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Quarterly vitamin D injections 2 years after burns did not help bones – March 2015

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, Volume 41, Issue 2, March 2015, Pages 317–325, doi:10.1016/j.burns.2014.07.005
Anne-Françoise Rousseaua, , , Marguerite Foidart-Desalleb, Didier Ledouxa, Christophe Remya, c, Jean-Louis Croisierc, Pierre Damasa, Etienne Cavalierd

VitaminDWiki questions
  • How long after injection was the vitamin D test made?
  • Why so long between injections ?– 1 month is much better
  • How much Calcium was give?
  • Why did they wait for 2-5 years after burn for bones to break down so much that half of the people had osteopenia,
    Much better results expected if had supplemented with vitamin D within weeks of the burn

See also VitaminDWiki

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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