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Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch‐Ernst K, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Lanham‐New S, Passeri G, Craciun I, Fabiani L, De Sousa RF, Martino L, Martínez SV, Naska A. Scientific opinion on the tolerable upper intake level for vitamin D, including the derivation of a conversion factor for calcidiol monohydrate. EFSA J 2023; 21:e08145. [PMID: 37560437 PMCID: PMC10407748 DOI: 10.2903/j.efsa.2023.8145] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Abstract
Following two requests from the European Commission (EC), the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the revision of the tolerable upper intake level (UL) for vitamin D and to propose a conversion factor (CF) for calcidiol monohydrate into vitamin D3 for labelling purposes. Vitamin D refers to ergocalciferol (vitamin D2), cholecalciferol (vitamin D3), and calcidiol monohydrate. Systematic reviews of the literature were conducted to assess the relative bioavailability of calcidiol monohydrate versus vitamin D3 on serum 25(OH)D concentrations, and for priority adverse health effects of excess vitamin D intake, namely persistent hypercalcaemia/hypercalciuria and endpoints related to musculoskeletal health (i.e. falls, bone fractures, bone mass/density and indices thereof). Based on the available evidence, the Panel proposes a CF for calcidiol monohydrates of 2.5 for labelling purposes. Persistent hypercalciuria, which may be an earlier sign of excess vitamin D than persistent hypercalcaemia, is selected as the critical endpoint on which to base the UL for vitamin D. A lowest-observed-adverse-effect-level (LOAEL) of 250 μg/day is identified from two randomised controlled trials in humans, to which an uncertainty factor of 2.5 is applied to account for the absence of a no-observed-adverse-effect-level (NOAEL). A UL of 100 μg vitamin D equivalents (VDE)/day is established for adults (including pregnant and lactating women) and for adolescents aged 11-17 years, as there is no reason to believe that adolescents in the phase of rapid bone formation and growth have a lower tolerance for vitamin D compared to adults. For children aged 1-10 years, a UL of 50 μg VDE/day is established by considering their smaller body size. Based on available intake data, European populations are unlikely to exceed the UL, except for regular users of food supplements containing high doses of vitamin D.
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McKenna MJ, Flynn MAT. Preventing Type 2 Diabetes With Vitamin D: Therapy Versus Supplementation. Ann Intern Med 2023; 176:415-416. [PMID: 36745887 DOI: 10.7326/m23-0220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Affiliation(s)
- Malachi J McKenna
- Department of Clinical Chemistry, St. Vincent's University Hospital, and UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Mary A T Flynn
- Food Safety Authority of Ireland, Dublin, Ireland, and Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, United Kingdom
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Voulgaridou G, Papadopoulou SK, Detopoulou P, Tsoumana D, Giaginis C, Kondyli FS, Lymperaki E, Pritsa A. Vitamin D and Calcium in Osteoporosis, and the Role of Bone Turnover Markers: A Narrative Review of Recent Data from RCTs. Diseases 2023; 11:diseases11010029. [PMID: 36810543 PMCID: PMC9944083 DOI: 10.3390/diseases11010029] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023] Open
Abstract
Osteoporosis is a common disease, defined primarily by a low measured bone density, which is associated with an increased risk of fragility fractures. Low calcium intake and vitamin D deficiency seem to be positively correlated with the prevalence of osteoporosis. Although they are not suitable for the diagnosis of osteoporosis, the biochemical markers of bone turnover can be measured in serum and/or urine, enabling the assessment of the dynamic bone activity and the short-term effectiveness of the osteoporosis treatment. Calcium and vitamin D are essential for maintaining bone health. The aim of this narrative review is to summarize the effects of vitamin D and calcium supplementation separately and in combination, on bone density and circulating serum and blood plasma vitamin D, calcium, parathyroid hormone levels, markers of bone metabolism concentrations, and clinical outcomes, such as falls and osteoporotic fractures. We searched the PubMed online database to find clinical trials from the last five years (2016-April 2022). A total of 26 randomized clinical trials (RCTs) were included in this review. The present reviewed evidence suggests that vitamin D alone or in combination with calcium increases circulating 25(OH)D. Calcium with concomitant vitamin D supplementation, but not vitamin D alone, leads to an increase in BMD. In addition, most studies did not detect significant changes in circulating levels of plasma bone metabolism markers, nor in the incidence of falls. Instead, there was a decrease in blood serum PTH levels in the groups receiving vitamin D and/or Ca supplementation. The plasma vitamin D levels at the beginning of the intervention, and the dosing regimen followed, may play a role in the observed parameters. However, further study is needed to determine an appropriate dosing regimen for the treatment of osteoporosis and the role of bone metabolism markers.
