Advertisement

European Journal of Nutrition

, Volume 53, Issue 2, pp 367–374 | Cite as

Vitamin D supplementation, body weight and human serum 25-hydroxyvitamin D response: a systematic review

  • Armin Zittermann
  • Jana B. Ernst
  • Jan F. Gummert
  • Jochen Börgermann
Review

Abstract

Purpose

There is considerable variation in incremental circulating 25-hydroxyvitamin D (25OHD) levels on vitamin D supplements, even when similar age groups and identical vitamin D doses are compared. We therefore aimed to investigate the importance of body weight for the dose–response relation in circulating 25OHD.

Methods

We performed a systematic review of randomized placebo-controlled vitamin D supplementation trials in all age groups ≥10 years to clarify the influence of body weight and other parameters on incremental circulating 25OHD levels (difference between baseline and in-study values) in vitamin D-deficient and non-deficient individuals.

Results

We included 144 cohorts from 94 independent studies, published from 1990 to November 2012, in our systematic review. There was a logarithmic association between vitamin D dose per kg body weight per day and increment in circulating 25OHD. In multivariable regression analysis, vitamin D dose per kg body weight per day could explain 34.5 % of variation in circulating 25OHD. Additional significant predictors were type of supplement (vitamin D2 or vitamin D3), age, concomitant intake of calcium supplements and baseline 25OHD, explaining 9.8, 3.7, 2.4 and 1.9 %, respectively, of the variation in circulating 25OHD.

Conclusions

This systematic review demonstrates that body weight is an important predictor of variation in circulating 25OHD in cohorts on vitamin D supplements. Our model provides an estimate of the daily vitamin D dose that is necessary for achieving adequate circulating 25OHD levels in vitamin D-insufficient or vitamin D-deficient individuals/cohorts with different body weights and ages.

Keywords

Vitamin D Body weight 25-Hydroxyvitamin D Supplementation Age Calcium supplements 

Notes

Conflict of interest

AZ has received speaker honoraria from DiaSorin, Germany, and Abbott, Germany, two companies that provide test kits for 25-hydroxyvitamin D measurement. None of the other authors has a conflict of interest to declare.

Supplementary material

394_2013_634_MOESM1_ESM.pdf (35 kb)
Supplementary material 1 (PDF 34 kb)

