Overreporting of vitamin D deficiency with the Roche Elecsys Vitamin D3 (25-OH) method

Application of Enzyme-Linked Fluorescence Assay (ELFA) to Obtain In Vivo Matured Dog Oocytes through the Assessment of Progesterone Level

Successful dog cloning requires a sufficient number of in vivo matured oocytes as recipient oocytes for reconstructing embryos. The accurate prediction of the ovulation day in estrus bitches is critical for collecting mature oocytes. Traditionally, a specific serum progesterone (P4) range in the radioimmunoassay (RIA) system has been used for the prediction of ovulation. In this study, we investigated the use of an enzyme-linked fluorescence assay (ELFA) system for the measurement of P4. Serum samples of estrus bitches were analyzed using both RIA and ELFA, and the measured P4 values of ELFA were sorted into 11 groups based on the standard concentration measured in RIA and compared. In addition, to examine the tendency of changes in the P4 values in each system, the P4 values on ovulation day (from D - 6 to D + 1) in both systems were compared. The ELFA range of 5.0-12.0 ng/mL was derived from the RIA standard range of 4.0-8.0 ng/mL. The rates of acquired matured oocytes in RIA and ELFA were 55.47% and 65.19%, respectively. The ELFA system successfully produced cloned puppies after the transfer of the reconstructed cloned oocytes. Our findings suggest that the ELFA system is suitable for obtaining in vivo matured oocytes for dog cloning.

Vitamin D deficiency in Ukraine: current evidence

BACKGROUND

Data from numerous studies demonstrate the high frequency of vitamin D deficiency (VDD) and insufficiency (VDI) in many countries worldwide that depend on age and sex, seasons, country, and concomitant pathology. This research aimed to study vitamin D status in the Ukrainian population during 2016-2022 years depending on age, sex, month, and year of the observation, and compare the results with the data of previous Ukrainian epidemiologic studies.

METHODS

In a single-center cohort study, we analyzed the serum total 25-hydroxyvitamin D (25(OH)D) level in 7,418 subjects aged 20-99 years. The analysis was performed depending on age, sex, month, season, and year of the observation. Also, we compared the results with the data of previous Ukrainian studies. 25(OH)D level was measured using the electrochemiluminescence method.

RESULTS

The mean serum 25(OH)D level in the total group was 31.0 [22.3-41.1] ng/mL, the lowest level was in the age group 90-99 years old. No gender differences were found in 25(OH)D levels, except the one for the women aged 60-69 years old who had higher vitamin D levels compared to male parameters. 41.6% of the subjects had an optimal (> 30-50 ng/mL) 25(OH)D level, 27.3% had VDI, and 19.5% had a VDD. The suboptimal and high serum concentration of 25(OH)D (> 50-100 ng/mL) was found in 11.4% of the subjects. Also, we established the increase of serum 25(OH)D level from 2016 to 2022 with the highest values in 2020-2022. Seasonal variations of 25(OH)D concentration confirmed the highest index in autumn (33.0 [24.0-42.4] ng/mL) and the lowest one in the spring (28.5 [19.7-38.7] ng/mL) with the highest 25(OH)D level in September and the lowest one in March.

CONCLUSION

Our results confirmed a decrease in VDD and VDI in 2020-2022 in the Ukrainian population compared to the previous years (2016-2019) and previous Ukrainian studies with similar age and seasonal particularities. It may be the consequence of an improvement in public awareness of global vitamin D deficiency, its positive skeletal and extra-skeletal effects, as well as more intensive vitamin D supplementation due to the COVID-19 pandemic in the recent years.

Vitamin D Deficiency in Lebanese Adults: Prevalence and Predictors from a Cross-Sectional Community-Based Study

METHODS

A random sample of Lebanese adults residing in the Greater Beirut area was selected based on area probability and multistage cluster sampling. Data from 446 participants (68% females) with mean age 45.3 ± 15 years were used for the analyses. Participants were recruited between March and May. Serum 25-hydroxyvitamin D levels were measured using electrochemiluminescent immunoassay.

RESULTS

Vitamin D deficiency was highly prevalent whether using the cutoff of 50 nmol/L or using the more conservative cutoff of 30 nmol/L; more specifically, 71.9% and 39.1% of the study population were deficient using the above cutoffs, respectively In the bivariate analyses, gender, BMI and body fat mass, socioeconomic factors (income and education level), alcohol consumption, dietary intake of fat and of vitamin D, serum LDL-cholesterol, and serum creatinine were all associated with vitamin D status. After adjustment for multiple covariates, age, income, alcohol consumption, and serum creatinine were independent predictors of vitamin D deficiency.