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Affiliation(s)
- Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Paraskevi Detopoulou
- Department of Clinical Nutrition, General Hospital Korgialenio Benakio, 11526 Athens, Greece
- Department of Nutritional Science and Dietetics, University of the Peloponnese, 24100 Kalamata, Greece
| | - Despoina Tsoumana
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of the Aegean, 81400 Myrina, Greece
| | - Foivi S. Kondyli
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Evgenia Lymperaki
- Department of Biomedical Sciences, International Hellenic University, 57400 Thessaloniki, Greece
| | - Agathi Pritsa
- Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece
- Correspondence:
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Aghsaeifard Z, Alizadeh R. Two-way Road of Kidney and Hypercalcemia: A Narrative Review. Cardiovasc Hematol Disord Drug Targets 2023; 22:200-206. [PMID: 36475333 DOI: 10.2174/1871529x23666221205143041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022]
Abstract
Calcium homeostasis is regulated by the dyad of parathyroid hormone and calcitriol, whereas kidney, intestine, and bone are the primary target sites. Elevation of serum calcium levels and hypercalcemia are likely markers of pathological conditions, particularly malignancy and hyperparathyroidism. Similarly, several dysfunctions within the body can direct hypercalcemia. Furthermore, chemicals and drugs can also drive this condition. Owing to the significant role of the kidney in calcium homeostasis, renal abnormalities lead to hypercalcemia and increased calcium levels can have pathological effects on the kidney. This review is designed to highlight some of the commonly known causes of hypercalcemia and their effects on the kidney.
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Affiliation(s)
- Ziba Aghsaeifard
- Department of Internal Medicine, School of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Alizadeh
- Department of Anesthesiology and Intensive Care, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
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Zhang H, Ke Z, Dong S, Du Y, Tang W, Chen M, Yu W, Cheng Q. Eldecalcitol prevents muscle loss by suppressing PI3K/AKT/FOXOs pathway in orchiectomized mice. Front Pharmacol 2022; 13:1018480. [PMID: 36386197 PMCID: PMC9650589 DOI: 10.3389/fphar.2022.1018480] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 10/17/2022] [Indexed: 11/29/2022] Open
Abstract
Elderly male patients are susceptible to develop osteoporosis and sarcopenia, especially those with fragility fractures, hypogonadism, and prostate cancer with androgen deprivation therapy. However, at present, very few treatments are available for men with sarcopenia. Previous preclinical studies in ovariectomized rats have shown the promising effects of eldecalcitol in ameliorating the bone strength and muscle atrophy. We thus investigated the effects of eldecalcitol on androgen-deficient male mice. Six-week-old male mice underwent orchiectomy (ORX) or sham surgery. Mice were randomly divided into 4 groups (n = 12/per group), including 1) sham mice, 2) ORX group, 3) ORX eldecalcitol 30 ng/kg, and 4) ORX eldecalcitol 50 ng/kg. Eldecalcitol increased bone mass and strength of femur in ORX mice. Eldecalcitol 30 ng/kg dose completely rescued ORX-induced muscle weakness. The RT-qPCR showed that eldecalcitol enhanced the mRNA levels of type I and IIa fibers. The expression levels of MuRF1 and Atrogin-1 of gastrocnemius in the eldecalcitol groups were much lower than that of the ORX group. It is assumed that eldecalcitol potentially acts via PI3K/AKT/FOXOs signaling pathway. These findings provide evidence for evaluating eldecalcitol as an investigational treatment for male patients with sarcopenia and osteoporosis.
