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The effect of cholecalciferol supplementation on vitamin D levels and insulin sensitivity is dose related in vitamin D‐deficient HIV‐1‐infected patients
Author(s) -
Van Den Boutvan den Beukel CJP,
Van Den Bos M,
Oyen WJG,
Hermus Ad RMM,
Sweep FCGJ,
Tack CJJ,
Bosch MEW,
Burger DM,
Koopmans PP,
Van Der Ven AJAM
Publication year - 2008
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2008.00630.x
Subject(s) - cholecalciferol , medicine , vitamin d and neurology , endocrinology , vitamin d deficiency , parathyroid hormone , vitamin , insulin , leptin , adiponectin , insulin resistance , calcium , obesity
Objective The aim of this study was to explore the effects of cholecalciferol supplementation on vitamin D levels, bone mineral density (BMD), body fat distribution and insulin sensitivity in vitamin D‐deficient HIV‐1‐infected patients. Methods Twenty vitamin D‐deficient HIV‐1‐infected patients were prospectively treated with 2000 IU cholecalciferol/day for 14 weeks, whereafter treatment was continued with half this dosage until 48 weeks. BMD, body fat distribution, 1,25‐dihydroxy vitamin D 3 (1,25(OH) 2 D 3 ), fasting glucose, insulin, adiponectin, leptin, interleukin (IL)‐6 and tumour necrosis factor (TNF)‐α were measured at baseline, and at 24 and 48 weeks. Parathyroid hormone (PTH), 25‐hydroxy vitamin D 3 [25(OH)D 3 ], cholesterol and triglycerides were measured at baseline, and at 12, 24 and 48 weeks. Results After 24 weeks, cholecalciferol supplementation significantly increased 25(OH)D 3 and 1,25(OH) 2 D 3 levels and decreased PTH and insulin sensitivity. After 48 weeks, however, only 25(OH)D 3 levels remained significantly different from baseline, while the other parameter levels returned to baseline, suggesting a dose–response effect. Cholecalciferol had no effect on BMD, adipokines and triglycerides. Conclusions The effect of cholecalciferol treatment in this cohort appears to be dose dependent. Cholecalciferol dosages of ≥2000 IU are necessary to achieve 1,25(OH) 2 D 3 levels that significantly decrease PTH, but also negatively affect insulin sensitivity. The results of this hypothesis‐driven explorative study need to be confirmed in larger clinical trials.