CONCLUSION

Vitamin D deficiency is highly prevalent in Lebanon. Preventive measures should target the modifiable risk factors.

Vitamin D status in adults and children in Transcarpathia, Ukraine in 2019

Background

Vitamin D deficiency is a global health problem, it is assessed by measuring serum 25-hydroxivitamin D (25(OH) D), nevertheless epidemiological data for many countries remains underreported.

Objectives

To study the prevalence of vitamin D deficiency throughout the calendar year in a large cohort recruited ina multiethnic Transcarpathian region of Ukraine.

Methods

In this retrospective study 25(OH) D serum concentration was measured during all 12 months of the year 2019 by electrochemoluminescent assay on the automatic analyzer Cobas e411 in 1823 subjects, including both children and adults (1551 females (85.03%) and 273 males (14.97%)).

Results

The mean 25(OH) D concentration in adults demonstrates significantly lower levels compared to children (22.67 ± 8.63 ng/ml vs. 26.00 ± 10.72 ng/ml respectively, p < 0.001). Adult women expressed significantly lower mean annual serum 25 (OH) D concentrations in comparison to men (22.29 ± 8.46 ng/ml vs. 25.75 ± 9.38 ng/ml respectively, p < 0.001). In contrast, children did not show a significant difference between sexes (girls 24.98 ± 10.38 ng/ml vs. boys 27.01 ± 11.01 ng/ml, p = 0.2003). In the winter months, 25(OH) D levels fell below 20 ng/ml in 51,74% of adult population of Thranscarpathia, and in 12.91%, − below 12 ng/ml.

Conclusions

The results of this study contradict the previously reported evaluations of the vitamin D levels in Ukraine which were assessed by measuring serum 25(OH) D. Specifically, only approximately half of the studied population is vitamin D deficient during winter season. This study features the most representative sample size in Ukraine to date.

Relationship Between Statin-associated Muscle Symptoms, Serum Vitamin D and Low-density Lipoprotein Cholesterol - A Cross-sectional Study

INTRODUCTION

Statin-associated muscle symptoms (SAMS) can lead to medication non-adherence among statin users. There is a complex relationship between SAMS, vitamin D and low-density lipoprotein cholesterol (LDL-C). The objective of this study was to evaluate the relationship between vitamin D, LDL-C and occurrence of SAMS.

METHODS

This was a cross-sectional study in patients using statins. Thorough patient histories were taken, a clinical examination was conducted and SAMS were recorded. Levels of vitamin D, creatine phosphokinase (CPK) and LDL-C were measured. These parameters were compared amongst statin users with SAMS and those without SAMS. Levels of vitamin D and LDL-C were converted into percentiles and their relationship with SAMS was evaluated in terms of odds ratio. Receiver operating characteristics (ROC) were drawn, taking vitamin D and LDL-C as predictors of SAMS.

RESULTS

A total of 121 statin users were enrolled in this study. Thirty-eight patients (31.4%) presented with SAMS. Significantly lower levels of serum vitamin D were observed amongst statin users with SAMS compared with those without SAMS (19.8 ± 9.67 ng/mL versus 25.0 ± 14.6 ng/mL; 95% confidence interval -10.4 to -0.07; p=0.04). With vitamin D levels less than or equal to 5th, 10th and 25th percentile, the chances of occurrence of SAMS were significantly higher, but not at the 50th percentile (corresponding vitamin D level of 20.21 ng/mL). LDL-C did not show any conclusive relationship with SAMS. ROC curves showed a significant discrimination for vitamin D levels, but not for LDL-C.

CONCLUSION

Statin users with low levels of vitamin D are at increased risk of developing SAMS. However, LDL-C status of statin users failed to predict any meaningful association with SAMS. Given the small sample size of this study, these results should be regarded as preliminary.

Comparison of the effects of perceptual-motor exercises, vitamin D supplementation and the combination of these interventions on decreasing stereotypical behavior in children with autism disorder

OBJECTIVES

The aim of this study was to examine the combined effects of perceptual-motor exercises and vitamin D3 supplementation on the reduction of stereotypical behavior in children with autism spectrum disorder (ASD).

