Comparison of the effect of daily versus bolus dose maternal vitamin D3 supplementation on the 24,25-dihydroxyvitamin D3 to 25-hydroxyvitamin D3 ratio
Supplementing lactating mothers with high doses of vitamin D3 can adequately meet vitamin D requirements of the breastfed infant. We compared the effect of bolus versus daily vitamin D3 dosing in lactating mothers on vitamin D3 catabolism. We hypothesized that catabolism of 25(OH)D3 to 24,25(OH)2D3...
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| Vydáno v: | Bone (New York, N.Y.) Ročník 110; s. 321 - 325 |
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Elsevier Inc
01.05.2018
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| ISSN: | 8756-3282, 1873-2763, 1873-2763 |
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| Abstract | Supplementing lactating mothers with high doses of vitamin D3 can adequately meet vitamin D requirements of the breastfed infant. We compared the effect of bolus versus daily vitamin D3 dosing in lactating mothers on vitamin D3 catabolism. We hypothesized that catabolism of 25(OH)D3 to 24,25(OH)2D3 would be greater in the bolus than in the daily dose group.
Randomized controlled trial (clinicaltrials.govNCT01240265) in 40 lactating women.
Subjects were randomized to receive vitamin D3 orally, either a single dose of 150,000IU or 5000IU daily for 28days. Vitamin D metabolites were measured in serum and breast milk at baseline, 1, 3, 7, 14 and 28days.
Temporal changes in the serum 24,25(OH)2D3/25(OH)D3 ratio.
The concentration of serum 24,25(OH)2D3 was directly related to that of 25(OH)D in both groups (r2=0.63; p<0.001). The mean (±SD) 24,25(OH)2D3/25(OH)D3 ratio remained lower at all time points than baseline values in the daily dose group (0.093±0.024, 0.084±0.025, 0.083±0.024, 0.080±0.020, 0.081±0.023, 0.083±0.018 at baseline, 1, 3, 7, 14, and 28days, respectively). In the single dose group, the increase in 24,25(OH)2D3 lagged behind that of 25(OH)D, but the 24,25(OH)2D3/25(OH)D3 values (0.098±0.032, 0.067±0.019, 0.081±0.017, 0.092±0.024, 0.103±0.020, 0.106±0.024, respectively) exceeded baseline values at 14 and 28days and were greater than the daily dose group at 14 and 28days (p=0.003). The 24,25(OH)2D3/25(OH)D3 ratio remained in the normal range with both dosing regimens. Greater breast milk vitamin D3 values in the single dose group were inversely associated with the 24,25(OH)2D3/25(OH)D3 ratio (r2=0.14, p<0.001), but not with daily dosing.
After a 14-day lag, a single high dose of vitamin D led to greater production of 24,25(OH)2D3, presumably via induction of the 24-hydroxylase enzyme (CYP24A1), relative to the 25(OH)D3 value than did daily vitamin D supplementation, and this effect persisted for at least 28days after vitamin D administration. A daily dose of vitamin D may have more lasting effectiveness in increasing 25(OH)D3 with lesser diversion of 25(OH)D3 to 24,25(OH)2D3 than does larger bolus dosing.
•Bolus high-dose vitamin D produced more 24,25(OH)2D than daily supplementation.•After bolus vitamin D, the increase in 24,25(OH)2D lagged behind that of 25(OH)D.•Daily vitamin D may increase 25(OH)D more effectively than larger bolus dosing. |
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| AbstractList | Supplementing lactating mothers with high doses of vitamin D3 can adequately meet vitamin D requirements of the breastfed infant. We compared the effect of bolus versus daily vitamin D3 dosing in lactating mothers on vitamin D3 catabolism. We hypothesized that catabolism of 25(OH)D3 to 24,25(OH)2D3 would be greater in the bolus than in the daily dose group.
Randomized controlled trial (clinicaltrials.govNCT01240265) in 40 lactating women.
Subjects were randomized to receive vitamin D3 orally, either a single dose of 150,000IU or 5000IU daily for 28days. Vitamin D metabolites were measured in serum and breast milk at baseline, 1, 3, 7, 14 and 28days.
Temporal changes in the serum 24,25(OH)2D3/25(OH)D3 ratio.
