Abstract
Purpose Vitamin D deficiency is highly prevalent among the very elderly and is associated with a wide variety of clinical conditions other than musculoskeletal diseases. This study aims to ascertain the efficacy and safety of high-dose intramuscular vitamin D2 in very elderly Chinese patients with vitamin D deficiency. Methods Very elderly (aged 80 years or over) Chinese patients with vitamin D deficiency were recruited to receive monthly intramuscular injections of 600,000 IU vitamin D2 until their serum 25-hydroxyvitamin D (25(OH)D) reached ≥30 ng/mL. The serum levels of 25(OH)D2, 25(OH)D3, iPTH, BTMs, immune parameters, and other biochemical parameters were measured at baseline and one month after each dose. Results Of the 30 very elderly Chinese patients who had been recruited into the study, 27 (90.0%) had their vitamin D deficiency corrected, and 26 (86.7%) reached vitamin D sufficiency. The mean time (±SD) was 3.1 (±1.3) months for vitamin D deficiency to be corrected, and 6.1 (±0.8) months for vitamin D sufficiency to be reached. The mean (±SD) serum level of 25(OH)D2 increased from 0.69 (±1.51) ng/mL to 29.07 (±5.68) ng/mL, while the mean (±SD) serum level of 25(OH)D3 decreased from 9.82 (±2.75) ng/mL to 5.30 (±3.09) ng/mL (both P < 0.001). The total T cells in serum remained unchanged (P > 0.05), and the CD4 and B cells (CD19+) were increased significantly (both P < 0.05). In addition, no significant change was observed in the serum levels of iPTH and BTMs. Conclusion Monthly intramuscular injection of 600,000 IU vitamin D2 is an effective and safe dosing regimen to reach vitamin D sufficiency and enhances immune function in the very elderly Chinese patients with vitamin D deficiency.
Highlights
Vitamin D deficiency, which is defined as a serum level of 25-hydroxyvitamin D (25(OH)D) below 20 ng/mL [1], is an ever-increasing health concern globally
27 (90.0%) patients had their vitamin D deficiency corrected, 26 (86.7%) patients reached vitamin sufficiency and completed the study. e data from these 26 patients were used to analyze the effects of the intervention
The mean (±standard deviation (SD)) serum level of 25(OH)D2 increased from 0.69 (±1.51) ng/mL to 29.07 (±5.68) ng/mL, while the mean (±SD) serum level of 25(OH)D3 decreased from 9.82 (±2.75) ng/mL to 5.30 (±3.09) ng/mL, which was illustrated by the changes in the patients who received six shots of vitamin D2 injection (Figure 1). ere was no significant change observed in serum levels of iPTH, beta-CTx, P1NP, OC, calcium, phosphorus, urea nitrogen, creatinine, total bilirubin, aspartate transaminase (AST), alanine transaminase (ALT), and gamma-glutamyl transpeptidase (GGT)
Summary
Vitamin D deficiency, which is defined as a serum level of 25-hydroxyvitamin D (25(OH)D) below 20 ng/mL [1], is an ever-increasing health concern globally. In addition to increasing sun exposure and dietary intake of vitamin D-rich foods, oral intake and intramuscular injection of vitamin D pharmaceutical preparations are two major routes to reach this target [17]. Intake of low-dose vitamin D often needs a long period to reach target vitamin D status, while maintaining long-term adherence is not easy [18]. Some studies demonstrated that intramuscular high-dose vitamin D is an effective approach to vitamin D sufficiency [20, 21], and that intramuscular administration is more effective than oral intake in the long term [22]
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