METHODS

In this study, 100 eligible children with age ranging from 6 to 9 years were randomly selected and divided into four groups: Group A-perceptual-motor exercises (n = 25); Group B-25-hydroxycholecalciferol (25 (OH) D) (n = 25); Group C-perceptual-motor exercises and 25 (OH) D (n = 25); and Group D-control (n = 25).

RESULTS

The stereotypes decreased from elementary level, 17% in Group A, 13% in Group B and 28% in Group C among the participants. There was no change in the stereotypical in the control group during the interventions. Also, the stereotypes in Group C showed the highest decrease, compared to the other three groups.

CONCLUSIONS

We concluded that combination of perceptual-motor exercises and vitamin D3 supplementation in children with ASD leads to significant reduction in their stereotypic behaviors.

Vitamin D shows in vivo efficacy in a placebo-controlled, double-blinded, randomised clinical trial on canine atopic dermatitis

Atopic dermatitis (AD) in dogs is among the most common skin diseases in small animal practice. It is an inflammatory disease based on a genetic predisposition to develop hypersensitivity against environmental and food allergens and typical clinical signs up exposure. Treatment sometimes can be difficult and associated with adverse effects. Previous studies evaluating cholecalciferol as treatment for human AD have shown promising results. With canine AD being a good animal model for its human counterpart, it was hypothesised that cholecalciferol might have beneficial clinical effects in dogs, too. In this randomised, placebo-controlled, double-blinded eight-week cross-over study, 23 client-owned dogs received either systemic cholecalciferol (n=16), a vitamin D receptor analogue (n=8) or placebo (n=13). Blood samples for ionised calcium were obtained regularly during the study, and Canine Atopic Dermatitis Extent and Severity Index and pruritus scores, blood levels of vitamin D metabolites, measurements of skin pH and transepidermal water loss were determined before and after. Pruritus and lesion scores decreased significantly in the cholecalciferol group versus placebo. No differences in water loss or skin pH were observed. An increase in serum 25-hydroxycholecalciferol strongly correlated with a reduction in pruritus. Systemic cholecalciferol may be a viable treatment option for canine AD.

Association of Vitamin D Deficiency and Degree of Coronary Artery Disease in Cardiac Patients with Type 2 Diabetes

Several modifiable factors may influence cardiac function in diabetic patients. The aim of the study was to evaluate the influence of vitamin D level on the stage of coronary atherosclerosis in cardiac patients diagnosed with type 2 diabetes. The study was performed in 337 consecutive patients undergoing coronarography. The stage of atherosclerosis was evaluated using Coronary Artery Surgery Study Score. The plasma 25(OH)D concentration was determined by an electrochemiluminescence method. Patients without significant lesions in coronary arteries presented the highest 25(OH)D level, significantly higher than patients with one-, two-, and three-vessel coronary artery disease (CAD) (p < 0.01). Significantly lower level of the 25(OH)D was observed in patients hospitalized due to acute coronary syndrome (ACS) in comparison to patients hospitalized due to stable CAD (p < 0.001). Lower 25(OH)D levels were observed in patients with the history of myocardial infarction (MI) in comparison to patients without previous MI (p < 0.001). In cardiac patients with diabetes, the higher number of stenotic coronary arteries is associated with lower values of the 25(OH)D. A group of male cardiac patients with diabetes with significant stenosis in three coronary arteries, hospitalized due to acute coronary syndrome, with a history of previous MI and hyperlipidemia presented the lowest vitamin D level.

High prevalence of vitamin D deficiency in urban health checkup population

BACKGROUND

Vitamin D deficiency is documented as a common health problem in the world. Limited data has been found on the prevalence of vitamin D deficiency in Beijing area.

AIM

To investigate the prevalence s of vitamin D deficiency in urban Beijing residents and the seasonal and monthly serum 25(OH)D variation in this population.

METHODS

This is an urban hospital based cross-sectional study lasting whole 2 years. 5531 (5-101 years old) urban Beijing residents for health checkup are recruited from December 9th, 2011 to December 8th, 2013. Each subject completed a questionnaire designed to quantify intake of vitamin D through food, vitamin D supplements, hours of sun exposure, sunscreen use over the past month. Serum 25(OH)D is statistically analyzed in accordance with gender, age, and time-lines.

