title: A randomized clinical trial comparing 3 different replacement regimens of vitamin D in clinically asymptomatic pediatrics and adolescents with vitamin D insufficiency.
abstract: BACKGROUND
  Pediatric and Adolescent populations both have special needs for vitamin D especially for growing bone. Inadequate vitamin D is defined as 25 (OH) D(25hydroxy vitamin D) < 30 ng/ml.
  
  
  METHODS
  We conducted a randomized, controlled clinical trial from July 2014 over 1 year, aiming to assess the changes in 25 (OH) D and biochemical outcome on calcium and PTH(parathyroid hormone) using 3 different regimens of vitamin D replacement. Initial and 4 month 25 (OH) D, calcium, PTH and 12 month 25 (OH) D levels were assayed. Participants divided into 3 groups: 1) given 400 IU daily, 2) given 45000 IU weekly for 2 months then 400 IU daily, 3) given 2000 IU daily for 3 months then 1000 IU daily.
  
  
  RESULTS
  The results showed significant difference between the 3 groups as regards 25 (OH) D at 4 and 12 months (P < 0.001). Regimens used in group 2 and 3 caused increase in 25 (OH) D after 4 month (median increase is 225% and 200% respectively). 25 (OH) D dropped in group 1 and 2 (median decrease is 42 and 53% respectively) but continued to increase in group 3 (median change is 6%). In group 2 serum calcium median change was 1.2% with few cases of hypercalcuria. 94.9, 76.1 and 7.7 are the percent of vitamin D deficient participants in groups 1, 2 and 3 respectively after 12 months follow up.
  
  
  CONCLUSIONS
  We advise as a replacement for vitamin D insufficiency, low loading dose with high maintaince dose rather than the opposite to achieve steady increase in serum 25 (OH) D with no hypercalcemic side effects.
authors.affiliation: Pediatric department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. i_talaat@yahoo.com.
authors.forename: Iman M
authors.initials: IM
authors.lastname: Talaat
authors.affiliation: Pediatric department, Faculty of Medicine, Cairo University, Cairo, Egypt.|Pediatric department, Alhada Armed Forces Hospital, Taif, Saudi Arabia.
authors.forename: Naglaa M
authors.initials: NM
authors.lastname: Kamal
authors.affiliation: Pediatric department, Alhada Armed Forces Hospital, Taif, Saudi Arabia.|Director of Alhada Armed Forces Hospital, Taif, Saudi Arabia.
authors.forename: Hamed A
authors.initials: HA
authors.lastname: Alghamdi
authors.affiliation: Pediatric department, Alhada Armed Forces Hospital, Taif, Saudi Arabia.|College of Medicine, Taif University, Taif, Saudi Arabia.
authors.forename: Abdulla A
authors.initials: AA
authors.lastname: Alharthi
authors.affiliation: Laboratory department, Prince Mansour Military Community Hospital, Taif, KSA, Saudi Arabia.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Alshahrani
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004534:Egypt; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage*; D014808:Vitamin D Deficiency / Q000188:drug therapy*
chemical_list: D014807:Vitamin D
keywords: 25 (OH) D; Replacment regimens; Vitamin D deficiency; Vitamin D insufficiency