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1.
J Steroid Biochem Mol Biol ; 202: 105719, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32535032

RESUMO

Coronavirus infection is a serious health problem awaiting an effective vaccine and/or antiviral treatment. The major complication of coronavirus disease 2019 (COVID-19), the Acute Respiratory Distress syndrome (ARDS), is due to a variety of mechanisms including cytokine storm, dysregulation of the renin-angiotensin system, neutrophil activation and increased (micro)coagulation. Based on many preclinical studies and observational data in humans, ARDS may be aggravated by vitamin D deficiency and tapered down by activation of the vitamin D receptor. Several randomized clinical trials using either oral vitamin D or oral Calcifediol (25OHD) are ongoing. Based on a pilot study, oral calcifediol may be the most promising approach. These studies are expected to provide guidelines within a few months.


Assuntos
Calcifediol/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Pneumonia Viral/tratamento farmacológico , Vitamina D/uso terapêutico , Vitaminas/uso terapêutico , Administração Oral , Betacoronavirus/efeitos dos fármacos , Calcifediol/administração & dosagem , Infecções por Coronavirus/complicações , Infecções por Coronavirus/patologia , Humanos , Pandemias , Projetos Piloto , Pneumonia Viral/complicações , Pneumonia Viral/patologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Sistema Renina-Angiotensina/efeitos dos fármacos , /patologia , Vitamina D/administração & dosagem , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/tratamento farmacológico , Deficiência de Vitamina D/patologia , Vitaminas/administração & dosagem
2.
Poult Sci ; 99(5): 2608-2615, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32359596

RESUMO

This study was conducted to determine the effects of 25-hydroxycholecalciferol (25-OH-D3) on performance, egg quality, tibia quality, and serum hormones concentration in laying hens reared under high stocking density. A total of 800 45-week-old Lohmann laying hens were randomly allotted into a 2 × 2 factorial design with 2 levels of dietary 25-OH-D3 levels (0 and 69 µg/kg) and 2 rates of stocking densities [506 (low density) and 338 (high density) cm2/hen]. Laying hens were monitored for 16 wk. High stocking density decreased laying rate, egg weight, and feed intake compared with low stocking density (P < 0.01) during 1 to 8 wk and 1 to 16 wk. Overall, high stocking density increased eggshell lightness value and decreased shell redness and yellowness value, strength, thickness, and relative weight compared with low stocking density (P < 0.05). Dietary supplementation with 25-OH-D3 reduced the value of the eggshell lightness and increased its yellowness and eggshells weight (P ≤ 0.05). The increase in eggshell thickness was more pronounced when 25-OH-D3 was supplemented to layers under high stocking density (interaction, P < 0.05). Layers under high stocking density had lower ash content and calcium content in the tibia than layers under low stocking density (P = 0.04); dietary 25-OH-D3 increased tibia strength compared with no addition (P = 0.05). Layers under high stocking density had higher serum concentrations of 25-OH-D3, corticosterone (CORT), lipopolysaccharide (LPS), and osteocalcin (OC; P < 0.05), lower content of parathyroid hormone (PTH) compared with layers under low stocking density (P < 0.01). Dietary 25-OH-D3 increased serum concentration of 25-OH-D3, carbonic anhydrase (CA), and calcitonin (CT) (P < 0.01) and reduced corticosterone, lipopolysaccharide and osteocalcin concentration (P ≤ 0.05). The increase effect in PTH was more pronounced when 25-OH-D3 was supplemented to layers under high stocking density (interaction, P = 0.05). Overall, the results gathered in this study indicate that high stocking density result in reducing production performance, shell color and quality, and tibia health, whereas dietary 25-OH-D3 was able to maintain tibia health and to mitigate the negative impact of high stocking density on productive performance.


Assuntos
Calcifediol/metabolismo , Galinhas/fisiologia , Óvulo/química , Tíbia/química , Ração Animal/análise , Animais , Calcifediol/administração & dosagem , Galinhas/crescimento & desenvolvimento , Dieta/veterinária , Suplementos Nutricionais/análise , Feminino , Densidade Demográfica , Distribuição Aleatória
3.
Poult Sci ; 99(3): 1241-1253, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32111302

RESUMO

Genetic selection and intensive nutrition for increased growth rate in meat-type ducks has resulted in an imbalance between pectorales increment and sternal mass, which is detrimental to productivity and welfare. Reducing body weight and increasing sternal mass probably reverses these adverse effects. Therefore, 2 experiments (Expt.) were conducted to investigate the effects of 25-hydroxycholecalciferol (25-OH-D3), a vitamin D3 metabolites, on sternal mass. In Expt. 1, 512 1-day-old male ducks were randomly assigned to 4 low-nutrient density diets and received following treatments in a 2 × 2 factorial arrangement: (i) NRC or China Agricultural industry standards (NY/T) vitamin premixes and (ii) 0.069 mg/kg 25-HyD in feed or not. At 49 D of age, regardless of 25-OH-D3, NY/T vitamin regimen inhibited bone turnover and consequently increased sternal trabecular bone volume and mineral deposition compared with NRC vitamin premix. Supplementing 25-OH-D3 to NRC but not NY/T vitamin regimen significantly improved sternal microarchitecture and mineral content, which companied by decreased serum bone resorption markers concentration, as well as downregulation of the gene expressions of osteoclast differentiation and activity. In Expt. 2, 256 1-day-old male ducks were fed a standard nutrient density diet contained NRC vitamin premix with 0 or 0.069 mg/kg of 25-OH-D3. Results also showed that 25-OH-D3 treatment significantly improved sternal mineral accumulation and microarchitecture, along with decreasing osteoblast and osteoclast numbers in bone surface, declining serum bone turnover markers levels, and increasing serum Ca concentration. Collectively, these findings indicated that the dietary administration of 25-OH-D3 increased sternal mass in NRC vitamin diet by suppressing bone resorption in 49-day-old meat duck.


