Bone health markers generally not improved by 550 IU of vitamin D after birth

Impact of vitamin D supplementation on markers of bone mineral metabolism in term infants.

Bone. 2012 Jul 6.

Czech-Kowalska J, Pludowski P, Dobrzanska A, Kryskiewicz E, Karczmarewicz E, Gruszfeld D, Pleskaczynska A, Golkowska M.

Department of Neonatology and Neonatal Intensive Care, The Children's Memorial Health Institute, 04-730 Warsaw, Al. Dzieci Polskich 20, Poland.

25-hydroxyvitamin D (25OHD) may influence bone turnover. We compared the dynamics of bone markers in 30 infants on vitamin D supplementation (?550IU/d) with different degrees of hypovitaminosis D (25OHD <11ng/ml - deficiency vs. ?11<20ng/ml - insufficiency). Baseline and follow-up (after 10 weeks), 25OHD, 1,25-dihydroxyvitamin D (1,25(OH)(2)D), alkaline phosphatase (ALP), PTH, osteocalcin (OC), N-terminal propeptide of type I procollagen (PINP), C-terminal telopeptide of type I collagen (CTX), amino-terminal propeptide of C-type natriuretic peptide (NT-proCNP) were measured. None of the newborns had craniotabes, hypocalcaemia or hyperparathyroidism.

The median (Q1;Q3) 25OHD increased from a baseline of 8.45 (7;11.9) ng/ml to 54.6 (34.7;67.3) ng/ml (p<0.001).

The baseline 25OHD negatively correlated with total increment of 25OHD (r=-0.54; p=0.002). There were changes in ALP (241 vs. 331IU; p<0.001), 1,25(OH)(2)D (48 vs. 95.5pg/ml, p<0.001), OC (88.8 vs. 159.1ng/ml, p<0.001), PINP (3886 vs. 2409ng/ml; p<0.001), CTX (1.6 vs. 1.1ng/ml; p<0.001), NT-proCNP (75.1 vs. 35.1pmol/l; p<0.001).

Vitamin D deficient infants at baseline, compared to the insufficient group, revealed significantly higher percentage changes for 25OHD (745% vs. 167%, p<0.0001), OC (113% vs. 40%, p<0.05) and 1,25(OH)(2)D (95% vs. 58%, p<0.05).

Conclusions: Vitamin D supplements had little to no impact on markers of bone turnover in term infants in the first few months of life, with the exception of osteocalcin .

Ten weeks of cholecalciferol supplementation at a dose of 550 IU/d led to a marked increase of 25OHD concentration. The magnitude of 25OHD increment was inversely related to vitamin D status at baseline. Irrespective of the severity of vitamin D deficiency, a secondary hyperparathyroidism with elevated iPTH, ALP, phosphaturia or hypophosphatemia was not observed in the studied neonates.

Copyright © 2012. Published by Elsevier Inc.

PMID: 22776138

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Summary: 550 IU of vitamin D for 10 weeks

  • Average 8.5 ng ==> 55 ng (6.9 x)

  • Deficient: 7 ng ==> 35 ng ( 5 x)

  • Insufficient: 12 ng ==>67 ng (5.6 X)

No indication of amounts of bone cofactors

  • Calcium, Magnesium, Vitamin K2, etc.

The Deficient infants probably were still increasing vitamin D levels at 10 weeks (had not stabilized)

See also Vitamin D Life