)D in each group. The lack of difference in serum 25(OH)D levels between the two groups may be due to compromised absorption secondary to their Crohn's disease. |
| Databáze: | OpenAIRE |
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