Assuntos
Conservadores da Densidade Óssea/metabolismo , Calcifediol/metabolismo , Patos/fisiologia , Esterno/fisiologia , Vitaminas/metabolismo , Ração Animal/análise , Animais , Conservadores da Densidade Óssea/administração & dosagem , Calcifediol/administração & dosagem , Dieta/veterinária , Suplementos Nutricionais/análise , Masculino , Tamanho do Órgão , Osteoblastos/efeitos dos fármacos , Osteoblastos/metabolismo , Osteoclastos/efeitos dos fármacos , Osteoclastos/metabolismo , Distribuição Aleatória
4.
J Steroid Biochem Mol Biol ; 199: 105616, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32027935

RESUMO

To evaluate the measured free 25-hydroxyvitamin D [25(OH)D] levels in patients with hyperparathyroidism (PHPT) and healthy controls. Eighty patients with PHPT(n = 40) and age and BMI matched controls (n = 40) were examined. Serum levels of total or free 25(OH)D, vitamin D binding protein (DBP), intact parathyroid hormone (iPTH) and calcium were measured. There was no significant difference in age (61.2 ± 11.9 vs 60.2 ± 7.0 years) and BMI (30.0 ± 6.1 vs 30.0 ± 2.2 kg/m2) between PHPT patients and healthy subjects. Levels of total 25(OH)D were about 20 % lower in PHPT patients (26.4 ± 7.7 ng/mL) compared to controls (31.0 ± 7.8 ng/mL, P < 0.05). There were no significant differences in calculated or measured free 25(OH)D levels between PHPT patients (4.9 ± 1.8 or 4.9 ± 1.6 pg/mL, respectively) and control subjects (5.1 ± 1.2 or 5.3 ± 1.6 pg/mL, respectively). Levels of free 25(OH)D were positively associated with levels of total 25(OH)D (r = 0.28, P < 0.05) but negatively correlated with iPTH and calcium levels (r=-0.22 and -0.23 respectively, P < 0.05). Serum total 25(OH)D levels were lower but the calculated or measured free 25(OH)D levels in patients with PHPT did not differ from healthy subjects. We suggest that total 25(OH)D levels may not reflect true vitamin D nutritional status in patients with PHPT.


Assuntos
Calcifediol/administração & dosagem , Hiperparatireoidismo Primário/sangue , Vitamina D/análogos & derivados , Vitamina D/genética , Idoso , Índice de Massa Corporal , Cálcio/sangue , Cálcio na Dieta/administração & dosagem , Feminino , Humanos , Hiperparatireoidismo Primário/genética , Hiperparatireoidismo Primário/patologia , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Hormônio Paratireóideo/sangue , Vitamina D/sangue
5.
Nutr. hosp ; 37(1): 28-36, ene.-feb. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-187571

RESUMO

Background: although supplementation with vitamin D has been reported as a main determinant of 25-hydroxyvitamin D status [25(OH)D] levels, there are limited data in regard to the factors associated with vitamin D supplementation in older adults. Aims: to examine the characteristics of participants associated with vitamin D supplement use and its effect on 25(OH)D concentrations according to bone mineral density (BMD). Methods: the present analysis was based on data from participants aged 60 years and older in the National Health and Nutrition Examination Survey. Logistic regression models were created to examine the demographic, lifestyle, and health characteristics associated with vitamin D supplementation. Moreover, general linear models were assembled to assess the effect of vitamin D supplement doses on 25(OH)D concentrations according to BMD status. Results: of 5,204 participants, 45.3 % reported taking vitamin D supplements, at least 400 IU per day. Overall, women, non-Hispanic whites, college education, former smokers, physical activity, and > 2 comorbidities were variables significantly associated with increased odds of taking vitamin D supplements. Notably, among subjects with osteoporosis, those taking vitamin D supplements between 400 and 800 IU per day had on average 20.7 nmol/L higher 25(OH)D concentrations compared with their non-user counterparts. Conclusions: demographic and healthy lifestyle characteristics are the main determinants of vitamin D supplement use among older adults. Moreover, even among subjects with low bone mass, vitamin D supplements between 400 and 800 IU per day are adequate to reach sufficient 25(OH)D concentrations


Antecedentes: si bien la suplementación con vitamina D es un determinante principal de los niveles séricos de 25-hidroxivitamina D [25(OH)D], pocos estudios han descrito los factores determinantes del uso de suplementos de vitamina D en los adultos mayores. Objetivos: examinar los factores determinantes del uso de suplementos de vitamina D y su efecto en los niveles de 25(OH)D según la densidad ósea. Métodos: el presente análisis se basó en datos de participantes de 60 años o más en la Encuesta Nacional de Examen de Salud y Nutrición de EUA. Se crearon modelos de regresión logística para examinar las características demográficas, de estilo de vida y de salud asociadas al uso de suplementos de vitamina D. Además, se usaron modelos lineales generales para evaluar, según la densidad ósea, el efecto de la suplementación de vitamina D en las concentraciones de 25(OH)D. Resultados: de 5204 sujetos, el 45,3 % informaron que tomaban suplementos de vitamina D, al menos 400 UI por día. En general, las mujeres, los blancos no hispanoamericanos, la educación universitaria, ser exfumador, la actividad física y > 2 comorbilidades fueron características asociadas al aumento de las probabilidades de tomar suplementos de vitamina D. En particular, entre los sujetos con osteoporosis, aquellos que tomaron suplementos de vitamina D en dosis de entre 400 y 800 UI por día tenían de promedio concentraciones 20,7 nmol/l más altas de 25(OH)D que sus homólogos no usuarios. Conclusiones: las características demográficas y un estilo de vida saludable son los principales factores asociados al uso de suplementos de vitamina D en los adultos mayores. Además, incluso entre los sujetos con densidad ósea baja, la suplementación con vitamina D entre 400 y 800 UI por día es adecuada para alcanzar los niveles óptimos de 25(OH)D


Assuntos
Humanos , Idoso , Vitamina D/administração & dosagem , Densidade Óssea/efeitos dos fármacos , Calcifediol/administração & dosagem , Atividade Motora , Estado Nutricional , Modelos Logísticos , Dosagem , Estudos Transversais , Inquéritos e Questionários
6.
Andrologia ; 52(3): e13507, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31943308

RESUMO

Our aim was to explore the existence of a possible relationship of sperm motility with serum 25-hydroxyvitamin D3 (25-OH VD) levels and with ischaemia-modified albumin (IMA) levels in infertile Turkish men. A total of 30 men with nonobstructive azoospermia (no spermatozoa in ejaculate), 30 men with oligospermia (total progressive motile sperm count (TPMSC) <15 × 106 /ml) and 33 fertile men with normospermia (with at least one child, as the control group) were enrolled in the study. The mean 25-OH VD levels for groups 1, 2 and 3 were 9.31 ± 6.46, 19.71 ± 12.80 and 30.52 ± 12.49 respectively (p < .05). There was a statistically significant difference in serum IMA levels among the groups (479.32 ± 307.56 vs. 296.37 ± 127.27 vs. 150.04 ± 81.05, respectively; p < .05). A positive correlation between serum 25-OH VD levels and TPMSC, and a negative correlation between TPMSC and serum IMA levels were determined. Infertile men had lower serum 25-OH VD and higher IMA levels than fertile men, with a positive correlation between serum 25-OH VD levels and TPMSC, and a negative correlation between TPMSC and serum IMA levels. Vitamin D supplementation may increase the sperm motility.