RESULTS

Vitamin D deficiency (Serum 25(OH)D level ≤20 ng/mL) and sever deficiency (Serum 25(OH)D level ≤ 10 ng/mL) are highly prevalent in this population. The prevalence of vitamin D deficiency is 87.1% and higher prevalence is found in female (89.0%) than male (84.9% P < 0.001). Severe vitamin D deficiency is also higher in female than male (59.3% and 42.7%, respectively, P < 0.001). Female under 20 and over 80 have lower 25(OH)D levels compared to 40-60 years old female (both P < 0.05). Severe vitamin D deficiency are also highly prevalence in this two group (60.9% and 54.1%) compared with 40-60 years old females (43.1%, both P < 0.05). Seasonal variation are also found in this population (P < 0.01). Autumn and summer have the higher 25(OH)D level than winter and spring in both genders (P < 0.001). Winter and spring have higher vitamin D deficiency and Severe deficiency than the other two seasons (P < 0.05). Serum 25(OH)D level peaks in October and troughed in April in both female and male. Lower serum 25(OH)D level are found in April than February (P < 0.05) in both gender.

CONCLUSIONS

This is the first time to examine the prevalence of vitamin D deficiency among urban Beijing residents spanning the age spectrum. And Vitamin D deficiency and severe deficiency is found highly prevalent in this population, especially among females under 20 and older than 80 and in winter and spring seasons. Targeted prevention on vitamin D deficiency is urgent for this population.

Method evaluation study of a new generation of vitamin D assays

Introduction

Recently several diagnostic manufacturers have launched new 25-hydroxy-vitamin D (25[OH]D) assays, which are aligned to the National Institute of Standards and Technology (NIST) Standard Reference Materials (SRM) (NIST, Gaithersburg, Maryland). The aim of this study was to compare the performance of one liquid chromatography-tandem mass spectrometry (LC-MS/MS) method, one enzyme linked immunosorbent assay (ELISA), and one recalibrated and previous version of a chemiluminescence immunoassay (CLIA).

Material and methods

Serum-aliquots of 198 patient samples from routine 25(OH)D analysis were measured by the ClinMass® LC-MS/MS Complete Kit (RECIPE Chemicals + Instruments GmbH, Munich, Germany), the ORGENTEC 25(OH)D₃/D₂ ELISA (ORGENTEC Diagnostika GmbH, Mainz, Germany), the recalibrated Immunodiagnostic Systems (IDS)-iSYS 25(OH)D^S and the previous used IDS-iSYS 25(OH)D CLIA (Immunodiagnostic Systems Ltd, Boldon, United Kingdom). Bland-Altman and Deming regression analyses were calculated for methods comparison of all tested 25(OH)D assays. The LC-MS/MS method was defined as the reference method. Within-run and between-run precision measurements were performed for all methods with three different concentration levels.

Results

Compared to the LC-MS/MS method, the new IDS-iSYS 25(OH)D^S and ORGENTEC 25(OH)D₃/D₂ assay demonstrated mean relative biases of 16.3% and 17.8%. The IDS-iSYS 25(OH)D assay showed the lowest mean bias of 1.5%. Deming regression analyses of the recalibrated IDS-iSYS 25(OH)D^S and the ORGENTEC 25(OH)D₃/D₂ assay showed proportional differences, when compared to the reference method. All assays showed a within-run and between-run imprecision of ≤ 20% at each of the evaluated concentration levels.

Conclusions

The evaluated standardized immunoassays and LC-MS/MS are useful methods for measuring 25(OH)D serum-levels in clinical laboratories.

Determination of vitamin D and its metabolites

The demand for analysis of 25-hydroxyvitamin D has increased dramatically throughout the world over the past decade. As a consequence, a number of new automated assays have been introduced for 25-hydroxyvitamin D measurement. Automated assays have shown variable ability to meet the technical challenges associated with 25-hydroxyvitamin D measurement. Assays are able to meet performance goals for precision at high concentrations but fail to do so at low concentrations of 25-hydroxyvitamin D. The overall accuracy of automated methods has improved over recent years and generally shows good overall agreement with reference methods; however, discrepancies persist for individual samples. Liquid chromatography-tandem mass spectrometry is used by some routine laboratories for 25-hydroxyvitamin D analysis but its widespread use is hampered by limited sample throughput. 1,25-Dihydroxyvitamin D is an important analyte in specific clinical situations, which remains in the hands of specialised laboratories using manual analytical methods.

