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.
BACKGROUND
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)(2)D], ionized calcium, and parathyroid hormone (PTH) at baseline, and at 3, 7, 30, and 60 d.


METHODS
This was a prospective randomized intervention study.


METHODS
The study was performed in a nursing home residence.


METHODS
A total of 32 elderly female patients (age range 66-97 yr), with vitamin D deficiency was included in the study.


METHODS
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 (D(3) im: 15.9 +/- 11.3; D(2) os: 17.3 +/- 4.7; D(2) im: 5 +/- 4.4; all P < 0.001). The area under the curve (AUC) of the serum 25(OH)D against time (AUC(60)) was: D(3) os, 3193 +/- 759 ng x d/ml vs. D(2) os, 1820 +/- 512, P < 0.001; and D(3) im, 1361 +/- 492 vs. D(2) 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.
Romagnoli
Elisabetta
E
Department of Clinical Sciences, University of Rome "Sapienza," Viale del Policlinico 155, 00161 Rome, Italy. romagnoli.elisabetta@fastwebnet.it
Mascia
Maria Lucia
ML
Cipriani
Cristiana
C
Fassino
Valeria
V
Mazzei
Franco
F
D'Erasmo
Emilio
E
Carnevale
Vincenzo
V
Scillitani
Alfredo
A
Minisola
Salvatore
S
D000368:Aged; D000369:Aged, 80 and over; D002117:Calcitriol / Q000097:blood*; D002118:Calcium / Q000097:blood*; D002762:Cholecalciferol / Q000008:administration & dosage*; D004872:Ergocalciferols / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D010281:Parathyroid Hormone / Q000097:blood*; D011446:Prospective Studies; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
D004872:Ergocalciferols; D010281:Parathyroid Hormone; D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D; D002117:Calcitriol; D002118:Calcium