Assuntos
Azoospermia/sangue , Calcifediol/sangue , Oligospermia/sangue , Adulto , Azoospermia/tratamento farmacológico , Biomarcadores/sangue , Calcifediol/administração & dosagem , Estudos Transversais , Humanos , Masculino , Oligospermia/tratamento farmacológico , Albumina Sérica Humana , Contagem de Espermatozoides , Motilidade Espermática/efeitos dos fármacos , Turquia
7.
J Dairy Sci ; 103(1): 805-822, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31668442

RESUMO

Objectives were to determine the effects of feeding supplemental 25-hydroxyvitamin D3 [25(OH)D3] on concentrations of vitamin D metabolites and minerals in serum, mammary immune status, and responses to intramammary bacterial infection in dairy cows. Sixty multiparous, pregnant lactating Holstein cows with somatic cell count <200,000/mL were blocked by days in milk and milk yield and randomly assigned to receive a daily top-dressed dietary supplement containing 1 or 3 mg of vitamin D3 (1mgD or 3mgD), or 1 or 3 mg 25(OH)D3 (1mg25D or 3mg25D) for 28 d (n = 15/treatment). Cows were kept in a freestall barn and fed a total mixed ration in individual feeding gates. Individual dry matter intake (DMI) and milk yield were recorded daily, and milk and blood samples were collected at 0, 7, 14, and 21 d relative to the start of treatment. At 21 d, cows fed 1mgD and 3mg25D received an intramammary challenge with Streptococcus uberis. Cows were observed for severity of mastitis, and blood and milk samples were collected every 12 h to measure inflammation. The 1mg25D and 3mg25D cows had greater serum 25(OH)D3 concentrations at 21 d compared with 1mgD and 3mgD cows (62 ± 7, 66 ± 8, 135 ± 15, and 232 ± 26 ng/mL for 1mgD, 3mgD, 1mg25D, and 3mg25D, respectively). The 3mg25D cows had greater concentrations of Ca and P in serum at 21 d compared with other treatments (Ca = 2.38, 2.4, 2.37, and 2.48 ± 0.02 mM, 1.87, 1.88, and 2.10 ± 0.08 mM for 1mgD, 3mgD, 1mg25D, and 3mg25D, respectively). Yields of milk and milk components, DMI, body weight, and concentrations of 1,25-dihydroxyvitamin D and Mg in serum did not differ among treatments. Abundance of mRNA transcripts for interleukin-1ß (IL1B) and inducible nitric oxide synthase (iNOS) in milk somatic cells before S. uberis challenge were increased in cows fed 25(OH)D3 compared with cows fed vitamin D3. Furthermore, IL1B, iNOS, ß-defensin 7, and ß-defensin 10 in milk somatic cells increased as concentrations of 25(OH)D3 increased in serum. Cows fed 3mg25D had less severe mastitis at 60 and 72 h after challenge with S. uberis compared with cows fed 1mgD. Concentrations of bacteria, somatic cells, and serum albumin in milk after challenge did not differ between treatments; however, an interaction between treatment and day was detected for lactate dehydrogenase in milk. Expression of adhesion protein CD11b on milk neutrophils after the S. uberis challenge was greater among 3mg25D cows compared with 1mgD cows. Transcripts of CYP24A1 and iNOS in milk somatic cells during mastitis also were greater in 3mg25D cows compared with 1mgD cows. Feeding 25(OH)D3 increased serum 25(OH)D3 more effectively than supplemental vitamin D3, resulting in increased serum mineral concentrations, increased expression of vitamin D-responsive genes, and altered immune responses to intramammary bacterial challenge.


Assuntos
Calcifediol/administração & dosagem , Suplementos Nutricionais , Lactação/efeitos dos fármacos , Minerais/sangue , Animais , Calcifediol/farmacologia , Bovinos , Dieta/veterinária , Feminino , Leite/metabolismo , Gravidez , Vitamina D/análogos & derivados , Vitamina D/sangue
8.
J Nutr ; 150(1): 73-81, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31518424

RESUMO

BACKGROUND: There are few studies directly comparing the pharmacokinetics of 25-hydroxycholecalciferol [25(OH)D3] to cholecalciferol (D3). OBJECTIVES: The primary objectives were to compare the effectiveness of D3 and 25(OH)D3 in raising 25-hydroxyvitamin D [25(OH)D] serum concentrations and achieving steady state. METHODS: This was a randomized, double-blind, active comparator trial of 91 participants (53 females, 38 males), aged 63.3 ± 7.9 y. 25(OH)D3 (10, 15, and 20 µg) and D3 (20 µg) were dosed daily for 6 mo followed by 6 mo of washout. Frequent measurements of serum 25(OH)D were performed. Pharmacokinetic parameters were fitted for each individual and the treatment average was modeled with linear regression using the individual baseline level, sex, and gender as covariates. RESULTS: Mean baseline 25(OH)D was similar in all groups (47.1-49.5 nmol/L). Increases in 25(OH)D to steady state were higher in the 25(OH)D3 groups than in the D3 group [least squares (LS) means (95% CI): 50.1 (43.3-58.0), 72.5 (64.3-81.7), 97.4 (86.6-109.6) nmol/L in 10, 15, and 20 µg/d and 38.7 (33.1-45.2) nmol/L in the D3 group; P = 0.0173, P < 0.0001, P < 0.0001]. The rate to reach steady state was similar in all groups, but the time to reach 25(OH)D concentrations of 75 nmol/L was faster in the higher-dosed 25(OH)D3 groups than in the D3 group (7 and 10 d compared with 40 d, P < 0.0001 and P < 0.0001 for 15 and 20 µg/d). The rate of elimination was 59-109% higher in the 25(OH)D3 groups than in the D3 group. The area under the curve (AUC)/µg dose demonstrated that 25(OH)D3 was 3 times as effective as D3 at raising 25(OH)D concentrations. CONCLUSIONS: 25(OH)D3 is ∼3 times as effective as D3 at raising 25(OH)D concentrations. Once supplementation is discontinued, the elimination rate of 25(OH)D3 is faster than D3. This trial was registered at clinicaltrials.gov as NCT02333682.