Design of the South East Asian Nutrition Survey (SEANUTS): a four-country multistage cluster design study

Nutrition is a well-known factor in the growth, health and development of children. It is also acknowledged that worldwide many people have dietary imbalances resulting in over- or undernutrition. In 2009, the multinational food company FrieslandCampina initiated the South East Asian Nutrition Survey (SEANUTS), a combination of surveys carried out in Indonesia, Malaysia, Thailand and Vietnam, to get a better insight into these imbalances. The present study describes the general study design and methodology, as well as some problems and pitfalls encountered. In each of these countries, participants in the age range of 0·5–12 years were recruited according to a multistage cluster randomised or stratified random sampling methodology. Field teams took care of recruitment and data collection. For the health status of children, growth and body composition, physical activity, bone density, and development and cognition were measured. For nutrition, food intake and food habits were assessed by questionnaires, whereas in subpopulations blood and urine samples were collected to measure the biochemical status parameters of Fe, vitamins A and D, and DHA. In Thailand, the researchers additionally studied the lipid profile in blood, whereas in Indonesia iodine excretion in urine was analysed. Biochemical data were analysed in certified laboratories. Study protocols and methodology were aligned where practically possible. In December 2011, data collection was finalised. In total, 16 744 children participated in the present study. Information that will be very relevant for formulating nutritional health policies, as well as for designing innovative food and nutrition research and development programmes, has become available.

Vitamin D Measurements — Facts and Fancies

Clinical laboratories have seen an increased interest in vitamin D measurements as new knowledge about the vitamin's pathobiology escalates. Clinicians now recognise that besides bone health, vitamin D insufficiency may be associated with potential health risks such as coronary artery disease, diabetes, depression, epilepsy, polycystic ovaries, musculoskeletal pain, autoimmune disease, multiple sclerosis, and cancers. While vitamin D testing and supplementation has been touted for these patients, benefit is evident only for the prevention of falls and fractures. The main form of vitamin D measured is 25-hydroxy-vitamin D (25OHD). While 25OHD assays have improved, they remain a work in progress.

Serum 25-hydroxyvitamin D and biochemical markers of bone metabolism in patients with juvenile idiopathic arthritis

Our objective was to evaluate the concentrations of serum 25-hydroxyvitamin D [25(OH)D], serum calcium, serum phosphorus, alkaline phosphatase, and parathormone (PTH) in patients with polyarticular juvenile idiopathic arthritis (JIA) and to associate them with disease duration and activity, bone mineral density and use of medications. In a cross-sectional and controlled study, 30 patients with polyarticular JIA were evaluated and compared to 30 healthy individuals matched for age and gender. Clinical status, anthropometry, laboratory markers in both patients and controls, and bone mineral density, only in the patients, were measured. Of the 30 patients included in the study, 23 (76.7%) were female and 16 (53.3%) non-Caucasian; mean age was 14 years (range = 4 to 20 years). Mean disease duration was 5 years (range = 1 to 12 years). The mean concentrations of serum albumin-corrected calcium (9.04 ± 0.41 mg/dL) and alkaline phosphatase (153.3 ± 100.1 IU) were significantly lower in patients with JIA than in controls (P < 0.0001 and P = 0.001, respectively). No differences in 25(OH)D, PTH or serum phosphorus were observed between JIA and control subjects. Regarding 25(OH)D concentration, 8 patients (26.7%) and 5 controls (16.7%) had 25(OH)D concentrations compatible with deficiency (lower than 20 ng/mL) and 14 patients (46.7%) and 18 controls (60%) had concentrations compatible with insufficiency (20-32 ng/mL). These values were not associated with disease activity, use of medications or bone mineral density. We observed a high frequency of 25(OH)D insufficiency and deficiency in the study sample. The compromised bone metabolism emphasizes the importance of follow-up of JIA patients.

High prevalence of vitamin D insufficiency in China: relationship with the levels of parathyroid hormone and markers of bone turnover

There is a lack of large-scale studies on vitamin D status and its relationship to parathyroid hormone (PTH) and bone turnover markers in adults living in Shanghai. The objectives were to determine the prevalence of vitamin D insufficiency in Shanghai and to investigate the relationship of 25(OH)D with parathyroid function and bone turnover markers. This cross-sectional study involved 649 men and 1939 women aged 20–89 years who were randomly sampled in Shanghai. Serum concentrations of 25(OH)D, PTH, albumin, and bone turnover markers were measured. During the winter season, the prevalence of vitamin D insufficiency (<30 ng/mL) was 84% in males and 89% in females. The prevalence of vitamin D deficiency (<20 ng/mL) was 30% in males and 46% in females. With increasing serum 25(OH)D concentrations categorized as <10, 10–20, 20–30, and ≥30 ng/mL, the mean PTH and bone turnover markers levels gradually decreasd in both sexes (p<0.001). There was an inverse relationship between the serum 25(OH)D and PTH concentrations in both genders, but no threshold of 25(OH)D at which PTH levels plateaued was observed. There were modest but significantly inverse relationships between the levels of 25(OH)D and bone turnover markers, but no plateau was observed for serum 25(OH)D levels up to 40 ng/mL.

