title: A randomized clinical trial in vitamin D-deficient adults comparing replenishment with oral vitamin D3with narrow-band UV type B light: effects on cholesterol and the transcriptional profiles of skin and blood.
abstract: Background:Vitamin D deficiency, defined as a serum 25-hydroxyvitamin D [25(OH)D] concentration <20 ng/mL, is correlated with a more atherogenic lipid profile. However, oral vitamin D supplementation does not lower LDL-cholesterol concentrations or raise HDL-cholesterol concentrations. This uncoupling between association and causation may result from a failure of oral vitamin D to mimic the effect of dermally synthesized vitamin D in response to ultraviolet type B (UVB) light.Objective:We tested the hypothesis that, in vitamin D-deficient adults, the replenishment of vitamin D with UVB exposure would lower LDL-cholesterol concentrations compared with the effect of oral vitamin D3supplementation.Design:We performed a randomized clinical trial in vitamin D-deficient adults and compared vitamin D replenishment between subjects who received oral vitamin D3(n= 60) and those who received narrow-band UVB exposure (n= 58) ≤6 mo.Results:There was no difference in the change from baseline LDL-cholesterol concentrations between oral vitamin D3and UVB groups (difference in median of oral vitamin D3minus that of UVB: 1.5 mg/dL; 95% CI: -5.0, 7.0 mg/dL). There were also no differences within groups or between groups for changes in total or HDL cholesterol or triglycerides. Transcriptional profiling of skin and blood, however, revealed significant upregulation of immune pathway signaling with oral vitamin D3but significant downregulation with UVB.Conclusions:Correcting vitamin D deficiency with either oral vitamin D3or UVB does not improve the lipid profile. Beyond cholesterol, these 2 modalities of raising 25(OH)D have disparate effects on gene transcription. This trial was registered at clinicaltrials.gov as NCT01688102.
authors.affiliation: Laboratory of Biochemical Genetics and Metabolism, mponda@rockefeller.edu.
authors.forename: Manish P
authors.identifier: 0000-0001-5812-790X
authors.initials: MP
authors.lastname: Ponda
authors.affiliation: Rockefeller University Hospital Center for Clinical and Translational Science, and.
authors.forename: Yupu
authors.initials: Y
authors.lastname: Liang
authors.affiliation: Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY; and.
authors.forename: Jaehwan
authors.initials: J
authors.lastname: Kim
authors.affiliation: Rockefeller University Hospital Center for Clinical and Translational Science, and.
authors.forename: Richard
authors.initials: R
authors.lastname: Hutt
authors.affiliation: Rockefeller University Hospital Center for Clinical and Translational Science, and.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Dowd
authors.affiliation: Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY; and.
authors.forename: Patricia
authors.initials: P
authors.lastname: Gilleaudeau
authors.affiliation: Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY; and.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Sullivan-Whalen
authors.affiliation: Laboratory of Biochemical Genetics and Metabolism.
authors.forename: Tori
authors.initials: T
authors.lastname: Rodrick
authors.affiliation: Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY; and.
authors.forename: Dong Joo
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
authors.forename: Irina
authors.initials: I
authors.lastname: Barash
authors.affiliation: Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY; and.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Lowes
authors.affiliation: Laboratory of Biochemical Genetics and Metabolism.
authors.forename: Jan L
authors.initials: JL
authors.lastname: Breslow
mesh_terms: D000328:Adult; D002762:Cholecalciferol / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use; D002784:Cholesterol / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D019587:Dietary Supplements; D005260:Female; D005786:Gene Expression Regulation / Q000187:drug effects; D006801:Humans; D007107:Immune System; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000097:blood / Q000209:etiology; D015398:Signal Transduction; D012867:Skin / Q000378:metabolism* / Q000528:radiation effects; D014158:Transcription, Genetic / Q000187:drug effects*; D014466:Ultraviolet Rays; D014807:Vitamin D / Q000031:analogs & derivatives / Q000096:biosynthesis / Q000097:blood / Q000494:pharmacology* / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D014815:Vitamins / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D008078:Cholesterol, LDL; D014815:Vitamins; D014807:Vitamin D; D002762:Cholecalciferol; D002784:Cholesterol; C104450:25-hydroxyvitamin D
keywords: 25-hydroxycholesterol; UV light; cholesterol; gene transcription; oxysterol; vitamin D