Assuntos
Calcifediol/administração & dosagem , Colecalciferol/administração & dosagem , Vitamina D/análogos & derivados , Idoso , Área Sob a Curva , Suplementos Nutricionais , Relação Dose-Resposta a Droga , Método Duplo-Cego , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vitamina D/sangue
9.
J Nutr ; 150(3): 427-433, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31665381

RESUMO

BACKGROUND: 25-Hydroxycholecalciferol [25(OH)D] is the predominant circulating metabolite of vitamin D and serves as the precursor for 1α,25-dihydroxycholecalciferol [1,25(OH)2D], the hormonally active form. The presence of 1α-hydroxylase (1α-OHase) in the intestine suggests that 1,25(OH)2D can be produced from 25(OH)D, but the effects of oral 25(OH)D on the intestine have not been determined. OBJECTIVES: We investigated the acute intestinal response to orally consumed 25(OH)D in mice by assessing mRNA induction of cytochrome p450 family 24 subfamily A member 1 (Cyp24), a vitamin D-dependent gene. The mechanism of action then was determined through in vitro analyses with Caco2 and HT-29 cells. METHODS: Adult male C57BL6 mice were given a single oral dose of 40, 80, 200, or 400 ng 25(OH)D (n = 4 per dose) or vehicle (n = 3), and then killed 4 h later to evaluate the duodenal expression of Cyp24 mRNA by qPCR and RNA in situ hybridization. The 25(OH)D-mediated response was also evaluated with Caco2 and HT-29 cells by inhibition assay and dose-response analysis. A cytochrome p450 family 27 subfamily B member 1 (CYP27B1) knockdown of HT-29 was created to compare the dose-response parameters with wild-type HT-29 cells. RESULTS: Oral 25(OH)D induced expression of Cyp24 mRNA in the duodenum of mice with 80 ng 25(OH)D by 3.3 ± 0.8 ΔΔCt compared with controls (P < 0.05). In vitro, both Caco2 and HT-29 cells responded to 25(OH)D treatment with 200-fold and 175-fold greater effective concentration at 50% maximal response than 1,25(OH)2D, yet inhibition of 1α-OHase and knockdown of CYP27B1 had no effect on the responses. CONCLUSIONS: In mice, orally consumed 25(OH)D elicits a vitamin D-mediated response in the duodenum. In vitro assessments suggest that the response from 25(OH)D does not require activation by 1α-OHase and that 25(OH)D within the intestinal lumen acts as a vitamin D receptor agonist.


Assuntos
Calcifediol/administração & dosagem , Duodeno/efeitos dos fármacos , 25-Hidroxivitamina D3 1-alfa-Hidroxilase/genética , Administração Oral , Animais , Células CACO-2 , Calcifediol/farmacologia , Família 24 do Citocromo P450/genética , Relação Dose-Resposta a Droga , Técnicas de Silenciamento de Genes , Células HT29 , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL
10.
Artigo em Inglês | MEDLINE | ID: mdl-31881679

RESUMO

Little is known about the effect of working conditions on vitamin D status in Southeast Asia, where vitamin D deficiency is common despite the presence of sunlight all year round in most places. We examined the prevalence of vitamin D deficiency and its associated work-related factors among indoor workers using the data of 213 participants (aged ≥21 years) from a workplace cohort study in Singapore. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D (25(OH)D) concentration <50 nmol/L. Data on work-related factors, socio-demographic characteristics, and lifestyle habits were collected using standardized questionnaires. Clinical and biochemical measurements were performed using standard tools and protocols. Multivariate Poisson regression was used to examine the independent association of work-related factors with vitamin D deficiency. Mean serum 25(OH)D concentration was 59.6 nmol/L. The prevalence of vitamin D deficiency was 32.9% (95% confidence interval (CI): 26.6-39.6%). In the multivariate analysis, office workers (prevalence ratio (PR): 2.16, 95% CI: 1.12-4.16 versus control room workers), workshop workers (PR: 2.25, 95% CI: 1.05-4.81 versus control room workers), and night shift workers (PR: 1.31, 95% CI: 1.03-1.67) were at a greater risk for vitamin D deficiency. Workplace policies and wellness programs should encourage workers to take regular breaks to go outdoors for sunlight exposure and to consume adequate amounts of vitamin D-rich foods to maintain optimal vitamin D levels.


Assuntos
Luz Solar , Deficiência de Vitamina D/sangue , Vitamina D/análogos & derivados , Local de Trabalho , Adulto , Calcifediol/administração & dosagem , Estudos de Coortes , Estudos Transversais , Grupos Étnicos , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Prevalência , Singapura , Inquéritos e Questionários , Vitamina D/sangue , Vitaminas/administração & dosagem , Adulto Jovem
11.
Pediatr. catalan ; 79(4): 127-132, oct.-dic. 2019. tab, graf
Artigo em Catalão | IBECS | ID: ibc-191077

