Impact of BMI on serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D with calcifediol supplementation in young adults: a longitudinal study.

Jun 11, 2024Endocrine

BMI may affect levels of vitamin D and its active form during calcifediol supplementation in young adults over time.

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Abstract

Participants experienced an increase in 25-hydroxyvitamin D concentrations of 74.4 ng/mL in the obese group at 3 months following calcifediol supplementation.

Participants were categorized as obese (11.2%), overweight (32.1%), or normal weight (56.7%).
Baseline serum concentrations of 25-hydroxyvitamin D did not differ significantly among the groups, averaging around 13.1 ng/mL for obese, 12.8 ng/mL for overweight, and 11.6 ng/mL for normal weight.
All groups showed an increase in serum 25-hydroxyvitamin D concentrations at 3 and 6 months after supplementation.
The increase in 25-hydroxyvitamin D concentrations at 3 months was 74.4 ng/mL in obese, 62.2 ng/mL in overweight, and 47.1 ng/mL in normal weight participants.
1,25-dihydroxyvitamin D concentrations also increased across all groups without significant differences.

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BACKGROUND: High body mass index (BMI) is a risk factor for vitamin D deficiency. The rise in serum 25-hydroxyvitamin D [25(OH)D] concentrations following cholecalciferol supplementation is suboptimal, owing to adipose tissue sequestration and/or volumetric dilution. Calcifediol is a proven potent oral alternative for vitamin D supplementation, but whether BMI adversely affects its efficacy in raising 25(OH)D concentrations, is not well known.

MATERIAL AND METHODS: Adults with serum concentrations of 25(OH)D < 30 ng/mL were recruited and stratified as normal, overweight, or obese using WHO criteria. Baseline evaluation included 25(OH)D, parathyroid hormone (PTH), and total 1,25-dihydroxyvitamin D [1,25(OH)D] based on BMI category (n = 883). A subset of participants was supplemented with 50 µg calcifediol (n = 193) and assessed for the rise in serum concentrations of 25(OH)D at 3- and 6-months following supplementation. 2

RESULTS: Participants were stratified as obese (11.2%), overweight (32.1%), or normal weight (56.7%). There were no significant baseline differences in serum concentrations of 25(OH)D among the groups (13.1 ± 6.4 vs 12.8 ± 6.8 vs 11.6 ± 6.6 ng/mL, p = 0.62). Similarly, PTH or 1,25(OH)D concentrations were not different among the groups. On follow-up, 25(OH)D concentrations increased in all three groups at 3 and 6 months from baseline. The increase in 25(OH)D was 74.4 ng/mL (IQR 35.3-115.3) in obese, followed by overweight 62.2 ng/mL (18.1-98.7) and normal weight groups 47.1 ng/mL (17.5-89.7) at 3 months. 1,25(OH)D also increased in all groups, without any significant intergroup differences (p > 0.05). 2 2

CONCLUSION: BMI does not impede the rise in 25(OH)D concentrations following supplementation with calcifediol in young adults with vitamin D deficiency.

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