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Andjela Drincic, Eileen Fuller, Robert P. Heaney, Laura A. G. Armas, 25-Hydroxyvitamin D Response to Graded Vitamin D3 Supplementation Among Obese Adults, The Journal of Clinical Endocrinology & Metabolism, Volume 98, Issue 12, 1 December 2013, Pages 4845–4851, https://doi.org/10.1210/jc.2012-4103
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Guidelines have suggested that obese adults need 2 to 3 times more vitamin D than lean adults to treat vitamin D deficiency, but few studies have evaluated the vitamin D dose response in obese subjects.
The purpose of this study was to characterize the pharmacokinetics of 25-hydroxyvitamin D [25(OH)D] response to 3 different doses of vitamin D3 (cholecalciferol) in a group of obese subjects and to quantify the 25(OH)D dose-response relationship.
This was a randomized, single-blind study of 3 doses of oral vitamin D3 (1000, 5000, or 10,000 IU) given daily to 67 obese subjects for 21 weeks during the winter months.
Serum 25(OH)D levels were measured at baseline and after vitamin D replacement, and 25(OH)D pharmacokinetic parameters were determined, fitting the 25(OH)D concentrations to an exponential model.
Mean measured increments in 25(OH)D at week 21 were 12.4 ± 9.7 ng/mL in the 1000 IU/d group, 27.8 ± 10.2 ng/mL in the 5000 IU/d group, and 48.1 ± 19.6 ng/mL in the 10,000 IU/d group. Steady-state increments computed from the model were 20.6 ± 17.1, 35.2 ± 14.6, and 51.3 ± 22.0 ng/mL, respectively. There were no hypercalcuria or hypercalcemia events during the study.
Our data show that in obese people, the 25(OH)D response to vitamin D3 is directly related to dose and body size with ∼2.5 IU/kg required for every unit increment in 25(OH)D (nanograms per milliliter).