RESUMO

FONAMENT: En els prematurs, uns nivells inadequats de vitamina D poden comportar més comorbiditat, però hi ha controvèrsia en les recomanacions de suplementació. OBJECTIU: Intentar correlacionar aportacions (dieta I suplementació) de vitamina D amb nivells inadequats d'aquesta vitamina. MÉTODE: Estudi descriptiu retrospectiu dels prematurs als quals se'ls determina calcifediol (25(OH)D3) entre els mesos de gener I desembre del 2016 al nostre centre. RESULTATS: Incloem 36 determinacions de 25(OH)D3 de 17 nadons (58,8% de sexe masculí) amb mediana d'edat gestacional de 29,8 setmanes (rang: 24,85-35,14) I mediana de pes de 980 g (rang: 420-2.220 g). La mediana d'edat en dies en el moment de l'extracció és 58,5 (rang: 6-188); la mediana de 25(OH)D3 és 53,92ng/ml (rang: 17,1-150). Segons el càlcul de les aportacions de vitamina D, s'obté una mediana de 885 U/dia (rang: 2-1416). Hi ha una correlació estadísticament significativa entre 25(OH)D3 plasmàtica I aportacions. El 75% que rep aportacions de <400 U tenen nivells insuficients; el 62,5% que rep >1.200 U tenen nivells tòxics. Dels que reben 400-1.200 U, el 84% tenen nivells òptims; hi ha diferència entre els que reben 400-800 U, amb un 60% amb nivells suficients, I els que reben 800-1.200 U, amb un 92% amb nivells adequats. Hi ha diferència en el percentatge de mostres amb nivells insuficients segons la classificació de 2009 respecte de l'actual. CONCLUSIONS: Les aportacions de vitamina D d'entre 800 I 1.200 U/dia s'associen a nivells òptims en un percentatge elevat de nadons. Les aportacions inferiors a 400 U o superiors a 1.200 U s'associen a nivells inadequats. L'alimentació per si sola no garanteix els requeriments necessaris de vitamina D, però és una dada essencial que s'ha de tenir en compte. Cal individualitzar la dosi segons els nivells plasmàtics


FUNDAMENTO: En los prematuros, unos niveles inadecuados de vitamina D pueden comportar mayor comorbilidad, pero existe controversia en las recomendaciones de suplementación. OBJETIVO: Intentar correlacionar aportaciones (dieta y suplementación) de vitamina D con niveles inadecuados de esta vitamina. MÉTODO: Estudio descriptivo retrospectivo de los prematuros a los que se les realiza determinación de calcifediol (25(OH)D3) entre enero y diciembre de 2016 en nuestro centro. RESULTADOS: Incluimos 36 determinaciones de 25(OH)D3 de 17 pacientes (58,8% de sexo masculino) con mediana de edad gestacional de 29,8 semanas (rango: 24,85-35,17) y mediana de peso de 980 g (rango: 420-2.220 g). La mediana de edad en días en el momento de la extracción es 58,5 (rango: 6-188); la mediana de 25(OH)D3 es 53,92 ng/ml (rango: 17,1-150). Según el cálculo de los aportes de vitamina D, se obtiene una mediana de 885 U/día (rango: 2-1.416). Existe una correlación estadísticamente significativa entre niveles de 25(OH)D3 y aportes. El 75% que recibe aportes de <400 U tienen niveles insuficientes; el 62,5% que recibe >1.200 U tienen niveles tóxicos. De los que reciben 400-1200 U, el 84% tienen niveles óptimos; existe diferencia entre aquellos que reciben 400-800 U, con un 60% con niveles suficientes, y los que reciben 800-1.200 U, con un 92% con niveles adecuados. Existe diferencia en el porcentaje de muestras con niveles insuficientes según la clasificación de 2009 versus la actual. CONCLUSIONES: Los aportes de vitamina D entre 800 y 1.200 U/día se asocian a niveles óptimos en un porcentaje elevado de prematuros. Las aportaciones inferiores a 400 U o superiores a 1.200 U se asocian a niveles inadecuados. La alimentación por sí sola no garantiza los requerimientos necesarios de vitamina D, pero es un dato esencial a tener en cuenta. Es necesario individualizar la dosis en función de los niveles plasmáticos


BACKGROUND: Inadequate levels of vitamin D in premature newborns may lead to additional comorbidities; however, controversy exists regarding recommendations for supplementation. OBJECTIVE: To analyze correlations between vitamin D intake (diet and supplementation) with inadequate calcifediol (25(OH)D3) levels. METHOD: Descriptive, retrospective study of premature babies, whose 25(OH)D3 levels were determined between January and December 2016, in our medical centre. RESULTS: Thirty-six plasma level determinations of 25(OH)D3 in 17 patients (58.8% male) with median gestational age of 29.8 weeks (range: 24.85-35.14) and median weight of 980g (range 420-2220). The median age in days was 58,5 (range: 6-188) at the moment of determination, and the median plasma level of 25(OH)D3 was 53,92ng/ml (range:17.1-150). The median vitamin D intake was 885U/day (range: 2-1416). There was a significant correlation between 25(OH)D3 levels and vitamin D intake. Seventy-five percent of patients who received <400U intake had insufficient levels; and 62,5% who received >1200 had toxic levels. Eighty-four percent of those who received between 400 and 1200U had adequate levels; 60% of premature newborns who received 400-800U had sufficient levels versus 92% of babies who received 800 to 1200U. There were differences in percentage of samples with insufficient levels according to 2009 classification versus the current one. CONCLUSIONS: In a high percentage of premature babies, 800-1200U vitamin D intake result in adequate levels. Vitamin D in-take of <400U or >1200U correlate with inadequate levels. It is important to consider that nutrition by itself doesn't guarantee the required vitamin D intake. Individualized doses are needed according to blood plasma levels


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Nutrição Enteral , Alimentos Fortificados , Vitamina D/administração & dosagem , Vitamina D/sangue , Calcifediol/administração & dosagem , Recém-Nascido Prematuro/sangue , Estudos Retrospectivos
12.
Nutrients ; 11(11)2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31731651

RESUMO

Vitamin D inadequacy is pervasive in the oldest-old. Many vitamin D metabolites are available for supplementation, their effects on the recovery of adequate serum levels remain unknown. We investigate the effects of supplementation with cholecalciferol (D3) and calcifediol (25D3) on serum levels of 25(OH)D, 1-25(OH)D, bone and inflammatory markers, ultimately identifying clinical predictors of successful treatment. Sixty-seven oldest-old individuals were randomized to weekly administration of 150 mcg of 25D3 or D3, from hospital admission to 7 months after discharge. Supplementation of 25D3 and D3 were associated with increasing serum levels of 25(OH)D (p < 0.001) and 1-25(OH)D (p = 0.01). Participants on 25D3 experienced a steeper rise than those on D3 (group*time interaction p = 0.01), after adjustment for intact parathyroid hormone (iPTH) levels the differences disappeared (intervention*iPTH interaction p = 0.04). Vitamin D supplementation was associated with a decreasing trend of iPTH and C-reactive protein (CRP) (p < 0.001). Polypharmacy and low handgrip strength were predictors of failure of intervention, independent of vitamin D metabolites. In conclusion, D3 and 25D3 supplementation significantly increase vitamin D serum levels in the oldest-old individuals, with a tendency of 25D3 to show a faster recovery of acceptable iPTH levels than D3. Polypharmacy and low muscle strength weaken the recovery of adequate vitamin D serum levels.


