FRI0468 EFFECTS OF DIFFERENT VITAMIN D SUPPLEMENTATION SCHEMES IN POSTMENOPAUSAL WOMEN
Authors: Stefano Berardi, Addolorata Corrado, Angiola Mele, Cinzia Rotondo, Antonello Trotta, Natalia Mansueto, Francesco Paolo Cantatore
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Vitamin D exerts different extra-skeletal effects, including a positive effect on muscle function. Circulating levels of the 25 hydroxylated Vitamin D - 25(OH)D - reflect the body Vitamin D reserves; to reach the optimal serum 25(OH)D threshold, Vitamin D supplementation is often requested. The commonest Vitamin D supplementation is represented by cholecalciferol (D3), but the hydroxylated Vitamin D metabolite calcifediol (HyD) represents a therapeutic alternative. <h3>Objectives</h3> The aim of the study was to evaluate the efficacy of the calficediol supplementation compared to various cholecalciferol administration schedules in increasing the 25(OH) vitamin D serum levels and the effects on muscular function in post-menopausal women. <h3>Methods</h3> 60 post-menopausal women aged ≤ 65 years with low serum 25(OH)D levels (8-24 ng/ml) were included in the study. Recruited patients were randomly assigned to receive oral Vitamin D 1000 UI/day according to four different regimens. 1) cholecalciferol (D3) 300.000 UI, single oral dose; 2) monthly cholecalciferol 100.000 UI for three consecutive months; 3) weekly cholecalciferol 7000 UI; 4) weekly HyD 7000 UI. At baseline and every three months, for 12 months, the following parameters were evaluated: serum levels of 25(OH)D; PTH, calcium, phosphates; at baseline and every 15 days muscular function was evaluated using the Timed Up and Go (TUG) and the Sit to Stand test. <h3>Results</h3> Weekly administration of HyD induced a significantly faster and greater increase of 25(OH)D levels, compared to the other treatment groups (at 12 months: +384% vs +145%, + 220%, + 248% in groups 1, 2, 3, respectively); the increase appeared after 1 month from baseline. D3 300.000 UI single dose induces a slower increase of 25(OH)D compared to monthly and weekly supplementation. An increase of muscular strength was observed after 12 months in all supplementation groups, starting from 1 months from baseline, with a greater effect in subjects treated with weekly HyD compared to D3 treated subjects (TUG 6 second vs 7.3, 7.7, 7.9 in groups 1, 2, 3, respectively; Sit to Stand 16,2 vs 15.4, 15.3, 15.7 in groups 1, 2, 3 respectively). Overall, the effects on 25(OH)D levels and on muscular function were greater in subject treated with weekly D3 compared to subject treated with monthly or single dose D3. No differences in PTH, calcium and phosphate serum levels were found between supplementation groups. <h3>Conclusion</h3> Supplementation with calcifediol is more effective and faster compared to cholecalciferol in increasing 25(OH)D serum levels; further, weekly cholecalciferol is more effective and faster compared to single dose or monthly administration. Increase in circulating levels of 25(OH)D is associated to an improvement of muscular strength. <h3>References</h3> [1] Bischoff-Ferrari, et al., Oral supplementation with 25(OH)D3 versus Vitamin D3: effects on 25(OH)D levels, lower extremity function, blood pressure, and markers of innate immunity. Journal for bone and mineral Research, Vol. 27, N. 1,January2012, pp 160-169. [2] Bischoff – Ferrari, Which vitamin D oral supplement is best for Postmenopausal women?CurrOsteoporos Rep (2012) 10:251-257. <h3>Disclosure of Interests</h3> Stefano Berardi: None declared, Addolorata Corrado: None declared, Angiola Mele: None declared, Cinzia Rotondo: None declared, Antonello Trotta: None declared, Natalia Mansueto: None declared, Francesco Paolo Cantatore Speakers bureau: PFIZER, ROCHE