Prospective, Randomized, Double-Blind, Parallel-Group, Comparative Effectiveness Clinical Trial Comparing a Powder Vehicle Compound of Vitamin D With an Oil Vehicle Compound in Adults With Cystic Fibrosis

• Published in: JPEN. Journal of parenteral and enteral nutrition Vol. 41; no. 6; p. 952
• Main Authors: Hermes, Wendy A, Alvarez, Jessica A, Lee, Moon J, Chesdachai, Supavit, Lodin, Daud, Horst, Ron, Tangpricha, Vin
• Format: Journal Article
• Language: English
• Published: United States 01.08.2017
• Subjects: Adult; Cholecalciferol - blood; Cystic Fibrosis - blood; Cystic Fibrosis - complications; Cystic Fibrosis - drug therapy; Dietary Supplements; Dose-Response Relationship, Drug; Double-Blind Method; Female; Humans; Lipid Metabolism; Male; Parathyroid Hormone - blood; Pilot Projects; Powders; Prospective Studies; Treatment Outcome; Vitamin D - administration & dosage; Vitamin D - blood; Vitamin D Deficiency - drug therapy; Vitamin D Deficiency - etiology; Young Adult; ergocalciferol; pancreatic insufficiency; cystic fibrosis; vitamin D; vitamin D3; malabsorption; cholecalciferol; vehicle
• ISSN: 1941-2444
• DOI: 10.1177/0148607116629673

There is little consensus on the most efficacious vehicle substance for vitamin D supplements. Fat malabsorption may impede the ability of patients with cystic fibrosis (CF) to absorb vitamin D in an oil vehicle. We hypothesized that vitamin D contained in a powder vehicle would be absorbed more efficiently than vitamin D contained in an oil vehicle in patients with CF. In this double-blind, randomized controlled trial, hospitalized adults with CF were given a one-time bolus dose of 100,000 IU of cholecalciferol (D ) in a powder-based or oil-based vehicle. Serum D , 25-hydroxyvitamin D, and parathyroid hormone concentrations were analyzed at 0, 12, 24, and 48 hours posttreatment. The area under the curve for serum D and the 12-hour time point were also assessed as indicators of D absorption. This trial was completed by 15 patients with CF. The median (interquartile range) age, body mass index, and forced expiratory volume in 1 second were 23.7 (19.9-33.2) years, 19.9 (18.6-22.6) kg/m , and 63% (37%-80%), respectively. The increase in serum D and the area under the curve was greater in the powder group ( P = .002 and P = .036, respectively). Serum D was higher at 12 hours in the powder group compared with the oil group ( P = .002), although levels were similar between groups by 48 hours. In adults with CF, cholecalciferol is more efficiently absorbed in a powder compared with an oil vehicle. Physicians should consider prescribing vitamin D in a powder vehicle in patients with CF to improve the absorption of vitamin D from supplements.