Assuntos
Calcifediol/administração & dosagem , Colecalciferol/administração & dosagem , Suplementos Nutricionais , Deficiência de Vitamina D/terapia , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Proteína C-Reativa/efeitos dos fármacos , Esquema de Medicação , Feminino , Força da Mão , Hospitalização , Humanos , Masculino , Hormônio Paratireóideo/sangue , Polimedicação , Resultado do Tratamento , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/fisiopatologia
13.
BMJ Case Rep ; 12(7)2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31289164

RESUMO

A 56-year-old man was referred with left-sided hip pain. MRI scans demonstrated an undisplaced stress fracture in the femoral neck and subchondral oedema within the femoral head. Bone densitometry showed T-scores of -2.0 at the spine, -3.5 at the femoral neck and -2.4 for the total hip. Laboratory tests revealed 25-hydroxyvitamin D <10 nmol/L. He was prescribed a 10-day course of calciferol 1.25 mg (50 000 IU)/day and started on calcium carbonate 1.25 g twice daily. Following the correction of vitamin D deficiency, his symptoms resolved. A striking feature of this patient was the complete reversal of 'osteoporosis' within 14 months with vitamin D and calcium supplementation. Bone mineral densities (BMDs) increased by 19.5% and 33.4% at the spine and hip, respectively. Such changes are never seen with conventional pharmacological management of osteoporosis. Vitamin D deficiency should be considered as a cause for reduced BMD in people with risk factors.


Assuntos
Colo do Fêmur/diagnóstico por imagem , Osteomalacia/diagnóstico , Vitamina D/análogos & derivados , Idoso , Densidade Óssea/efeitos dos fármacos , Conservadores da Densidade Óssea/administração & dosagem , Conservadores da Densidade Óssea/uso terapêutico , Calcifediol/administração & dosagem , Calcifediol/uso terapêutico , Colo do Fêmur/patologia , Fraturas de Estresse/diagnóstico por imagem , Fraturas de Estresse/etiologia , Humanos , Imagem por Ressonância Magnética , Masculino , Osteomalacia/sangue , Osteomalacia/tratamento farmacológico , Osteomalacia/etiologia , Resultado do Tratamento , Vitamina D/sangue , Deficiência de Vitamina D/complicações
14.
Arch Anim Nutr ; 73(1): 44-51, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31274343

RESUMO

The study evaluated the effects of different doses of 25-hydroxyvitamin D3 (25(OH)D3) on growth performance, immune function and antioxidative capacity in piglets. In a 21-d trial, 35 weaned pigs were divided into five groups and diets were supplemented with 5.5 (control), 43.0, 80.5, 118.0 and 155.5 µg 25(OH)D3/kg, respectively. No treatment effects were observed for average daily gain, average daily feed intake and feed to gain ratio. Increasing dietary 25(OH)D3 levels increased serum 25(OH)D3 concentrations linearly (p < 0.01), decreased the frequency of CD3+CD4+ and CD3+CD8+ T cells (p < 0.01), and the serum level of complement component 3 (p < 0.05). Supplementation of 80.5 and 118.0 µg 25(OH)D3/kg enhanced the activity of serum glutathione peroxidase (p < 0.05) and addition of 43.0 µg 25(OH)D3/kg increased the malondialdehyde concentration (p < 0.05). Overall, feeding high-dose 25(OH)D3 to weaned pigs partly improved immune functions and the antioxidative capacity.


Assuntos
Antioxidantes/metabolismo , Calcifediol/metabolismo , Imunidade Inata/imunologia , Sus scrofa/fisiologia , Vitaminas/metabolismo , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal/efeitos dos fármacos , Animais , Calcifediol/administração & dosagem , Dieta/veterinária , Suplementos Nutricionais/análise , Imunidade Inata/efeitos dos fármacos , Sus scrofa/crescimento & desenvolvimento , Sus scrofa/imunologia , Vitaminas/administração & dosagem , Desmame
15.
Poult Sci ; 98(11): 6108-6116, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31222260

RESUMO

The study aimed to examine the effects of 25-hydroxycholecalciferol (25-OH-D3) on reproductive performance and livability in broiler breeder hens. Hens at age of 26 wk were continued on restricted rations (R) or allowed ad libitum feeding (Ad) to 60 wk of age. Ad-feed intake greatly impaired egg production and hens' livability. The survival rate in both R- and Ad-hens was improved (86.7 vs.78.9% and 48.2 vs.29.1%, respectively) as was egg production in R-hens (P < 0.05) by inclusion of 69 µg 25-OH-D3/kg feedin the basal diet. Sudden death (SD) was the cause of hen mortality; hens died earlier with heavier BW and greater absolute and relative abdominal fat weights than surviving hens. Interestingly, feed intake of SD hens became less than that of surviving hens after 37 and 42 wk in Ad- and R-groups, respectively, and led to a progressive decline in SD hen BW with a ratio (relative to surviving hens of the same age) equaled 1 around 34 to 38 wk in Ad-groups and 52 to 53 wk in R-groups. Supplementation of 25-OH-D3 ameliorated untoward changes of heart and respiratory rate of Ad-survivors after 29 wk (P < 0.05), but had no significant effects on SD AD-hens. In contrast to the surviving counterparts, all SD hens experienced persistently higher respiratory rates in conjunction with declining heart rates (P < 0.05), suggesting compromised cardiac function as the cause of SD, in which hens increased heart and respiratory rate for more blood and oxygen supply to meet the need for rapid BW gain and/or adiposity in response to Ad-feed intake or due to genetically better feed efficiency even under R-feed intake. As the cardiorespiratory derangements advanced, compromised cardiac function ultimately led to heart failure and sudden death despite spontaneous reductions in feed intake and BW loss in all SD hens. Provision of 69 µg 25-OH-D3/kg feed is an effective and practical method to improve livability in broiler breeder hens.