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Affiliation(s)
- Haichao Zhang
- Department of Osteoporosis and Bone Disease, Research Section of Geriatric Metabolic Bone Disease, Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Zheng Ke
- Medical Division, Chugai Pharma China Co., Ltd, Shanghai, China
| | | | - Yanping Du
- Department of Osteoporosis and Bone Disease, Research Section of Geriatric Metabolic Bone Disease, Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Wenjing Tang
- Department of Osteoporosis and Bone Disease, Research Section of Geriatric Metabolic Bone Disease, Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Minmin Chen
- Department of Osteoporosis and Bone Disease, Research Section of Geriatric Metabolic Bone Disease, Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Weijia Yu
- Department of Osteoporosis and Bone Disease, Research Section of Geriatric Metabolic Bone Disease, Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Qun Cheng
- Department of Osteoporosis and Bone Disease, Research Section of Geriatric Metabolic Bone Disease, Shanghai Geriatric Institute, Huadong Hospital Affiliated to Fudan University, Shanghai, China
- *Correspondence: Qun Cheng,
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Bu SY, Choi MJ, Choi DS, Jung YM, Jang IS, Yang N, Kim K, Park CY. Perspectives on the systematic review for the 2020 Dietary Reference Intakes for Koreans for calcium. Nutr Res Pract 2022; 16:S89-S112. [PMID: 35651839 PMCID: PMC9127516 DOI: 10.4162/nrp.2022.16.s1.s89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 11/15/2022] Open
Abstract
An accurate assessment of the recommended calcium (Ca) intake may contribute to reducing the risk of fractures and chronic diseases, ultimately improving quality of life. This review was performed to summarize key findings of Ca studies, investigate the effect of Ca intake on health outcomes, and determine the adequacy of evidence to revise the 2015 Dietary Reference Intakes for Koreans (KDRIs) for Ca in 2020. Databases were searched for intervention studies that assessed health outcomes by providing Ca in diets or as supplements. The framework of the systematic review comprised conducting literature searches, data extraction, quality assessment of the literature, and summarizing key findings relevant to set the Estimated Average Requirement (EAR) and Tolerable Upper Intake Level (UL) for Ca for the 2020 KDRI. The final search was performed in June 2019. A total of 13,309 studies were identified through databases and manual search. Sixtyfive studies were included in the final quality assessment and were summarized according to health indicators. As bone health was used as an indicator of the EAR for Ca, literature reports on bone health were further categorized by the life-cycle stage of the participants. This systematic review did not find new evidence that could be applied to the general Korean adult population, including postmenopausal women, for defining a new EAR for Ca in the 2020 KDRIs. Evidence in most of the reviewed literature was considered weak; however, some evidence was found that could improve the criteria on how the EAR for Ca was determined in children and adolescents. A review of the literature for the 2020 KDRIs for Ca did not find strong evidence in order to change the recommended values of the 2015 KDRIs. More clinical interventions are required among Koreans to strengthen the body of evidence to warrant the revision of the KDRIs.
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Affiliation(s)
- So Young Bu
- Department of Food and Nutrition, Daegu University, Gyeongsan 38453, Korea
| | - Mi Ja Choi
- Department of Food and Nutrition, Keimyung University, Daegu 42601, Korea
| | - Da Seul Choi
- Graduate School of Education, Chonnam National University, Gwangju 61186, Korea
| | - You-Mi Jung
- Department of Food and Nutrition, Keimyung University, Daegu 42601, Korea
| | - In-Sil Jang
- Department of Food and Nutrition, Keimyung University, Daegu 42601, Korea
| | - Narae Yang
- Department of Food Science and Nutrition, Dankook University, Cheonan 31116, Korea
| | - Kirang Kim
- Department of Food Science and Nutrition, Dankook University, Cheonan 31116, Korea
| | - Clara Yongjoo Park
- Department of Food and Nutrition, Chonnam National University, Gwangju 61186, Korea
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Schleicher RL, Sternberg MR, Potischman N, Gahche JJ, Storandt RJ, Maw KL, Pfeiffer CM. Supplemental Vitamin D Increased Serum Total 25-Hydroxyvitamin D in the US Adult Population During 2007-2014. J Nutr 2021; 151:2446-2454. [PMID: 34036360 PMCID: PMC8349116 DOI: 10.1093/jn/nxab147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/11/2021] [Accepted: 04/21/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Data from the 2007-2010 NHANES suggested that vitamin D supplements contributed to increased serum concentrations of 25-hydroxyvitamin D [25(OH)D] in the US population. OBJECTIVES We sought to determine whether 25(OH)D continued to increase during NHANES 2011-2014 and whether associations of 25(OH)D with preselected covariates differed across time periods. METHODS For this study, 25(OH)D was measured in adults (≥20 y) using LC-MS/MS. Descriptive and regression analyses were stratified by survey period to investigate the effects of age, race-Hispanic origin, sex, season, BMI, dietary vitamin D, and vitamin D-containing supplements. A multiple linear regression model was used to assess 25(OH)D changes between two 4-y survey periods, namely 2007-2010 and 2011-2014. RESULTS We observed several significant concomitant increases between 2007-2010 and 2011-2014: unadjusted mean 25(OH)D increased by 2.7 nmol/L (95% CI: 0, 5.4 nmol/L; P = 0.048), the percentage of persons taking any vitamin D-containing supplements increased 2.9% (95% CI: 0.03, 5.5%; P = 0.0314), and the percentage of persons taking high-dose (≥1000 IU/d) vitamin D-containing supplements increased 8.6% (95% CI: 6.9, 9.9%; P < 0.0001). With covariate adjustment, the increase in 25(OH)D from 2007-2010 to 2011-2014 was no longer statistically significant [1.4 nmol/L (95% CI: -3.0, 0.23 nmol/L; P = 0.09)]. After adjustments, several large differences in 25(OH)D remained, namely non-Hispanic blacks had 25(OH)D 22 nmol/L lower than that of non-Hispanic whites, and users of vitamin D-containing supplements ≥1000 IU/d had 25(OH)D 31 nmol/L higher than that of nonusers. CONCLUSIONS After adjusting for vitamin D supplement dose, the overall adjusted increase in 25(OH)D was no longer statistically significant, suggesting that changes in US adults' 25(OH)D concentrations between NHANES periods 2007-2010 and 2011-2014 may primarily be associated with changes in vitamin D supplementation.
