Adequacy of Vitamin D Replacement in Severe Deficiency Is Dependent on Body Mass Index

作者：Lee Paul^*; Greenfield Jerry R; Seibel Markus J; Eisman John A; Center Jacqueline R

来源：American Journal of Medicine, 2009, 122(11): 1056-1060.

DOI：10.1016/j.amjmed.2009.06.008

• Hyperparathyroidism
• Obesity
• Vitamin D

BACKGROUND: Obesity is associated with hypovitaminosis D. Whether body mass index (BMI) determines the replacement dose of vitamin D to achieve sufficiency is unclear.
OBJECTIVE: To determine the relationship between BMI and serum 25-OH vitamin D concentrations and whether the increase in serum 25-OH vitamin D concentrations with vitamin D replacement is dependent on BMI.
METHODS: Retrospective review of anthropometric data and serum 25-OH vitamin D concentrations in 95 patients attending an outpatient clinic in a tertiary hospital. In a second component of the study, 17 hospital inpatients with severe vitamin D deficiency (serum 25-OH D concentrations <6 ng/mL [15 nmol/L]) were supplemented with 10,000 units vitamin D(3)/day orally for 1 week. Biochemistry and anthropometric measurements were compared before and after vitamin D replacement. RESULTS: Serum 25-OH vitamin D concentrations correlated negatively with BMI in the 95 outpatients (r(2) = 0.11, P <.01). In the longitudinal study, BMI correlated positively with serum intact parathyroid hormone (r(2) = 0.84, P <.01) and negatively with 1.25-(OH)(2) vitamin D (r(2) = 0.19, P <.06) at baseline. Serum 25-OH D concentrations achieved following 1 week of vitamin D 3 replacement correlated negatively with BMI (r(2) = 0.63, P <.01).
CONCLUSION: Efficacy of vitamin D supplementation is dependent on BMI. Overweight and obese patients with hypovitaminosis D might require higher doses of vitamin D to achieve vitamin D repletion compared with individuals with normal body weight.

• 出版日期2009-11
• 单位河北医科大学