Assuntos
Calcifediol/metabolismo , Galinhas/fisiologia , Longevidade/efeitos dos fármacos , Reprodução/efeitos dos fármacos , Vitaminas/metabolismo , Ração Animal/análise , Animais , Calcifediol/administração & dosagem , Dieta/veterinária , Suplementos Nutricionais/análise , Feminino , Vitaminas/administração & dosagem
16.
Poult Sci ; 98(11): 5679-5690, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31222321

RESUMO

Coccidiosis penalizes calcium (Ca), phosphorus (P), and fat-soluble vitamin status, as well as bone mineralization in broiler chickens. We hypothesized that dietary vitamin D (VitD) supplementation in the form of 25-hydroxycholecalciferol (OHD), compared to cholecalciferol (D3), would improve bone mineralization in broilers receiving marginally deficient Ca/P diets, with more pronounced effects during malabsorptive coccidiosis. In a 2 VitD source × 2 Ca/P levels × 2 levels of infection factorial experiment (n = 6 pens per treatment, 6 birds/pen), Ross 308 broilers were assigned to an Aviagen-specified diet supplemented with 4,000 IU/kg of either OHD or D3 between days 11 and 24 of age. The diet contained adequate (A; 8.7:4.4 g/kg) or marginally deficient (M; 6.1:3.1 g/kg) total Ca and available (av)P levels. At day 12 of age, birds were inoculated with water (C) or 7,000 Eimeria maxima oocysts (I). Pen performance was measured over 12 days post-infection (pi). One bird per pen was assessed for parameters of bone mineralization and intestinal histomorphometric features (day 6 and 12 pi), as well as E. maxima replication and gross lesions of the small intestine (day 6 pi). There was no interaction between infection status and Ca/avP level on bone mineralization. Bone breaking strength (BS), ash weight (AW), and ash percentage (AP) were highest in broilers fed the OHD-supplemented A diets irrespective of infection status. Eimeria maxima infection impaired (P < 0.05) ADG and FCR pi; Ca and P status at day 6 pi; OHD status, BS, AW, and AP at day 12 pi; and intestinal morphology at day 6 and 12 pi. A- compared to M-fed broilers had higher BS, AW, and AP at day 6 pi, and AW at day 12 pi. VitD source affected only OHD status, being higher (P < 0.001) for OHD- than D3-fed broilers at day 6 and 12 pi. In conclusion, offering OHD and adequate levels of Ca and P improved bone mineralization, with no effect on performance. Dietary D3 and OHD supplemented at 4,000 IU/kg had similar effects on coccidiosis-infected and uninfected broilers, which led to the rejection of our hypothesis.


Assuntos
Cálcio/deficiência , Galinhas/fisiologia , Colecalciferol/metabolismo , Fósforo/deficiência , Vitaminas/metabolismo , Ração Animal/análise , Animais , Calcifediol/administração & dosagem , Calcifediol/metabolismo , Calcificação Fisiológica/efeitos dos fármacos , Cálcio na Dieta/análise , Galinhas/crescimento & desenvolvimento , Colecalciferol/administração & dosagem , Coccidiose/parasitologia , Coccidiose/veterinária , Dieta/veterinária , Suplementos Nutricionais/análise , Eimeria/fisiologia , Intestinos/efeitos dos fármacos , Intestinos/fisiologia , Fósforo na Dieta/análise , Doenças das Aves Domésticas/parasitologia , Vitaminas/administração & dosagem
17.
Arch Anim Nutr ; 73(4): 271-286, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31192703

RESUMO

To investigate the effects of maternal 25-hydroxycholecalciferol (25OHD3) supplementation during lactation on nutrient digestibility and milk composition of sows and gut bacterial metabolites and their metabolites in the hindgut of suckling piglets, 24 Large White × Landrace sows were assigned randomly to one of two dietary treatments (Diet ND: 2000 IU vitamin D3/kg feed; Diet 25-D: 50 µg 25OHD3/kg feed). The experiment began on d 107 of gestation and continued until weaning on d 21 of lactation. Maternal 25OHD3 supplementation increased (p < 0.05) total litter weight gain during lactation. Milk fat content, immunoglobulin G level on d 21 of lactation and 25OHD3 concentration on d 7, 14, and 21 of lactation were higher (p < 0.05) in sows fed with 25OHD3. Apparent total tract digestibility of dietary calcium was higher (p < 0.05) in 25-D sows than ND sows. With respect to fatty-acid profile, C16:0 and saturated fatty acids in milk were higher (p < 0.05), but C20:4n-6, the ratios of monounsaturated fatty acids to saturated fatty acids and polyunsaturated fatty acids to saturated fatty acids were lower (p < 0.05) in 25-D sows than ND sows. 25OHD3 supplementation increased the mRNA expressions of acetyl-CoA carboxylase α and fatty-acid synthase in the mammary gland of lactating sows. For gut bacterial metabolites, concentration of butyrate in the caecal digesta was higher (p < 0.05) in piglets suckling 25-D sows than piglets suckling ND sows. In conclusion, 25OHD3 supplementation in maternal diets changed dietary calcium digestibility, milk composition and milk fatty-acid profile of lactating sows and altered gut bacterial metabolites in the hindgut of suckling piglets.


Assuntos
Calcifediol/metabolismo , Digestão/fisiologia , Ácidos Graxos/metabolismo , Microbioma Gastrointestinal/fisiologia , Leite/química , Sus scrofa/fisiologia , Vitaminas/metabolismo , Ração Animal/análise , Animais , Animais Lactentes , Bactérias/efeitos dos fármacos , Bactérias/metabolismo , Calcifediol/administração & dosagem , Dieta/veterinária , Suplementos Nutricionais/análise , Digestão/efeitos dos fármacos , Feminino , Microbioma Gastrointestinal/efeitos dos fármacos , Intestino Grosso/fisiologia , Lactação , Fenômenos Fisiológicos da Nutrição Materna , Leite/efeitos dos fármacos , Nutrientes/metabolismo , Sus scrofa/microbiologia , Vitaminas/administração & dosagem
18.
Nutrients ; 11(5)2019 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-31035488