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Affiliation(s)
| | | | | | | | - Renee J Storandt
- National Center for Health Statistics, CDC, Hyattsville, MD, USA
| | - Khin L Maw
- National Center for Environmental Health, CDC, Atlanta, GA, USA
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Billington EO, Burt LA, Rose MS, Davison EM, Gaudet S, Kan M, Boyd SK, Hanley DA. Safety of High-Dose Vitamin D Supplementation: Secondary Analysis of a Randomized Controlled Trial. J Clin Endocrinol Metab 2020; 105:5634116. [PMID: 31746327 DOI: 10.1210/clinem/dgz212] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 11/18/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT More than 3% of adults report vitamin D intakes of 4000 IU/day or more, but the safety of this practice is unknown. OBJECTIVE The objective of this work is to establish whether vitamin D doses up to 10 000 IU/day are safe and well tolerated. DESIGN The Calgary Vitamin D Study was a 3-year, double-blind, randomized controlled trial. SETTING A single-center study was conducted at the University of Calgary, Canada. PARTICIPANTS Participants included healthy adults (n = 373) ages 55 to 70 years with serum 25-hydroxyvitamin D 30 to 125 nmol/L. INTERVENTIONS Participants were randomly assigned 1:1:1 to vitamin D3 400, 4 000, or 10 000 IU/day. Calcium supplementation was initiated if dietary calcium intake was less than 1200 mg/day. MAIN OUTCOME MEASURES In these prespecified secondary analyses, changes in serum 25-hydroxyvitamin D, calcium, creatinine, 24-hour urine calcium excretion, and incidence of adverse events were assessed. Between-group differences in adverse events were examined using incident rate differences and logistic regression. RESULTS Of 373 participants (400: 124, 4000: 125, 10 000: 124), 49% were male, mean (SD) age was 64 (4) years, and 25-hydroxyvitamin D 78.0 (19.5) nmol/L. Serum calcium, creatinine, and 24-hour urine calcium excretion did not differ between treatments. Mild hypercalcemia (2.56-2.64 mmol/L) occurred in 15 (4%) participants (400: 0%, 4000: 3%, 10 000: 9%, P = .002); all cases resolved on repeat testing. Hypercalciuria occurred in 87 (23%) participants (400: 17%, 4000: 22%, 10 000: 31%, P = .01). Clinical adverse events were experienced by 365 (97.9%) participants and were balanced across treatment arms. CONCLUSIONS The safety profile of vitamin D supplementation is similar for doses of 400, 4000, and 10 000 IU/day. Hypercalciuria was common and occurred more frequently with higher doses. Hypercalcemia occurred more frequently with higher doses but was rare, mild, and transient.
