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. 2018 Oct 29:4:96.
doi: 10.1038/s41394-018-0129-9. eCollection 2018.

Effectiveness of two vitamin D3 repletion protocols on the vitamin D status of adults with a recent spinal cord injury undergoing inpatient rehabilitation: a prospective case series

Geneviève Mailhot  1   2 , Josée Lamarche  2   3   4 , Dany H Gagnon  3   4   5
Affiliations

Effectiveness of two vitamin D3 repletion protocols on the vitamin D status of adults with a recent spinal cord injury undergoing inpatient rehabilitation: a prospective case series

Geneviève Mailhot et al. Spinal Cord Ser Cases. .

Abstract

Study design: Prospective case series.

Objectives: To assess the effectiveness and safety of two vitamin D3 repletion protocols given to individuals with spinal cord injury (SCI).

Setting: Publicly-funded intensive inpatient rehabilitation center, Montreal, Canada.

Methods: Thirty adults with recent SCI complete or incomplete sensorimotor impairments were recruited upon admission from designated regional SCI trauma centers. Participants with serum 25OHD ≤ 30 nmol/L were given 10,000 IU of weekly and 1000 IU of daily vitamin D3 for 36.8 ± 11.9 days (higher dose: HD). Subjects with serum 25OHD > 30 nmol/L received 1000 IU of daily vitamin D3 for 38.2 ± 11.6 days (lower dose: LD). Outcomes were changes in 25OHD levels from baseline to the end of the study period and safety outcomes. Thresholds for vitamin D deficiency, insufficiency and sufficiency were: 25OHD levels ≤30 nmol/L, 30-74 nmol/L, and ≥75 nmol/L.

Results: At baseline, 34 and 66% of participants had serum 25OHD < 30 and >30 nmol/L. Both protocols induced a rise in serum 25OHD with a greater increase in the HD vs. LD regimen (31.4 [95% CI: 16.7, 46.0] vs. 11.7 nmol/L [95% CI: 2.2, 21.2]). None of the participants given the HD remained vitamin D deficient, but only one achieved vitamin D sufficiency. Nearly all individuals on the LD regimen remained vitamin D insufficient with only two reaching vitamin D sufficiency. No adverse effects were observed over the course of the supplementation.

Conclusions: Although 1000 IU of daily vitamin D3 alone or in combination with weekly 10,000 IU for an average of 37.6 days increased serum 25OHD, they were unsuccessful in improving the impaired vitamin D status during inpatient rehabilitation of individuals with a recent SCI.

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Conflict of interest statement

Compliance with ethical standardsThe authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of participant selection and retention. The number of subjects at screening, study initiation, follow-up and analysis are presented
Fig. 2
Fig. 2
a Serum 25-hydroxyvitamin D levels at baseline and at the end of the follow-up period. Individual 25OHD levels are represented by treatment group with the mean indicated by the straight gray line. The dotted line indicates the cut-point proposed for vitamin D sufficiency (75 nmol/L). Within-group comparisons were made by paired-t test. b Distribution of vitamin D status at baseline and at the end of the follow-up period in each treatment group. Black bar indicates vitamin D deficiency (serum 25OHD < 30 nmol/L); dashed bars indicate vitamin D insufficiency (serum 25OHD 30–74 nmol/L) and white bars indicate vitamin D sufficiency (serum 25OHD ≥ 75 nmol/L). Within-group comparisons were made by χ2 test
See this image and copyright information in PMC

References

    1. Morris HA, Anderson PH. Autocrine and paracrine actions of vitamin D. Clin Biochem Rev. 2010;31:129–38. - PMC - PubMed
    1. Christakos S, Dhawan P, Verstuyf A, Verlinden L, Carmeliet G. Vitamin D: metabolism, molecular mechanism of action, and pleiotropic effects. Physiol Rev. 2016;96:365–408. doi: 10.1152/physrev.00014.2015. - DOI - PMC - PubMed
    1. Jensen MP, Truitt AR, Schomer KG, Yorkston KM, Baylor C, Molton IR. Frequency and age effects of secondary health conditions in individuals with spinal cord injury: a scoping review. Spinal Cord. 2013;51:882–92. doi: 10.1038/sc.2013.112. - DOI - PubMed
    1. Bauman WA, Zhong YG, Schwartz E. Vitamin D deficiency in veterans with chronic spinal cord injury. Metabolism. 1995;44:1612–6. doi: 10.1016/0026-0495(95)90083-7. - DOI - PubMed
    1. Gaspar AP, Brandao CM, Lazaretti-Castro M. Bone mass and hormone analysis in patients with spinal cord injury: evidence for a gonadal axis disruption. J Clin Endocrinol Metab. 2014;99:4649–55. doi: 10.1210/jc.2014-2165. - DOI - PubMed