The concentration of serum 24,25(OH)2D3 was directly related to that of 25(OH)D in both groups (r2=0.63; p<0.001). The mean (±SD) 24,25(OH)2D3/25(OH)D3 ratio remained lower at all time points than baseline values in the daily dose group (0.093±0.024, 0.084±0.025, 0.083±0.024, 0.080±0.020, 0.081±0.023, 0.083±0.018 at baseline, 1, 3, 7, 14, and 28days, respectively). In the single dose group, the increase in 24,25(OH)2D3 lagged behind that of 25(OH)D, but the 24,25(OH)2D3/25(OH)D3 values (0.098±0.032, 0.067±0.019, 0.081±0.017, 0.092±0.024, 0.103±0.020, 0.106±0.024, respectively) exceeded baseline values at 14 and 28days and were greater than the daily dose group at 14 and 28days (p=0.003). The 24,25(OH)2D3/25(OH)D3 ratio remained in the normal range with both dosing regimens. Greater breast milk vitamin D3 values in the single dose group were inversely associated with the 24,25(OH)2D3/25(OH)D3 ratio (r2=0.14, p<0.001), but not with daily dosing.
After a 14-day lag, a single high dose of vitamin D led to greater production of 24,25(OH)2D3, presumably via induction of the 24-hydroxylase enzyme (CYP24A1), relative to the 25(OH)D3 value than did daily vitamin D supplementation, and this effect persisted for at least 28days after vitamin D administration. A daily dose of vitamin D may have more lasting effectiveness in increasing 25(OH)D3 with lesser diversion of 25(OH)D3 to 24,25(OH)2D3 than does larger bolus dosing.
•Bolus high-dose vitamin D produced more 24,25(OH)2D than daily supplementation.•After bolus vitamin D, the increase in 24,25(OH)2D lagged behind that of 25(OH)D.•Daily vitamin D may increase 25(OH)D more effectively than larger bolus dosing. Supplementing lactating mothers with high doses of vitamin D3 can adequately meet vitamin D requirements of the breastfed infant. We compared the effect of bolus versus daily vitamin D3 dosing in lactating mothers on vitamin D3 catabolism. We hypothesized that catabolism of 25(OH)D3 to 24,25(OH)2D3 would be greater in the bolus than in the daily dose group.OBJECTIVESupplementing lactating mothers with high doses of vitamin D3 can adequately meet vitamin D requirements of the breastfed infant. We compared the effect of bolus versus daily vitamin D3 dosing in lactating mothers on vitamin D3 catabolism. We hypothesized that catabolism of 25(OH)D3 to 24,25(OH)2D3 would be greater in the bolus than in the daily dose group.Randomized controlled trial (clinicaltrials.govNCT01240265) in 40 lactating women.DESIGN, SETTING AND PATIENTSRandomized controlled trial (clinicaltrials.govNCT01240265) in 40 lactating women.Subjects were randomized to receive vitamin D3 orally, either a single dose of 150,000IU or 5000IU daily for 28days. Vitamin D metabolites were measured in serum and breast milk at baseline, 1, 3, 7, 14 and 28days.INTERVENTIONSSubjects were randomized to receive vitamin D3 orally, either a single dose of 150,000IU or 5000IU daily for 28days. Vitamin D metabolites were measured in serum and breast milk at baseline, 1, 3, 7, 14 and 28days.Temporal changes in the serum 24,25(OH)2D3/25(OH)D3 ratio.MAIN OUTCOME MEASURETemporal changes in the serum 24,25(OH)2D3/25(OH)D3 ratio.The concentration of serum 24,25(OH)2D3 was directly related to that of 25(OH)D in both groups (r2=0.63; p<0.001). The mean (±SD) 24,25(OH)2D3/25(OH)D3 ratio remained lower at all time points than baseline values in the daily dose group (0.093±0.024, 0.084±0.025, 0.083±0.024, 0.080±0.020, 0.081±0.023, 0.083±0.018 at baseline, 1, 3, 7, 14, and 28days, respectively). In the single dose group, the increase in 24,25(OH)2D3 lagged behind that of 25(OH)D, but the 24,25(OH)2D3/25(OH)D3 values (0.098±0.032, 0.067±0.019, 0.081±0.017, 0.092±0.024, 0.103±0.020, 0.106±0.024, respectively) exceeded baseline values at 14 and 28days and were greater than the daily dose group at 14 and 28days (p=0.003). The 24,25(OH)2D3/25(OH)D3 ratio remained in the normal range with both dosing regimens. Greater breast milk vitamin D3 values in the single dose group were inversely associated with the 24,25(OH)2D3/25(OH)D3 ratio (r2=0.14, p<0.001), but not with daily dosing.RESULTSThe concentration of serum 24,25(OH)2D3 was directly related to that of 25(OH)D in both groups (r2=0.63; p<0.001). The mean (±SD) 24,25(OH)2D3/25(OH)D3 ratio remained lower at all time points than baseline values in the daily dose group (0.093±0.024, 0.084±0.025, 0.083±0.024, 