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Affiliation(s)
- Emma O Billington
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Canada
| | - Lauren A Burt
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Canada
| | - Marianne S Rose
- Research Facilitation, Alberta Health Services, Calgary, Canada
| | - Erin M Davison
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Canada
| | - Sharon Gaudet
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Canada
| | - Michelle Kan
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Canada
| | - Steven K Boyd
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Canada
| | - David A Hanley
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Canada
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Lippi G, Targher G. Are we overrating the extra-skeletal benefits of oral vitamin D supplementation? ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:499. [PMID: 31700935 PMCID: PMC6803180 DOI: 10.21037/atm.2019.08.93] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 08/15/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, Diabetes and Metabolism, University of Verona, Verona, Italy
| | - Giovanni Targher
- Section of Endocrinology, Diabetes and Metabolism, University of Verona, Verona, Italy
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Burt LA, Billington EO, Rose MS, Raymond DA, Hanley DA, Boyd SK. Effect of High-Dose Vitamin D Supplementation on Volumetric Bone Density and Bone Strength: A Randomized Clinical Trial. JAMA 2019; 322:736-745. [PMID: 31454046 PMCID: PMC6714464 DOI: 10.1001/jama.2019.11889] [Citation(s) in RCA: 173] [Impact Index Per Article: 34.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 07/22/2019] [Indexed: 12/13/2022]
Abstract
Importance Few studies have assessed the effects of daily vitamin D doses at or above the tolerable upper intake level for 12 months or greater, yet 3% of US adults report vitamin D intakes of at least 4000 IU per day. Objective To assess the dose-dependent effect of vitamin D supplementation on volumetric bone mineral density (BMD) and strength. Design, Setting, and Participants Three-year, double-blind, randomized clinical trial conducted in a single center in Calgary, Canada, from August 2013 to December 2017, including 311 community-dwelling healthy adults without osteoporosis, aged 55 to 70 years, with baseline levels of 25-hydroxyvitamin D (25[OH]D) of 30 to 125 nmol/L. Interventions Daily doses of vitamin D3 for 3 years at 400 IU (n = 109), 4000 IU (n = 100), or 10 000 IU (n = 102). Calcium supplementation was provided to participants with dietary intake of less than 1200 mg per day. Main Outcomes and Measures Co-primary outcomes were total volumetric BMD at radius and tibia, assessed with high resolution peripheral quantitative computed tomography, and bone strength (failure load) at radius and tibia estimated by finite element analysis. Results Of 311 participants who were randomized (53% men; mean [SD] age, 62.2 [4.2] years), 287 (92%) completed the study. Baseline, 3-month, and 3-year levels of 25(OH)D were 76.3, 76.7, and 77.4 nmol/L for the 400-IU group; 81.3, 115.3, and 132.2 for the 4000-IU group; and 78.4, 188.0, and 144.4 for the 10 000-IU group. There were significant group × time interactions for volumetric BMD. At trial end, radial volumetric BMD was lower for the 4000 IU group (-3.9 mg HA/cm3 [95% CI, -6.5 to -1.3]) and 10 000 IU group (-7.5 mg HA/cm3 [95% CI, -10.1 to -5.0]) compared with the 400 IU group with mean percent change in volumetric BMD of -1.2% (400 IU group), -2.4% (4000 IU group), and -3.5% (10 000 IU group). Tibial volumetric BMD differences from the 400 IU group were -1.8 mg HA/cm3 (95% CI, -3.7 to 0.1) in the 4000 IU group and -4.1 mg HA/cm3 in the 10 000 IU group (95% CI, -6.0 to -2.2), with mean percent change values of -0.4% (400 IU), -1.0% (4000 IU), and -1.7% (10 000 IU). There were no significant differences for changes in failure load (radius, P = .06; tibia, P = .12). Conclusions and Relevance Among healthy adults, treatment with vitamin D for 3 years at a dose of 4000 IU per day or 10 000 IU per day, compared with 400 IU per day, resulted in statistically significant lower radial BMD; tibial BMD was significantly lower only with the 10 000 IU per day dose. There were no significant differences in bone strength at either the radius or tibia. These findings do not support a benefit of high-dose vitamin D supplementation for bone health; further research would be needed to determine whether it is harmful. Trial Registration ClinicalTrials.gov Identifier: NCT01900860.
