This Article Full Text Full Text (PDF) All Versions of this Article: 93/8/3015    most recent Author Manuscript (PDF) Submit a related Letter to the Editor View responses Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Google Scholar Articles by Romagnoli, E. Articles by Minisola, S. PubMed PubMed Citation Articles by Romagnoli, E. Articles by Minisola, S. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB 1,25-DIHYDROXYCHOLECALCIFEROL CALCIUM COMPOUNDS CALCIUM, ELEMENTAL CHOLECALCIFEROL PARATHYROID HORMONE VITAMIN D2 Related Collections Calcium and Bone Metabolism

Short and Long-Term Variations in Serum Calciotropic Hormones after a Single Very Large Dose of Ergocalciferol (Vitamin D₂) or Cholecalciferol (Vitamin D₃) in the Elderly

Departments of Clinical Sciences (E.R., M.L.M., C.C., V.F., E.D., S.M.) and Chemistry and Technology of Biologically Active Substances (F.M.), University of Rome "Sapienza," 00161 Rome, Italy; and Departments of Internal Medicine (V.C.) and Endocrinology (A.S.), "Casa Sollievo della Sofferenza" Hospital, 71013 San Giovanni Rotondo, Italy

Address all correspondence and requests for reprints to: Elisabetta Romagnoli, M.D., Department of Clinical Sciences, University of Rome "Sapienza," Viale del Policlinico 155, 00161 Rome, Italy. E-mail: romagnoli.elisabetta{at}fastwebnet.it.

Context: In humans, few studies have compared the potencies of ergocalciferol and cholecalciferol in improving and maintaining vitamin D status.

Objective: Our objective was to evaluate the effects of a single very large dose of both calciferols on serum changes of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)₂D], ionized calcium, and parathyroid hormone (PTH) at baseline, and at 3, 7, 30, and 60 d.

Design: This was a prospective randomized intervention study.

Setting: The study was performed in a nursing home residence.

Participants: A total of 32 elderly female patients (age range 66–97 yr), with vitamin D deficiency was included in the study.

Intervention: Participants were randomized into four groups of eight to receive a single dose of 300,000 IU ergocalciferol or cholecalciferol by oral (os) or im route.

Results: 25(OH)D levels sharply increased at d 3 only when vitamins were given os. The 30-d basal difference in serum 25(OH)D was significantly greater after cholecalciferol os administration (47.8 ± 7.3 ng/ml) compared with other forms (D₃ im: 15.9 ± 11.3; D₂ os: 17.3 ± 4.7; D₂ im: 5 ± 4.4; all P < 0.001). The area under the curve (AUC) of the serum 25(OH)D against time (AUC₆₀) was: D₃ os, 3193 ± 759 ng x d/ml vs. D₂ os, 1820 ± 512, P < 0.001; and D₃ im, 1361 ± 492 vs. D₂ im, 728 ± 195, P < 0.01. 25(OH)D significantly influences PTH levels at 3 (P < 0.03), 7 (P < 0.01), 30 (P < 0.01), and 60 d (P < 0.05). At 60 d, the form of vitamin (cholecalciferol) significantly lowers PTH levels (P = 0.037).

Conclusions: Cholecalciferol is almost twice as potent as ergocalciferol in increasing serum 25(OH)D, when administered either by mouth or im. 25(OH)D plays a role in modulating serum PTH.

eLetters: