|Von Eckardstein, Arnold|
Submitted to: Journal of Bone and Mineral Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/22/2011
Publication Date: 12/22/2011
Citation: Bischoff-Ferrari, H., Dawson-Hughes, B., Stoecklin, E., Sidelnikov, E., Willett, W., Orav, E., Staehelin, H., Wolfram, S., Jetter, A., Schwager, J., Henschkowski, J., Von Eckardstein, A. 2011. Oral supplementation with 25(OH)D3 versus vitamin D3: effects on 25(OH)D levels, lower extremity function, blood pressure, and markers of innate immunity. Journal of Bone and Mineral Research. 27(1):160-169. Interpretive Summary: Vitamin D supplements are increasingly recommended to correct widespread insufficiency in the U.S. This study was done to compare the effectiveness of two forms of vitamin D, the parent compound, vitamin D3, and a form that has been partially activated, 25O Hydroxyvitamin D (250HD). In addition to the mail goal of comparing blood levels of 25OHD resulting from the two supplements, we also examined their effects on blood pressure, leg strength, and markers of immunity. Twenty healthy older women participated in the 4-month study and each came to the Center for 14 study visits. We found that the 25OHD supplement caused a rapid and sustained increase in the serum 25OHD concentration that was greater than that achieved with the parent vitamin D3 (final values were 69.5 and 31.0 ng/ml, respectively). The 25OHD supplement also significantly decreased blood pressure and increased leg strength. Both supplements had favorable effects on markers of immunity. We conclude that supplementation with 25OHD corrected vitamin D deficiency rapidly. In addition, it improved leg strength and systolic blood pressure when compared to vitamin D3; both forms of vitamin D had anti-inflammatory effects.
Technical Abstract: To test the effect of 25(OH)D3 (HyD) compared to vitamin D3 on serum 25-hydroxyvitamin D levels (25(OH)D), lower extremity function, blood pressure, and markers of innate immunity. Twenty healthy postmenopausal women with an average 25(OH)D level of 13.23.9 ng/mL (meanSD) and a mean age of 61.57.2 years were randomized to either 20 mg of HyD or 20mg (800 IU) of vitamin D3 per day in a double-blind manner. We measured on 14 visits over 4 months, 25(OH)D serum levels, blood pressure, and seven markers of innate immunity (eotaxin, interleukin [IL]-8, IL-12, interferon gamma-induced protein 10 kDa [IP-10], monocyte chemotactic protein-1 [MCP-1], macrophage inflammatory protein beta [MIP-1b], and "Regulated upon Activation, Normal T-cell Expressed, and Secreted"’ [RANTES]). At baseline and at 4 months, a test battery for lower extremity function (knee extensor and flexor strength, timed up and go, repeated sit-to-stand) was assessed. All analyses were adjusted for baseline measurement, age, and body mass index. Mean 25(OH)D levels increased to 69.5 ng/mL in the HyD group. This rise was immediate and sustained. Mean 25(OH)D levels increased to 31.0 ng/mL with a slow increase in the vitamin D3 group. Women on HyD compared with vitamin D3 had a 2.8-fold increased odds of maintained or improved lower extremity function (odds ratio [OR]1/4 2.79; 95% confidence interval [CI], 1.18–6.58), and a 5.7-mmHg decrease in systolic blood pressure (p 1/4 0.0002). Both types of vitamin D contributed to a decrease in five out of seven markers of innate immunity, significantly more pronounced with HyD for eotaxin, IL-12, MCP-1, and MIP-1 b. There were no cases of hypercalcemia at any time point. Twenty micrograms (20 mg) of HyD per day resulted in a safe, immediate, and sustained increase in 25(OH)D serum levels in all participants, which may explain its significant benefit on lower extremity function, systolic blood pressure, and innate immune response compared with vitamin D3.