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Longevity of daily oral vitamin D3 supplementation: differences in 25OHD and 24,25(OH)2D observed 2 years after cessation of a 1-year randomised controlled trial (VICtORy RECALL)

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Abstract

Summary

To determine how long vitamin D lasts after supplementation ceases, the marker of status was measured 2 and 3 years after a 1-year trial. Compared to placebo, the proportion of vitamin D-deficient women was still lower, if they had taken daily vitamin D3, after 2 years, indicating its longevity.

Introduction

The purpose of this study was to determine longevity of vitamin D status following cessation of vitamin D3 supplementation, 2 and 3 years after a 1-year randomised, double-blind placebo controlled trial and to investigate possible predictive factors.

Methods

Caucasian non-smoking postmenopausal women randomised to ViCtORY (2009–2010), who had not taken vitamin D supplements since the trial ended, were invited to attend follow-up visits. Total 25-hydroxyvitamin D (25OHD) and 24,25-dihydroxyvitamin D (24,25OH2D) were measured by dual tandem mass spectrometry of serum samples following removal of protein and de-lipidation; the original randomised controlled trial (RCT) samples were re-analysed simultaneously. Vitamin D-binding protein (VDBP) was measured by monoclonal immunoassay.

Results

In March 2012 and March 2013, 159 women (mean (SD) age 67.6 (2.1) years) re-attended, equally distributed between the original treatment groups: daily vitamin D3 (400 IU, 1000 IU) and placebo.

One month after the RCT ended (March 2010), the proportion of women in placebo, 400 IU and 1000 IU vitamin D3 groups, respectively, with 25OHD < 25 nmol/L was 15, 0 and 0 (chi-square p < 0.001, n = 46, 44, 54). After 2 years (March 2012), it was 22, 4 and 4% (p = 0.002, n = 50, 48, 57); after 3 years, it was 23, 13 and 15% (p = 0.429, n = 48, 45, 52). The respective proportions of women with 24,25OH2D < 2.2 nmol/L were 50, 2 and 2% (1 month, p < 0.001, n = 46, 44, 54); 42, 33 and 12% (2 years, p = 0.002, n = 50, 48, 57); and 45, 27 and 29% (3 years, p = 0.138, n = 47, 45, 51). VDBP was a predictor of circulating 25OHD longevity (beta for VDBP in μg/mL 0.736; 95% CI 0.216–1.255, p = 0.006) but not 24,25OH2D.

Conclusion

Four hundred international units or 1000 IU of daily vitamin D3 showed benefits over placebo 2 years after supplementation ceased in keeping 25OHD > 25 nmol/L.

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Acknowledgements

Any views expressed are the authors own. Original trial registration: Vitamin D effects on cardiovascular disease risk (VICtORy) study at controlled-trials.com as ISRCTN20328039 (http://controlled-trials.com/ISRCTN20328039/). We wish to thank all the women volunteers taking part in this study; Karen Secombes, Minimol Paulose and Jenny Scott for assistance with venesection; Martin Allen, Health Protection Agency, Cambridge for help in standardising the UVA badges; Maciej Gryka for creating the algorithms used to extract the data from the UVA badges; and Hamish Macdonald for assistance in generating the figures.

Role of the sponsor: the sponsor, research and innovation, University of Aberdeen, UK, were responsible for confirming proper arrangements to initiate, manage, monitor and finance this RCT as designated by the Scottish Executive Health Department Research Governance Framework for Health and Community Care and the Department of Health Research Governance Framework for Health and Social Care 2nd Edition (2006)–Confirmation of the Role of Sponsor.

Funding

This work was funded partly by the UK Food Standards Agency and the Department of Health.

Author information

Authors and Affiliations

  1. School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD, UK

    H. M. Macdonald, L. S. Aucott & A. D. Wood

  2. Obesity Action Scotland, Glasgow, UK

    A. Gryka

  3. Medical School, University of East Anglia, Norwich Research Park, Norwich, UK

    J. C. Y. Tang & W. D. Fraser

Authors
  1. H. M. Macdonald
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  2. A. Gryka
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  3. J. C. Y. Tang
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  4. L. S. Aucott
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  5. W. D. Fraser
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  6. A. D. Wood
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Corresponding author

Correspondence to H. M. Macdonald.

Ethics declarations

Ethical approval for the RECALL study was provided by North of Scotland Research Ethics Committee (12/NS/0013), and all women gave informed consent.

Conflicts of interest

None.

Electronic supplementary material

ESM 1

Monthly UV exposure throughout 2012-2013 in a subset of VICtORY RECALL. Daily UV exposure according to the month the badges were worn. A. Median (IQR) for UVB exposure in SED each month from April 2012 to July 2013 (from April 2012 to March 2013, average n=143; from April 2013-July 2013, average n=74): 0.2 (0.3), 0.7 (0.8), 0.5 (0.4), 0.5 (0.6), 0.7 (0.7), 0.4 (0.5), 0.1 (0.2), 0.0 (0.1), 0.0 (0.0), 0.0 (0.0), 0.1 (0.1), 0.1 (0.1), 0.4 (0.4), 0.7 (0.9), 0.7 (0.7), 1.1 (0.9). B. Median (IQR) for UVA exposure in SED each month from August 2012 to July 2013 (average n 77) : 578 (945), 534 (1008), 152 (306), 56 (100), 18 (24), 24 (33), 45 (67), 105 (219), 227 (566), 530 (993), 613 (862), 848 (1388). (DOCX 82 kb)

ESM 2

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Macdonald, H.M., Gryka, A., Tang, J.C.Y. et al. Longevity of daily oral vitamin D3 supplementation: differences in 25OHD and 24,25(OH)2D observed 2 years after cessation of a 1-year randomised controlled trial (VICtORy RECALL). Osteoporos Int 28, 3361–3372 (2017). https://doi.org/10.1007/s00198-017-4201-2

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