TY - JOUR
T1 - Absorption, dosage, and effect on mineral homeostasis of 25-hydroxycholecalciferol in premature infants
T2 - Comparison with 400 and 800 IU vitamin D2 supplementation
AU - Hillman, Laura S.
AU - Hollis, Bruce
AU - Salmons, Sharon
AU - Martin, Lesley
AU - Slatopolsky, Eduardo
AU - McAlister, William
AU - Haddad, John
N1 - Funding Information:
Supported by Grants HD-09998-06 (L.S.H.), AM-09976 and AM-07126 (E.S.), and AM-28292 (J.H.) from the National Institutes of Health~,'~a'ndb y Research Career Development Award HDAM-O0479 (B.H.). Submitted for publication Aug. 29, 1984; accepted Nov. 1, 1984.
PY - 1985/6
Y1 - 1985/6
N2 - Because the efficiency of vitamin D absorption or hepatic uptake and 25-hydroxylation appears decreased in very premature infants, the routine use of 25-hydroxycholecalciferol (25-OHD3) supplementation has been suggested. Absorption studies of a 3 μg/kg orally administered dose of 25-OHD3 showed peak serum 25-hydroxyvitamin D2 and -vitamin D3 (25-OHD) concentrations at 4 to 8 hours similar in timing but of lesser magnitude to those seen in adults. Administration of 1 μg/kg birth weight/day of 25-OHD3 corrected moderately low, but not very low serum (25-OHD) concentrations, and 2 μg/kg BW/day resulted in rapid and sustained increases in serum 25-OHD. Administration of 800 IU ergocalciferol (D2) also produced significantly higher serum 25-OHD concentrations than those in infants given 400 IU vitamin D2, but increases in serum 25-OHD were more gradual than in infants given 25-OHD3. In treatment trials with infants weighing <1500 gm, those given 800 IU D2, compared with those given 400 IU D2, had higher serum calcium concentrations and less frequent moderate or severe hypomineralization. Infants given 2 μg/kg BW 25-OHD3 had a significant increase in serum phosphorus values, but a decrease in serum calcium and magnesium concentrations, and parathyroid hormone also was suppressed to low normal values. The frequency of moderate to severe hypomineralization remained the same as in infants given 400 IU D2. In a subgroup of infants, serum 1,25-dihydroxyvitamin D was elevated over adult values, both in infants given 25-OHD3 (68.5±8.4 pg/ml) and in infants given vitamin D2 (60±6.7 pg/ml). Serum vitamin D concentrations were undetectable in four of six infants receiving 25-OHD3, but were elevated (5 to 31 ng/ml) in four infants receiving vitamin D2. Although 800 to 1000 IU D2 can be recommended as routine vitamin D supplementation in very premature infants fed standard formula, the use of 25-OHD3 requires further study.
AB - Because the efficiency of vitamin D absorption or hepatic uptake and 25-hydroxylation appears decreased in very premature infants, the routine use of 25-hydroxycholecalciferol (25-OHD3) supplementation has been suggested. Absorption studies of a 3 μg/kg orally administered dose of 25-OHD3 showed peak serum 25-hydroxyvitamin D2 and -vitamin D3 (25-OHD) concentrations at 4 to 8 hours similar in timing but of lesser magnitude to those seen in adults. Administration of 1 μg/kg birth weight/day of 25-OHD3 corrected moderately low, but not very low serum (25-OHD) concentrations, and 2 μg/kg BW/day resulted in rapid and sustained increases in serum 25-OHD. Administration of 800 IU ergocalciferol (D2) also produced significantly higher serum 25-OHD concentrations than those in infants given 400 IU vitamin D2, but increases in serum 25-OHD were more gradual than in infants given 25-OHD3. In treatment trials with infants weighing <1500 gm, those given 800 IU D2, compared with those given 400 IU D2, had higher serum calcium concentrations and less frequent moderate or severe hypomineralization. Infants given 2 μg/kg BW 25-OHD3 had a significant increase in serum phosphorus values, but a decrease in serum calcium and magnesium concentrations, and parathyroid hormone also was suppressed to low normal values. The frequency of moderate to severe hypomineralization remained the same as in infants given 400 IU D2. In a subgroup of infants, serum 1,25-dihydroxyvitamin D was elevated over adult values, both in infants given 25-OHD3 (68.5±8.4 pg/ml) and in infants given vitamin D2 (60±6.7 pg/ml). Serum vitamin D concentrations were undetectable in four of six infants receiving 25-OHD3, but were elevated (5 to 31 ng/ml) in four infants receiving vitamin D2. Although 800 to 1000 IU D2 can be recommended as routine vitamin D supplementation in very premature infants fed standard formula, the use of 25-OHD3 requires further study.
UR - http://www.scopus.com/inward/record.url?scp=0021807266&partnerID=8YFLogxK
U2 - 10.1016/S0022-3476(85)80255-9
DO - 10.1016/S0022-3476(85)80255-9
M3 - Article
C2 - 3889260
AN - SCOPUS:0021807266
SN - 0022-3476
VL - 106
SP - 981
EP - 989
JO - The Journal of Pediatrics
JF - The Journal of Pediatrics
IS - 6
ER -