Short and Long-Term Variations in Serum Calciotropic Hormones after a Single Very Large Dose of Ergocalciferol (Vitamin D2) or Cholecalciferol (Vitamin D3) in the Elderly

• Published in: The journal of clinical endocrinology and metabolism Vol. 93; no. 8; pp. 3015 - 3020
• Main Authors: Romagnoli, Elisabetta, Mascia, Maria Lucia, Cipriani, Cristiana, Fassino, Valeria, Mazzei, Franco, D'Erasmo, Emilio, Carnevale, Vincenzo, Scillitani, Alfredo, Minisola, Salvatore
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Endocrine Society 01.08.2008
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Calcitriol - blood; Calcium - blood; Cholecalciferol - administration & dosage; Endocrinopathies; Ergocalciferols - administration & dosage; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Humans; Medical sciences; Parathyroid Hormone - blood; Prospective Studies; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology; Vitamin D - analogs & derivatives; Vitamin D - blood; Human; Short term; Hormone; Obesity; Nutrition; Nutrition disorder; Single dose; Ergocalciferol; Variations; Metabolic diseases; Long term; Vitamin D; Serum; Elderly; Endocrinology; Nutritional status; Sterol; Colecalciferol
• ISSN: 0021-972X; 1945-7197
• DOI: 10.1210/jc.2008-0350

Context: In humans, few studies have compared the potencies of ergocalciferol and cholecalciferol in improving and maintaining vitamin D status. Objective: Our objective was to evaluate the effects of a single very large dose of both calciferols on serum changes of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)2D], ionized calcium, and parathyroid hormone (PTH) at baseline, and at 3, 7, 30, and 60 d. Design: This was a prospective randomized intervention study. Setting: The study was performed in a nursing home residence. Participants: A total of 32 elderly female patients (age range 66–97 yr), with vitamin D deficiency was included in the study. Intervention: Participants were randomized into four groups of eight to receive a single dose of 300,000 IU ergocalciferol or cholecalciferol by oral (os) or im route. Results: 25(OH)D levels sharply increased at d 3 only when vitamins were given os. The 30-d basal difference in serum 25(OH)D was significantly greater after cholecalciferol os administration (47.8 ± 7.3 ng/ml) compared with other forms (D3 im: 15.9 ± 11.3; D2 os: 17.3 ± 4.7; D2 im: 5 ± 4.4; all P < 0.001). The area under the curve (AUC) of the serum 25(OH)D against time (AUC60) was: D3 os, 3193 ± 759 ng × d/ml vs. D2 os, 1820 ± 512, P < 0.001; and D3 im, 1361 ± 492 vs. D2 im, 728 ± 195, P < 0.01. 25(OH)D significantly influences PTH levels at 3 (P < 0.03), 7 (P < 0.01), 30 (P < 0.01), and 60 d (P < 0.05). At 60 d, the form of vitamin (cholecalciferol) significantly lowers PTH levels (P = 0.037). Conclusions: Cholecalciferol is almost twice as potent as ergocalciferol in increasing serum 25(OH)D, when administered either by mouth or im. 25(OH)D plays a role in modulating serum PTH.