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IMR Press / FBL / Volume 27 / Issue 10 / DOI: 10.31083/j.fbl2710289
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Open Access Original Research
The Effect of a Single High Dose of Vitamin D on Serum Levels of Its Metabolites in the Elderly
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1 Department of Internal Medicine and Endocrinology, Centre of Postgraduate Medical Education, 01-809 Warsaw, Poland
2 Masdiag Laboratory, 01-882 Warsaw, Poland
3 Department of Medical Statistics, School of Public Health, Centre of Postgraduate Medical Education, 01-826 Warsaw, Poland
*Correspondence: alicja.szatko@gmail.com (Alicja Szatko)
Front. Biosci. (Landmark Ed) 2022, 27(10), 289; https://doi.org/10.31083/j.fbl2710289
Submitted: 25 July 2022 | Revised: 24 August 2022 | Accepted: 14 September 2022 | Published: 25 October 2022
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Vitamin D is a dietary micronutrient responsible for calcium and phosphorus metabolism and multiple extraskeletal actions. The assessment of vitamin D status is commonly based on measurement of 25(OH)D total concentration in serum. However, the usage of liquid chromatography with tandem mass spectrometry (LC-MS/MS) technique allows to reliably assess a panel of vitamin D metabolites in serum or plasma, which may help to investigate the metabolic paths of vitamin D, especially in populations at risk of deficiency. Methods: A randomized, two-arms, open study was conducted on 58 patients (28 female and 30 male; aged from 61 to 96 years old). The primary aim was to assess the effects of a single, high, oral dose of vitamin D${}_{3}$ (120,000 IU) on serum 25(OH)D${}_{3}$, 25(OH)D${}_{2}$, 24,25(OH)${}_{2}$D${}_{3}$, 3-epi-25(OH)D${}_{3}$, 1,25(OH)${}_{2}$D${}_{3}$, 24,25(OH)${}_{2}$D${}_{3}$/25(OH)D${}_{3}$ ratio, and 25(OH)D${}_{3}$/3-epi-25(OH)D${}_{3}$ ratio concentration (measured by LC-MS/MS) at baseline, 3 days and 7 days after administration, compared to control group. The secondary aim was assessment of influence of percentage of fat tissue on serum metabolites of vitamin D and their changes after bolus dose. Results: 56.6% study group attained a serum 25(OH)D${}_{3}$ concentration $>$30 ng/mL. All subjects, except for one patient achieved a serum 25(OH)D${}_{3}$ concentration $>$20 ng/mL after administration. No one exceed reference value of vitamin D (30–50 ng/mL). Among participants who received vitamin D${}_{3}$ there were significant increase in 25(OH)D${}_{3}$, 3-epi-25(OH)D${}_{3}$, 1,25(OH)${}_{2}$D${}_{3}$, 24,25(OH)${}_{2}$D${}_{3}$ on 3rd day after administration. 24,25(OH)${}_{2}$D${}_{3}$ concentration gradually grew, achieving the highest concentration on 7th day. The percentage increase of 25(OH)D${}_{3}$ was negatively correlated with baseline 25(OH)D${}_{3}$ (r = –0.688, p = 0.001). Positive correlation between percentage increase in 25(OH)D${}_{3}$ and a percentage increase serum concentration of 24,25(OH)${}_{2}$D${}_{3}$ (r = 0.954, p $<$ 0.001), 3-epi-25(OH)D${}_{3}$ (r = 8.03, p $<$ 0.001) and 1,25(OH)${}_{2}$D${}_{3}$ (r = 0.789, p $<$0.001) were found. None of the study participants developed hypercalcemia. The baseline concentration of analyzed metabolites of vitamin D in serum and their percentage increase were neither dependent on BMI nor percentage of fat tissue. Conclusions: High dose of vitamin D rapidly increases 25(OH)D${}_{3}$ concentration in the elderly patients. The response to the bolus of vitamin D includes activation of 3-epimerase, followed by production of 24,25(OH)${}_{2}$D${}_{3}$, which protects from excessive increase of active form of vitamin D.

Keywords
vitamin D
25(OH)D3
25(OH)D2
3-epi-25(OH)D3
24,25(OH)2D3
1,25(OH)2D3
vitamin D deficiency
supplementation
metabolites
elderly
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