References

  1. 1.
    Zittermann A, Gummert JF (2010) Nonclassical vitamin D actions. Nutrients 2:408–425CrossRefGoogle Scholar
  2. 2.
    Looker AC, Johnson CL, Lacher DA, Pfeiffer CM, Schleicher RL, Sempos CT (2011) Vitamin D status: United States, 2001–2006. NCHS Data Brief 59:1–8Google Scholar
  3. 3.
    Hintzpeter B, Scheidt-Nave C, Müller MJ, Schenk L, Mensink GB (2008) Higher prevalence of vitamin D deficiency is associated with immigrant background among children and adolescents in Germany. J Nutr 138:1482–1490Google Scholar
  4. 4.
    Hintzpeter B, Mensink GB, Thierfelder W, Müller MJ, Scheidt-Nave C (2008) Vitamin D status and health correlates among German adults. Eur J Clin Nutr 62:1079–1089CrossRefGoogle Scholar
  5. 5.
    Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, Fuleihan GEH, Josse RG, Lips P, Morales-Torres J, IOF Committee of Scientific Advisors (CSA) Nutrition Working Group (2009) Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 20:1807–1820CrossRefGoogle Scholar
  6. 6.
    Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA (2011) The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 96:53–58CrossRefGoogle Scholar
  7. 7.
    DGE (German Nutrition Society), Österreichische Gesellschaft für Ernährung, Schweizerische Gesellschaft für Ernährungsforschung, Schweizerische Vereinigung für Ernährung (2012) D-A-CH-Referenzwerte für die Nährstoffzufuhr, 1. Auflage, 4., korrigierter Nachdruck 2012, Neuer Umschau Buchverlag, Neustadt an der WeinstraßeGoogle Scholar
  8. 8.
    Bischoff-Ferrari HA, Willett WC, Orav EJ, Lips P, Meunier PJ, Lyons RA, Flicker L, Wark J, Jackson RD, Cauley JA, Meyer HE, Pfeifer M, Sanders KM, Stähelin HB, Theiler R, Dawson-Hughes B (2012) A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med 367:40–49CrossRefGoogle Scholar
  9. 9.
    Rizzoli R, Boonen S, Brandi ML, Bruyère O, Cooper C, Kanis JA, Kaufman JM, Ringe JD, Weryha G, Reginster JY (2013) Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). Curr Med Res Opin 29:305–313CrossRefGoogle Scholar
  10. 10.
    Holick MF (2007) Vitamin D deficiency. N Engl J Med 357:266–281CrossRefGoogle Scholar
  11. 11.
    Bjelakovic G, Gluud LL, Nikolova D, Whitfield K, Wetterslev J, Simonetti RG, Bjelakovic M, Gluud C (2011) Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Syst Rev 7:CD007470Google Scholar
  12. 12.
  13. 13.
    Mastaglia SR, Mautalen CA, Parisi MS, Oliveri B (2006) Vitamin D2 dose required to rapidly increase 25OHD levels in osteoporotic women. Eur J Clin Nutr 60:681–687CrossRefGoogle Scholar
  14. 14.
    Gallagher JC, Sai A, Templin T, Smith L (2012) Dose response to Vitamin D supplementation in postmenopausal women: a randomized trial. Ann Intern Med 156:425–437CrossRefGoogle Scholar
  15. 15.
    Michaëlsson K, Baron JA, Snellman G, Gedeborg R, Byberg L, Sundström J, Berglund L, Arnlöv J, Hellman P, Blomhoff R, Wolk A, Garmo H, Holmberg L, Melhus H (2010) Plasma vitamin D and mortality in older men: a community-based prospective cohort study. Am J Clin Nutr 92:841–848CrossRefGoogle Scholar
  16. 16.
    Durup D, Jørgensen HL, Christensen J, Schwarz P, Heegaard AM, Lind B (2012) A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice: the CopD study. J Clin Endocrinol Metab 97:2644–2652CrossRefGoogle Scholar
  17. 17.
    Zittermann A, Kuhn J, Dreier J, Knabbe C, Gummert JF, Börgermann J (2013) Vitamin D status and the risk of major adverse cardiac and cerebrovascular events in cardiac surgery. Eur Heart J 34:1358–1364CrossRefGoogle Scholar
  18. 18.
    Sanders KM, Stuart AL, Williamson EJ, Simpson JA, Kotowicz MA, Young D, Nicholson GC (2010) Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA 303:1815–1822CrossRefGoogle Scholar
  19. 19.
    Rossini M, Adami S, Viapiana O, Fracassi E, Idolazzi L, Povino MR, Gatti D (2012) Dose-dependent short-term effects of single high doses of oral vitamin D(3) on bone turnover markers. Calcif Tissue Int 91:365–369CrossRefGoogle Scholar
  20. 20.