0.080±0.020, 0.081±0.023, 0.083±0.018 at baseline, 1, 3, 7, 14, and 28days, respectively). In the single dose group, the increase in 24,25(OH)2D3 lagged behind that of 25(OH)D, but the 24,25(OH)2D3/25(OH)D3 values (0.098±0.032, 0.067±0.019, 0.081±0.017, 0.092±0.024, 0.103±0.020, 0.106±0.024, respectively) exceeded baseline values at 14 and 28days and were greater than the daily dose group at 14 and 28days (p=0.003). The 24,25(OH)2D3/25(OH)D3 ratio remained in the normal range with both dosing regimens. Greater breast milk vitamin D3 values in the single dose group were inversely associated with the 24,25(OH)2D3/25(OH)D3 ratio (r2=0.14, p<0.001), but not with daily dosing.After a 14-day lag, a single high dose of vitamin D led to greater production of 24,25(OH)2D3, presumably via induction of the 24-hydroxylase enzyme (CYP24A1), relative to the 25(OH)D3 value than did daily vitamin D supplementation, and this effect persisted for at least 28days after vitamin D administration. A daily dose of vitamin D may have more lasting effectiveness in increasing 25(OH)D3 with lesser diversion of 25(OH)D3 to 24,25(OH)2D3 than does larger bolus dosing.CONCLUSIONSAfter a 14-day lag, a single high dose of vitamin D led to greater production of 24,25(OH)2D3, presumably via induction of the 24-hydroxylase enzyme (CYP24A1), relative to the 25(OH)D3 value than did daily vitamin D supplementation, and this effect persisted for at least 28days after vitamin D administration. A daily dose of vitamin D may have more lasting effectiveness in increasing 25(OH)D3 with lesser diversion of 25(OH)D3 to 24,25(OH)2D3 than does larger bolus dosing. |
| Author | Singh, Ravinder J. Kumar, Rajiv Fischer, Philip R. Ketha, Hemamalini Thacher, Tom D. Oberhelman, Sara S. |
| AuthorAffiliation | 2 Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, 55905 6 Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, 55905 3 Department of Family Medicine, Mayo Clinic, Rochester, Minnesota, 55905 1 Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, 55905 4 Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, 55905 5 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, 55905 |
| AuthorAffiliation_xml | – name: 4 Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, 55905 – name: 5 Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, 55905 – name: 1 Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, 55905 – name: 2 Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, 55905 – name: 3 Department of Family Medicine, Mayo Clinic, Rochester, Minnesota, 55905 – name: 6 Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota, 55905 |
| Author_xml | – sequence: 1 givenname: Hemamalini surname: Ketha fullname: Ketha, Hemamalini organization: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, United States – sequence: 2 givenname: Tom D. orcidid: 0000-0002-7644-8173 surname: Thacher fullname: Thacher, Tom D. email: thacher.thomas@mayo.edu organization: Department of Family Medicine, Mayo Clinic, Rochester, MN, 55905, United States – sequence: 3 givenname: Sara S. surname: Oberhelman fullname: Oberhelman, Sara S. organization: Department of Family Medicine, Mayo Clinic, Rochester, MN, 55905, United States – sequence: 4 givenname: Philip R. surname: Fischer fullname: Fischer, Philip R. organization: Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, 55905, United States – sequence: 5 givenname: Ravinder J. surname: Singh fullname: Singh, Ravinder J. organization: Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, United States – sequence: 6 givenname: Rajiv surname: Kumar fullname: Kumar, Rajiv organization: Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, United States |
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| Copyright | 2018 Elsevier Inc. Copyright © 2018 Elsevier Inc. All rights reserved. |
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| Keywords | LC-MS/MS Vitamin D metabolism Catabolism Safety Nutrition Lactation |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 Present address: Department of Pathology, University of Michigan Health System, Ann Arbor, MI, 48105 |
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| Title | Comparison of the effect of daily versus bolus dose maternal vitamin D3 supplementation on the 24,25-dihydroxyvitamin D3 to 25-hydroxyvitamin D3 ratio |
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