Rapid rescue of vitamin D levels between 1 and 3 mo of age in neonates with low vitamin D levels using a daily supplementation dosage of 1200 IU supports higher bone mineral accretion

Abstract

IntroductionResearch focused on bone mineral accretion in otherwise healthy neonates with low vitamin D status (25‐hydroxyvitamin D [25(OH)D] <50 nmol/L) in response to early and rapid recovery of vitamin D status is very scarce.ObjectiveTo study bone mineral content (BMC) and mineral accretion in response to rapid recovery of low vitamin D status in otherwise healthy neonates.MethodsA secondary analysis of data from a published dose‐response study (NCT0038914) was performed. Infants with 1 mo 25(OH)D < 50 nmol/L receiving 400, 800 or 1200 IU/d of vitamin D up to 12 mo formed a low vitamin D (LOW‐D) group (n=19) while infants with 1 mo 25(OH)D > 50 nmol/L and receiving at least 400 IU of vitamin D up to 12 mo formed the reference group. Anthropometry, lumbar vertebrae (1–4) BMC (DXA), and plasma 25(OH)D (LC‐MS/MS) were measured at 1 and 3 mo of age. Differences between groups were tested using ANOVA and post‐hoc t‐tests.ResultsVitamin D levels increased in all groups by 2 and 3 mo of age. Significantly higher 25(OH)D concentration at 3 mo of age were observed in the LOW‐D group receiving the 1200 IU /d of vitamin D (25(OH)D > 75 nmol/L) in comparison with the LOW‐D groups receiving the 400 and 800 IU doses (25(OH)D<75 nmol/L), p<.05. Change (%) in lumbar vertebrae 1–4 BMC from 1 to 3 mo of age in infants from the reference groups was significantly higher among infants with plasma 25(OH)D exceeding 100 nmol/L at 3 mo of age. A similar but non‐significant pattern was detected among the smaller LOW‐D group.ConclusionVitamin D levels in infancy impact skeletal growth. Further investigation of the effect of a high recovery dosage of vitamin D (1000–1200 IU/d) among neonates with low vitamin D status on bone mineral accretion is deemed necessary.Support or Funding InformationThe data for the secondary analysis was derived from a study jointly funded by the Canadian Institutes for Health Research, Nutricia Research Foundation and in‐kind product by Europharm Inc, Montreal. Canada Foundation for Innovation funding provided for infrastructure.