Pilot Study Evaluating Efficacy of 2 Regimens for Hypovitaminosis D Repletion in Pediatric Inflammatory Bowel Disease.
Pilot Study Evaluating Efficacy of 2 Regimens for Hypovitaminosis D Repletion in Pediatric Inflammatory Bowel Disease.
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DOI：
10.1097/mpg.0000000000000915
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发表时间：
2016-02
影响因子：
2.9
通讯作者：
Kugathasan S
中科院分区：
文献类型：
--
作者：
Simek RZ;Prince J;Syed S;Sauer CG;Martineau B;Hofmekler T;Freeman AJ;Kumar A;McElhanon BO;Schoen BT;Tenjarla G;McCracken C;Ziegler TR;Tangpricha V;Kugathasan S
维生素D对骨骼健康至关重要，维生素D缺乏症在儿童IBD中很常见，但最佳的补充治疗尚未得到很好的研究。我们的目的是进行一项试点试验，比较两种每周给药的维生素D方案对儿童IBD维生素缺乏症D补充的疗效。从我们的IBD诊所确定25-羟基维生素D （25(OH)D）浓度低于30 ng/mL的受试者随机分为10,000 （n=18）或5,000 (n=14) IU口服维生素D3/10 kg体重/周，为期六周。在基线、第8周和第12周测定血清25(OH)D、Ca和PTH浓度。在高剂量组，血清25(OH)D从基线时的23.7±8.5 ng/mL增加到8周时的49.2±13.6 ng/mL；P < 0.001。在低剂量组，血清25(OH)D从基线时的24.0±7.0 ng/mL增加到8周时的41.5±9.6 ng/mL；P < 0.001。12周时，高剂量组和低剂量组的血清25(OH)D浓度分别为35.1±8.4 ng/mL和30.8±4.2 ng/mL。平均血清钙和甲状旁腺激素浓度在研究期间没有显著变化。无患者出现高钙血症，无严重不良事件发生。两个治疗组在使儿童IBD患者的维生素D营养正常化方面都是安全有效的。虽然低剂量组在8周时达到了25(OH)D浓度的显著补充，但这种效果在12周的随访中消失了。初始补充后的维持性维生素D治疗可能需要维持长期正常的维生素D状态。
Vitamin D is critical for skeletal health, hypovitaminosis D is common in pediatric IBD, yet optimal repletion therapy is not well studied. We aimed to conduct a pilot trial comparing the efficacy of two Vitamin D regimens of weekly dosing for repletion of hypovitaminosis D in pediatric IBD. Subjects identified from our IBD clinic with 25-hydroxyvitamin D (25(OH)D) concentrations below 30 ng/mL were randomized to 10,000 (n=18) or 5,000 (n=14) IU of oral vitamin D3/10 kg body weight/week for six weeks. Serum 25(OH)D, Ca, and PTH concentrations were measured at baseline, week 8 and week 12. In the higher dosing group, serum 25(OH)D increased from 23.7 ±8.5 ng/mL at baseline to 49.2 ±13.6 ng/mL at 8 weeks; P<0.001. In the lower dosing group, serum 25(OH)D increased from 24.0 ±7.0 ng/mL at baseline to 41.5 ±9.6 ng/mL at 8 weeks; P<0.001. At 12 weeks, serum 25(OH)D concentrations were 35.1 ± 8.4 ng/mL and 30.8 ± 4.2 ng/mL for the higher and lower dose regimens, respectively. Mean serum Ca and PTH concentrations did not significantly change during the study. No patient exhibited hypercalcemia, and no serious adverse events occurred. Both treatment arms were safe and effective at normalizing vitamin D nutriture in pediatric IBD. While significant repletion of 25(OH)D concentration was achieved in the lower dose group at 8 weeks, this effect was lost by the 12-week follow-up. Maintenance vitamin D therapy following initial repletion is likely required to maintain long-term normalized vitamin D status.