RESUMO

BACKGROUND: Epidemiological studies have suggested a survival benefit for hemodialysis patients on paricalcitol or calcitriol, but nutritional vitamin D supplementation of patients already on vitamin D receptor (VDR) activators is controversial. METHODS: This observational retrospective cohort study was conducted with prospectively collected data from all consecutive patients with chronic kidney disease (CKD) who underwent hemodialysis under routine clinical practice conditions for two years. RESULTS: Of the 129 patients, 89 were treated with calcidiol, paricalcitol, and/or calcitriol. The patients with any vitamin D formulation had higher serum concentrations of 25-hydroxy vitamin D and fibroblast growth factor-23 and tended to have higher mortality rates (42% vs. 25%, p = 0.07). On subgroup analysis, any calcidiol treatment or calcidiol combined with paricalcitol associated with significantly higher mortality rates than no treatment (47% and 62.5%, p = 0.043 and 0.008, respectively). The association between calcidiol/paricalcitol treatment and elevated mortality remained significant after adjusting for age, sex, diabetes, C-reactive protein, and hemodialysis vintage. Any calcidiol and calcidiol/paricalcitol treatment exhibited a dose-response relationship with mortality (p for trend: 0.002 and 0.005, respectively). CONCLUSIONS: These data draw attention to the hitherto unexplored safety of calcidiol supplementation in patients on hemodialysis, especially in those already on vitamin D. Until clinical trials demonstrate the safety and efficacy of this approach, caution should be exercised when prescribing these patients ≥0.5 calcidiol mg/month.


Assuntos
Calcifediol/efeitos adversos , Calcifediol/uso terapêutico , Diálise Renal , Idoso , Calcifediol/administração & dosagem , Ergocalciferóis/administração & dosagem , Ergocalciferóis/efeitos adversos , Ergocalciferóis/uso terapêutico , Feminino , Fatores de Crescimento de Fibroblastos/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D , Vitaminas/administração & dosagem , Vitaminas/efeitos adversos , Vitaminas/farmacologia
19.
J Oral Sci ; 61(1): 53-60, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30918217

RESUMO

The purpose of this study was to investigate the effects of vitamin D in rat models of chronic obstructive pulmonary disease (COPD) and periodontitis. Animals with both periodontitis and COPD, or with periodontitis only, were established. Once the animal model was established, experimental groups received intraperitoneal injections of 25-hydroxyvitamin D3 (25-OHD3) for 8 weeks, while control groups received refined peanut oil. After sacrifice, inflammatory status was examined in terms of the serum levels of receptor activator of the nuclear factor κB ligand (RANKL), tumor necrosis factor alpha (TNF-α) and interleukins (IL-1 and IL-10), as well as alveolar bone loss, forced expiratory volume (0.20) (FEV 0.20), and the ratio of FEV0.2 to forced vital capacity. The results showed that 25-OHD3 treatment significantly alleviated inflammation by decreasing the serum levels of RANKL, TNF-α and IL-1 and increasing that of IL-10, while reducing alveolar bone loss and slightly improving lung function. These findings suggest that vitamin D supplementation could be a new clinical approach for the treatment of COPD and periodontitis.


Assuntos
Calcifediol/farmacologia , Citocinas/sangue , Mediadores da Inflamação/metabolismo , Periodontite/sangue , Doença Pulmonar Obstrutiva Crônica/sangue , Animais , Calcifediol/administração & dosagem , Modelos Animais de Doenças , Injeções Intraperitoneais , Interleucina-1/sangue , Interleucina-10/sangue , Pulmão/patologia , Pulmão/fisiopatologia , Masculino , Ligante RANK/sangue , Ratos , Ratos Sprague-Dawley , Testes de Função Respiratória , Fator de Necrose Tumoral alfa/sangue
20.
Am J Nephrol ; 49(4): 284-293, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30878999

RESUMO

BACKGROUND: Vitamin D repletion is recommended for secondary hyperparathyroidism (SHPT) and associated vitamin D insufficiency (VDI) in chronic kidney disease (CKD), but optimal levels of serum total 25-hydroxyvitamin D remain undefined. Clinical practice guidelines target sufficiency, whereas recent data indicate that higher levels are required to control the elevation of intact parathyroid hormone (iPTH) as CKD advances. This secondary analysis of 2 randomized controlled trials seeks to identify the minimum level of mean serum 25-hydroxyvitamin D required to control SHPT arising from VDI in stage 3 or 4 CKD. METHODS: Adult subjects (n = 429) with SHPT, VDI, and stage 3 or 4 CKD were stratified by stage and treated daily with either extended-release calcifediol (ERC) or placebo in 2 identical, parallel, randomized, double-blind studies. After treatment for 26 weeks, all subjects were ranked by the level of serum total 25-hydroxyvitamin D and divided into quintiles in order to examine the relationships between the degree of vitamin D repletion and the associated changes in plasma iPTH, serum bone turnover markers, calcium, phosphorus, intact fibroblast growth factor 23 (FGF23) and vitamin D metabolites, estimated glomerular filtration rate (eGFR), and urine calcium:creatinine (Ca:Cr) ratio. RESULTS: Progressive increases in serum 1,25-dihydroxyvitamin D and reductions in plasma iPTH and serum bone turnover markers were observed as mean posttreatment serum 25-hydroxyvitamin D rose from 13.9 ng/mL (in Quintile 1) to 92.5 ng/mL (in Quintile 5), irrespective of CKD stage. Mean serum calcium, phosphorus and FGF23, eGFR, and urine Ca:Cr ratio (collectively "safety parameters") did not significantly change from Quintile 1. Suppression of iPTH and bone turnover markers was not observed until serum 25-hydroxyvitamin D rose to at least 50.8 ng/mL (Quintile 3). CONCLUSION: ERC therapy produced exposure-dependent reductions in plasma iPTH and bone turnover markers only when mean serum total 25-hydroxyvitamin D reached at least 50.8 ng/mL, indicating that current targets for vitamin D repletion therapy in CKD are too low. Gradual elevation of mean serum 25-hydroxyvitamin D to 92.5 ng/mL was not associated with significant adverse changes in safety parameters.


Assuntos
Calcifediol/administração & dosagem , Hiperparatireoidismo Secundário/tratamento farmacológico , Insuficiência Renal Crônica/complicações , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/análogos & derivados , Idoso , Método Duplo-Cego , Monitoramento de Medicamentos/normas , Feminino , Humanos , Hiperparatireoidismo Secundário/sangue , Hiperparatireoidismo Secundário/diagnóstico , Hiperparatireoidismo Secundário/etiologia , Masculino , Pessoa de Meia-Idade , Hormônio Paratireóideo/sangue , Guias de Prática Clínica como Assunto , Valores de Referência , Insuficiência Renal Crônica/sangue , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/etiologia
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