    Souberbielle JC, Body JJ, Lappe J, Plebani M, Shoenfeld Y, Wang TJ, Bianchi ML, Bischoff-Ferrari H, Cavalier E, Ebeling P, Fardellone P, Gandini S, Gruson D, Guerin A, Heickendorff L, Hollis B, Ish-Shalom S, Jean G, von Landenberg P, Largura A, Olsson T, Pierrot-Deseilligny C, Pilz S, Tincani A, Valcour A, Zittermann A (2010) Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: recommendations for clinical practise. Autoimmun Rev 9:709–715CrossRefGoogle Scholar
  21. 21.
    Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96:1911–1930CrossRefGoogle Scholar
  22. 22.
    Autier P, Gandini S, Mullie P (2012) A systematic review: influence of vitamin D supplementation on serum 25-hydroxyvitamin D concentration. J Clin Endocrinol Metab 97:2606–2613CrossRefGoogle Scholar
  23. 23.
    Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux MJ (2003) Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr 77:204–210Google Scholar
  24. 24.
    van Groningen L, Opdenoordt S, van Sorge A, Telting D, Giesen A, de Boer H (2010) Cholecalciferol loading dose guideline for vitamin D-deficient adults. Eur J Endocrinol 162:805–811CrossRefGoogle Scholar
  25. 25.
    Moher D, Cook DJ, Eastwood S, Olkin I, Rennie D, Stroup DF, For the 8 QUOROM group (1999) Improving the quality of reporting of meta-analysis of randomized controlled trials: the QUOROM statement. Lancet 354:1896–1900CrossRefGoogle Scholar
  26. 26.
    Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 5:13CrossRefGoogle Scholar
  27. 27.
    Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP (2007) A higher dose of vitamin d reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc 55:234–239CrossRefGoogle Scholar
  28. 28.
    Stephensen CB, Zerofsky M, Burnett DJ, Lin Y, Hammock BD, Hall LM, McHugh T (2012) Ergocalciferol from mushrooms or supplements consumed with a standard meal increases 25-hydroxyergocalciferol but decreases 25-hydroxycholecalciferol in the serum of healthy adults. J Nutr 142:1246–1252CrossRefGoogle Scholar
  29. 29.
    Zwart SR, Mehta SK, Ploutz-Snyder R, Bourbeau Y, Locke JP, Pierson DL, Smith SM (2011) Response to vitamin D supplementation during Antarctic winter is related to BMI, and supplementation can mitigate Epstein–Barr Virus Reactivation. J Nutr 141:692–697CrossRefGoogle Scholar
  30. 30.
    Gallagher JC, Yalamanchili V, Smith LM (2013) The effect of vitamin D supplementation on serum 25OHD in thin and obese women. J Steroid Biochem Mol Biol 136:195–200CrossRefGoogle Scholar
  31. 31.
    Mazess RB, Peppler WW, Gibbons M (1984) Total body composition by dual-photon (153Gd) absorptiometry. Am J Clin Nutr 40:834–839Google Scholar
  32. 32.
    Ducher G, Bass SL, Naughton GA, Eser P, Telford RD, Daly RM (2009) Overweight children have a greater proportion of fat mass relative to muscle mass in the upper limbs than in the lower limbs: implications for bone strength at the distal forearm. Am J Clin Nutr 90:1104–1111CrossRefGoogle Scholar
  33. 33.
    Lund B, Clausen N, Lund B, Andersen E, Sørensen OH (1980) Age-dependent variations in serum 1,25-dihydroxyvitamin D in childhood. Acta Endocrinol (Copenh) 94:426–429Google Scholar
  34. 34.
    Chesney RW, Rosen JF, Hamstra AJ, Smith C, Mahaffey K, DeLuca HF (1981) Absence of seasonal variation in serum concentrations of 1,25-dihydroxyvitamin D despite a rise in 25-hydroxyvitamin D in summer. J Clin Endocrinol Metab 53:139–142CrossRefGoogle Scholar
  35. 35.
    Börgermann J, Lazouski K, Kuhn J, Dreier J, Schmidt M, Gilis-Januszewski T, Knabbe C, Gummert JF, Zittermann A (2012) 1,25-Dihydroxyvitamin D fluctuations in cardiac surgery are related to age and clinical outcome. Crit Care Med 40:2073–2081CrossRefGoogle Scholar
  36. 36.
    Vieth R, Fraser D, Kooh SW (1987) Low dietary calcium reduces 25-hydroxycholecalciferol in plasma of rats. J Nutr 117:914–918Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Armin Zittermann
    • 1
  • Jana B. Ernst
    • 1
  • Jan F. Gummert
    • 1
  • Jochen Börgermann
    • 1
  1. 1.Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Centre North Rhine-Westphalia (NRW)Ruhr University BochumBad OeynhausenGermany

Personalised recommendations