Performance evaluation of Siemens ADVIA Centaur and Roche MODULAR Analytics E170 Total 25-OH Vitamin D assays

OBJECTIVES

To evaluate the newly developed Roche MODULAR Analytics E170 Total Vitamin D and the Siemens ADVIA Centaur Vitamin D Total assays.

MATERIALS AND METHODS

Assays were evaluated using the Clinical and Laboratory Standards Institute protocols. Split patient samples were compared with LC-MS/MS and DiaSorin LIAISON assays (n=79 including 15 specimens with detectable endogenous 25-OH vitamin D(2)). Assay accuracy was also evaluated using the Vitamin D External Quality Assessment Scheme (DEQAS) samples.

RESULTS

The ADVIA Centaur and E170 assays demonstrated maximum total CVs of 14.1% and 5.9%, respectively. Both showed excellent linearity (R(2)>0.99). The ADVIA Centaur assay demonstrated interference with bilirubin at 800 μmol/L, hemolysis at 1.25 g/L, and triglycerides at 2.8 mmol/L. Compared to LC-MS/MS, the ADVIA Centaur assay demonstrated a R(2) value of 0.893, average bias of -8.8%; the E170 assay an R(2) value of 0.872, average bias of 14.3% with underestimation of 25-OH vitamin D(2). Compared to the LIAISON assay, the ADVIA Centaur assay demonstrated an R(2) value of 0.781, average bias of -17.3%; the E170 assay an R(2) value of 0.823, average bias of 11.4%. The ADVIA Centaur and E170 assays demonstrated a biases of <20% in 10/10 and 8/10 DEQAS samples, respectively.

CONCLUSIONS

The ADVIA Centaur and E170 vitamin D assays demonstrated acceptable linearity, imprecision, and accuracy. The E170 assay demonstrated consistent underestimation of 25-OH vitamin D(2) levels. Compared with LC-MS/MS, the ADVIA Centaur assay demonstrated a higher R(2) value and a smaller average bias than the E170 assay.

Vitamin D insufficiency: evaluation of an oral standardized supplementation using 100,000 IU vials of cholecalciferol, depending on initial serum level of 25OH vitamin D

OBJECTIVES

There is no protocol of vitamin D supplementation used worldwide due to a great disparity of vitamin D supplements available in different countries. The aim of this study was to evaluate the efficiency of the protocol most often used in France to correct vitamin D deficiency defined by a serum 25-hydroxy vitamin D (25OHD) level of less than 30 ng/mL.

METHODS

This was a pragmatic multicentric study of vitamin D supplementation in 257 osteopenic/osteoporotic, vitamin D deficient patients who received 100,000 UI vitamin D3 vials every two weeks according to their initial serum 25OHD level (four vials when 25OHD less than 10 ng/mL, three when 25OHD was 10-19 ng/mL, two when 25OHD was 20-29 ng/mL). Blood samples were obtained at baseline, one (M1), two (M2), and three months (M3), after the end of the supplementation protocol.

RESULTS

At M1, 198/257 (77%) patients had a serum 25OHD level more than 30 ng/mL. Eighty-five percent of those with a BMI less than 25 kg/m2 had a 25OHD concentration more than 30 ng/mL, whereas only 66% of those with a BMI more than 25 had a level more than 30 ng/mL. At M2 and M3, 25OHD levels decreased significantly with 55% and 46% having still a level more than 30 ng/mL respectively, without any significant difference according to the initial 25OHD level.

CONCLUSION

This protocol was effective in rising serum 25OHD of most vitamin D insufficient patients with a BMI less than 25 kg/m2, but not in overweight patients. As almost one half of our patients had a serum 25OHD level less than 30 ng/mL at M2, we suggest that regular doses should be started quite soon after this initial supplementation.