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Differential effects of oral boluses of vitamin D2 versus vitamin D3 on vitamin D metabolism: a randomized controlled trial.

Abstract

CONTEXT

Vitamin D2 and vitamin D3 have been hypothesized to exert differential effects on vitamin D metabolism.

OBJECTIVE

To compare the influence of administering vitamin D2 vs vitamin D3 on metabolism of vitamin D3.

METHODS

We measured baseline and 4-month serum concentrations of vitamin D3, 25-hydroxyvitamin D3 (25[OH]D3), 25-hydroxyvitamin D2, 24R,25-dihydroxyvitamin D3 (24R,25[OH]2D3), 1α,25-dihydroxyvitamin D3 (1α,25[OH]2D3) and 4β,25-dihydroxyvitamin D3 (4β,25[OH]2D3) in 52 adults randomized to receive a total of four oral bolus doses of 2.5 mg vitamin D2 (n=28) or vitamin D3 (n=24) over four months. Metabolite-to-parent compound ratios were calculated to estimate hydroxylase activity. Pairwise before-versus-after comparisons were made to evaluate effects of vitamin D2 and vitamin D3 on metabolism of vitamin D. Mean post-supplementation metabolite-to-parent ratios were then compared between groups.

RESULTS

Vitamin D2 was less effective than vitamin D3 in elevating total 25(OH)D concentration. Vitamin D2 suppressed mean 4-month serum concentrations of 25(OH)D3, 24R,25(OH)2D3, 1α,25(OH)2D3 and 4β,25(OH)2D3 and mean ratios of 25(OH)D3-to-D3 and 1α,25(OH)2D3-to-25(OH)D3, while increasing the mean ratio of 24R,25(OH)2D3-to-25(OH)D3. Vitamin D3 increased mean 4-month serum concentrations of 25(OH)D3, 24R,25(OH)2D3, 1α,25(OH)2D3 and 4β,25(OH)2D3, and the mean ratio of 24R,25(OH)2D3-to-25(OH)D3. Participants receiving vitamin D2 had lower mean post-supplementation ratios of 25(OH)D3-to-vitamin D3 and 1α,25(OH)2D3-to-25(OH)D3 than those receiving vitamin D3. Mean post-supplementation ratios of 24R,25(OH)2D3-to-25(OH)D3 and 4β,25(OH)2D3-to-25(OH)D3 did not differ between groups.

CONCLUSIONS

Bolus-dose vitamin D2 is less effective than bolus-dose vitamin D3 in elevating total serum 25(OH)D concentration. Administration of vitamin D2 reduces 25-hydroxylation of vitamin D3 and 1-alpha hydroxylation of 25(OH)D3, while increasing 24R-hydroxylation of 25(OH)D3.

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  • Authors+Show Affiliations

    ,

    Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

    ,

    Department of Pharmaceutics, University of Washington, Seattle, WA, USA.

    ,

    Department of Pharmaceutics, University of Washington, Seattle, WA, USA.

    ,

    Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

    ,

    Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

    ,

    Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK. Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, UK.

    ,

    Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.

    Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

    Source

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31199458

    Citation

    Martineau, Adrian R., et al. "Differential Effects of Oral Boluses of Vitamin D2 Versus Vitamin D3 On Vitamin D Metabolism: a Randomized Controlled Trial." The Journal of Clinical Endocrinology and Metabolism, 2019.
    Martineau AR, Thummel KE, Wang Z, et al. Differential effects of oral boluses of vitamin D2 versus vitamin D3 on vitamin D metabolism: a randomized controlled trial. J Clin Endocrinol Metab. 2019.
    Martineau, A. R., Thummel, K. E., Wang, Z., Jolliffe, D. A., Boucher, B. J., Griffin, S. J., ... Hitman, G. A. (2019). Differential effects of oral boluses of vitamin D2 versus vitamin D3 on vitamin D metabolism: a randomized controlled trial. The Journal of Clinical Endocrinology and Metabolism, doi:10.1210/jc.2019-00207.
    Martineau AR, et al. Differential Effects of Oral Boluses of Vitamin D2 Versus Vitamin D3 On Vitamin D Metabolism: a Randomized Controlled Trial. J Clin Endocrinol Metab. 2019 Jun 14; PubMed PMID: 31199458.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Differential effects of oral boluses of vitamin D2 versus vitamin D3 on vitamin D metabolism: a randomized controlled trial. AU - Martineau,Adrian R, AU - Thummel,Kenneth E, AU - Wang,Zhican, AU - Jolliffe,David A, AU - Boucher,Barbara J, AU - Griffin,Simon J, AU - Forouhi,Nita G, AU - Hitman,Graham A, Y1 - 2019/06/14/ PY - 2019/01/26/received PY - 2019/06/07/accepted PY - 2019/6/15/entrez JF - The Journal of clinical endocrinology and metabolism JO - J. Clin. Endocrinol. Metab. N2 - CONTEXT: Vitamin D2 and vitamin D3 have been hypothesized to exert differential effects on vitamin D metabolism. OBJECTIVE: To compare the influence of administering vitamin D2 vs vitamin D3 on metabolism of vitamin D3. METHODS: We measured baseline and 4-month serum concentrations of vitamin D3, 25-hydroxyvitamin D3 (25[OH]D3), 25-hydroxyvitamin D2, 24R,25-dihydroxyvitamin D3 (24R,25[OH]2D3), 1α,25-dihydroxyvitamin D3 (1α,25[OH]2D3) and 4β,25-dihydroxyvitamin D3 (4β,25[OH]2D3) in 52 adults randomized to receive a total of four oral bolus doses of 2.5 mg vitamin D2 (n=28) or vitamin D3 (n=24) over four months. Metabolite-to-parent compound ratios were calculated to estimate hydroxylase activity. Pairwise before-versus-after comparisons were made to evaluate effects of vitamin D2 and vitamin D3 on metabolism of vitamin D. Mean post-supplementation metabolite-to-parent ratios were then compared between groups. RESULTS: Vitamin D2 was less effective than vitamin D3 in elevating total 25(OH)D concentration. Vitamin D2 suppressed mean 4-month serum concentrations of 25(OH)D3, 24R,25(OH)2D3, 1α,25(OH)2D3 and 4β,25(OH)2D3 and mean ratios of 25(OH)D3-to-D3 and 1α,25(OH)2D3-to-25(OH)D3, while increasing the mean ratio of 24R,25(OH)2D3-to-25(OH)D3. Vitamin D3 increased mean 4-month serum concentrations of 25(OH)D3, 24R,25(OH)2D3, 1α,25(OH)2D3 and 4β,25(OH)2D3, and the mean ratio of 24R,25(OH)2D3-to-25(OH)D3. Participants receiving vitamin D2 had lower mean post-supplementation ratios of 25(OH)D3-to-vitamin D3 and 1α,25(OH)2D3-to-25(OH)D3 than those receiving vitamin D3. Mean post-supplementation ratios of 24R,25(OH)2D3-to-25(OH)D3 and 4β,25(OH)2D3-to-25(OH)D3 did not differ between groups. CONCLUSIONS: Bolus-dose vitamin D2 is less effective than bolus-dose vitamin D3 in elevating total serum 25(OH)D concentration. Administration of vitamin D2 reduces 25-hydroxylation of vitamin D3 and 1-alpha hydroxylation of 25(OH)D3, while increasing 24R-hydroxylation of 25(OH)D3. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/31199458/Differential_effects_of_oral_boluses_of_vitamin_D2_versus_vitamin_D3_on_vitamin_D_metabolism:_a_randomized_controlled_trial L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2019-00207 DB - PRIME DP - Unbound Medicine ER -