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People with old burns improved muscle strength with 2200 IU average vitamin D – RCT Sept 2014

Effects of cholecalciferol supplementation and optimized calcium intakes on vitamin D status, muscle strength and bone health: A one-year pilot randomized controlled trial in adults with severe burns

Burns, Available online 16 September 2014
Anne-Françoise Rousseaua afrousseau at chu.ulg.ac.be, Marguerite Foidart-Desalleb, Didier Ledouxa, Christophe Remya, c, Jean-Louis Croisierc, Pierre Damasa, Etienne Cavalierd

Objective
Burn patients are at risk of hypovitaminosis D and osteopenia or sarcopenia. Vitamin D pleiotropic effects may influence bone and muscle health. The aim of this pilot study was to assess effects of a cholecalciferol (VD3) supplementation and an optimized calcium (Ca) regimen on vitamin D (VD) status, bone and muscle health during sequelar stage of burn injury.

Design
Monocentric randomized controlled trial.

Methods
Fifteen adults with thermal burns dating from 2 to 5 years were randomized into two groups. For 12 months, they either received a quarterly IM injection of 200,000 IU VD3 and daily oral Ca (Group D) or placebo (Group P). VD status and bone remodeling markers were assessed every 3 months. Knee muscle strength and bone mineral density were, respectively, assessed using isokinetic dynamometry and dual X-ray absorptiometry at initiation (M0) and completion (M12) of the protocol.

Results
Of all the patients, 66% presented with VD deficiency and 53% (with 3 men <40 y) were considered osteopenic at inclusion. After one year, calcidiol levels significantly increased in Group D to reach 40 (37–61) ng/ml. No significant change in bone health was observed in both groups while Group D significantly improved quadriceps strength when tested at high velocity.

Conclusions
This VD3 supplementation was safe and efficient to correct hypovitaminosis D in burn adults. When combined with optimized Ca intakes, it demonstrated positive effects on muscle health but not on bone health. A high prevalence of hypovitaminosis D and osteopenia in these patients, as well as their wide range of muscle performances, seem to be worrying when considering rehabilitation and quality of life.

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