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Affiliation(s)
- Lauren A. Burt
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Emma O. Billington
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Duncan A. Raymond
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - David A. Hanley
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Steven K. Boyd
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Bouderlique E, Tang E, Perez J, Coudert A, Bazin D, Verpont MC, Duranton C, Rubera I, Haymann JP, Leftheriotis G, Martin L, Daudon M, Letavernier E. Vitamin D and Calcium Supplementation Accelerates Randall's Plaque Formation in a Murine Model. THE AMERICAN JOURNAL OF PATHOLOGY 2019; 189:2171-2180. [PMID: 31449775 DOI: 10.1016/j.ajpath.2019.07.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/28/2019] [Accepted: 07/26/2019] [Indexed: 11/27/2022]
Abstract
Most kidney stones are made of calcium oxalate crystals. Randall's plaque, an apatite deposit at the tip of the renal papilla, is considered to at the origin of these stones. Hypercalciuria may promote Randall's plaque formation and growth. We analyzed whether long-term exposure of Abcc6-/- mice (a murine model of Randall's plaque) to vitamin D supplementation, with or without a calcium-rich diet, would accelerate the formation of Randall's plaque. Eight groups of mice (including Abcc6-/- and wild type) received vitamin D alone (100,000 UI/kg every 2 weeks), a calcium-enriched diet alone (calcium gluconate 2 g/L in drinking water), both vitamin D supplementation and a calcium-rich diet, or a standard diet (controls) for 6 months. Kidney calcifications were assessed by 3-dimensional microcomputed tomography, μ-Fourier transform infrared spectroscopy, field emission-scanning electron microscopy, transmission electron microscopy, and Yasue staining. At 6 months, Abcc6-/- mice exposed to vitamin D and calcium supplementation developed massive Randall's plaque when compared with control Abcc6-/- mice (P < 0.01). Wild-type animals did not develop significant calcifications when exposed to vitamin D. Combined administration of vitamin D and calcium significantly accelerates Randall's plaque formation in a murine model. This original model raises concerns about the cumulative risk of vitamin D supplementation and calcium intakes in Randall's plaque formation.
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Affiliation(s)
- Elise Bouderlique
- Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, Paris, France; INSERM, Unité Mixte de Recherche S 1155, Paris, France
| | - Ellie Tang
- Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, Paris, France; INSERM, Unité Mixte de Recherche S 1155, Paris, France
| | - Joëlle Perez
- Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, Paris, France; INSERM, Unité Mixte de Recherche S 1155, Paris, France
| | - Amélie Coudert
- Unité de Formation et de Recherche d'Odontologie, Département des Sciences Biologiques, Université Paris Diderot BIologie de l'Os et du CARtilage (BIOSCAR), INSERM U1132, Hôpital Lariboisière, Paris, France
| | - Dominique Bazin
- Laboratoire de Chimie Physique, Centre National de la Recherche-Unité Mixte de Recherche 8000, Université Paris XI, Orsay, France
| | - Marie-Christine Verpont
- Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, Paris, France; INSERM, Unité Mixte de Recherche S 1155, Paris, France
| | - Christophe Duranton
- Université Côte d'Azur, Centre National de la Recherche-Unité Mixte de Recherche 7370, Laboratoire de Physiomédecine Moléculaire, Nice, France
| | - Isabelle Rubera
- Université Côte d'Azur, Centre National de la Recherche-Unité Mixte de Recherche 7370, Laboratoire de Physiomédecine Moléculaire, Nice, France
| | - Jean-Philippe Haymann
- Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, Paris, France; INSERM, Unité Mixte de Recherche S 1155, Paris, France; Physiology Unit, Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Georges Leftheriotis
- Université Côte d'Azur, Centre National de la Recherche-Unité Mixte de Recherche 7370, Laboratoire de Physiomédecine Moléculaire, Nice, France; Laboratory of Physiology and Molecular Medicine, Centre National de la Recherche-Université Nice Sophia-Antipolis Unité Mixte de Recherche 7370, University of Nice, Nice Cedex 2, France
| | - Ludovic Martin
- Physiopathologie MITOchondriale et cardioVASCulaire (MITOVASC) Institute, Centre National de la Recherche-Unité Mixte de Recherche 6015, INSERM U1083, Angers University, Angers, France; Pseudoxanthoma Elasticum Reference Center, Reference Centre for Genetic Dermatologic Diseases Nord Center for Rare Skin Diseases, Angers University Hospital, Angers, France
| | - Michel Daudon
- Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, Paris, France; INSERM, Unité Mixte de Recherche S 1155, Paris, France; Physiology Unit, Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Emmanuel Letavernier
- Sorbonne Universités, Université Pierre et Marie Curie Univ Paris 06, Paris, France; INSERM, Unité Mixte de Recherche S 1155, Paris, France; Physiology Unit, Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Paris, France.
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12
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Aloia JF. Reply to: Towards a Consensus on Vitamin D Supplementation and Bone Health. J Bone Miner Res 2019; 34:401. [PMID: 30550628 DOI: 10.1002/jbmr.3633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 11/11/2018] [Indexed: 11/08/2022]
Affiliation(s)
- John F Aloia
- Bone Mineral Research Center, New York University (NYU) Winthrop Hospital, Mineola, NY, USA
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