Endokrinologie und metabolisches Syndrom
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Abstrakt

Efficacy and Safety of Cholecalciferol Supplementation in Vitamin D Deficient Subjects Based on Endocrine Society Clinical Practice Guidelines

Chittari Venkata Harinarayan, Leena Appicatlaa, Arunachalam Nalini and Shalini Joshi

Background: Hypovitaminosis is widely prevalent in India with limited data on vitamin D supplementation regimens.

Objective: We studied efficacy and safety of vitamin D supplementation as per the Endocrine Society Clinical Practice Guidelines (ESCPG) in vitamin D deficient subjects.

Design: Fifty two healthy subjects had their serum albumin, creatinine, calcium, alkaline phosphatase, 25 OH vitamin D (25OH D) and ntact PTH estimated at baseline, two and five months of supplementation. They were supplemented with Cholecalciferol 9572 IU/day and elemental calcium 1 gm/day. At the end of the 2nd month, those who attained vitamin D sufficiency were supplemented Cholecalciferol 3000 IU/day, and those still did not attain vitamin D sufficiency with Cholecalciferol 5286 IU/day along with 1 gm elemental calcium and the later were reassessed after
three months.

Results: The mean ± SD of serum calcium, phosphorous, alkaline phosphatase were in the normal range at baseline, 2 and 5 months of supplementation (P= NS). The baseline median (IQR-Interquartile range) of 25 OHD and PTH was 6 (4-11) ng/ml and 19.6 (33-62) pg/ml respectively. At 2nd month there was threefold increase in 25 OHD levels 19.6 (14.6-28.75) ng/ml and further 50% increase at 5th month of supplementation. PTH levels were suppressed by 38 % at 2nd month and remained stable at 5th month. At end of 5th month, 46% had attained vitamin D sufficiency and 27% of subjects were still vitamin D insufficient.

Conclusions: Vitamin D supplementation based on recent ESCPG even up to upper tolerable intake levels (UL) along with elemental calcium of 1gm/day is safe and does not lead to hypercalcemia.