Vitamin D levels in IBD: a randomised trial of weight-based versus fixed dose vitamin D supplementation
Abstract
Objectives:Body weight is one of the factors affecting blood levels of 25-hydroxyvitamin D (25OHD). The aim of this study was to establish whether a vitamin D (vitD) weight-based dosing is more appropriate to a fixed daily dose in patients with inflammatory bowel disease (IBD).
Materials/methods:This was an open label randomised trial. Patients with IBD were assigned to receive oral cholecalciferol at a dose of 28 IU/kg (IU/kg) or 2000 IU per day (IU/day) for 12 weeks during winter months. 25OHD plasma levels and other biochemical parameters were measured at baseline and after supplementation period.
The primary outcome measure was 25OHD level after a follow-up period. Results:A total of 173 patients were analysed.
The mean BMI was 25.5 +/- 5.1 and initial mean 25OHD level was 62.7 +/- 25.5 nmol/l. A similar increase (9.7 +/- 26.9 vs 9.8 +/- 26.7 nmol/l) in 25OHD levels occurred both in IU/kg and IU/day group.
The proportion of subjects with normal and sub-normal levels following the substitution was comparable irrespective of body weight. The change in 25OHD level correlated positively only with the dose of vitD (p < .001) and negatively with the baseline 25OHD level (p < .001).
A sustained 25OHD level of 75 nmol/l corresponds with a calculated daily vitD dose of 2034 IU. Conclusions:Weight-based dosing of vitamin D is not superior to a fixed dose in order to maintain stable 25OHD levels in IBD patients.
Cholecalciferol dose of 2,000 IU/day is safe and sufficient during winter period.