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Children who are overweight or asthmatic need more Vitamin D – Aug 2023


Pharmacokinetics of Oral Vitamin D in Children with Obesity and Asthma

Clin Pharmacokinet. 2023 Aug 30. doi: 10.1007/s40262-023-01285-9
Jason E Lang 1 2, Rodrigo Gonzalez Ramirez 3, Stephen Balevic 4 3, Scott Bickel 5, Christoph P Hornik 4 3, J Marc Majure 6, Saranya Venkatachalam 3, Jessica Snowden 7, Brian O'Sullivan 8, Laura James 7

Both overweight and asthma are known to reduce Vitamin D response

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Note: Some of the children (age 6-15) did not get >43 ng in 4 months

Background and objective: Vitamin D insufficiency is common in several pediatric diseases including obesity and asthma. Little data exist describing the pharmacokinetics of oral vitamin D in children or the optimal dosing to achieve therapeutic 25(OH)D targets. Describe the pharmacokinetics of oral Vitamin D in children with asthma.

Methods: This was a multi-center, randomized, open-label, oral supplementation study to describe the pharmacokinetics of vitamin D in children aged 6-17 years who have asthma and were overweight/obese. Participants had a serum 25(OH)D concentration between 10 and < 30 ng/mL at baseline. In Part 1 of the study, we assessed four 16-week dosing regimens for their ability to achieve 25(OH)D concentrations ≥ 40 ng/mL. Using serial serum 25(OH)D sampling over 28 weeks, we created a population pharmacokinetic model and performed dosing simulations to achieve 25(OH)D concentrations ≥ 40 ng/mL. In Part 2, the optimal regimen chosen from Part 1 was compared (2:1) to a standard-of-care control dose (600 international units IU daily) over 16 weeks. A final population pharmacokinetic model using both parts was developed to perform dosing simulations and determine important co-variates in the pharmacokinetics of vitamin D.

Results: Based on empiric and simulation data, the daily dose of 8000 IU and a loading dose of 50,000 IU were chosen; this regimen raised 25(OH)D concentrations above 40 ng/mL in the majority of participants while avoiding concentrations > 100 ng/mL. A 50,000-IU loading dose led to faster achievement of 25(OH)D therapeutic concentrations (≥ 40 ng/mL). The estimated median (5th-95th percentiles) apparent clearance of vitamin D from the final population pharmacokinetic model was 0.181 (0.155-0.206) L/h. The body mass index z-score was a significant covariate on apparent clearance and was associated with a significantly decreased median half-life in 25(OH)D (body mass index z-score 1.00-1.99: 97.7 days, body mass index z-score 2.00-2.99: 65.9 days, body mass index z-score ≥ 3.00: 39.1 days, p < 0.001).

Conclusions: Obesity impacts vitamin D clearance and the half-life, but serum concentrations > 40 ng/mL can be reached in most children using a loading dose of 50,000 IU followed by a daily dose of 8000 IU.
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VitaminDWiki – Overview Obesity and Vitamin D contains:

See also: Weight loss and Vitamin D - many studies   Child Obesity and Vitamin D - many studies   Obesity, Virus, and Vitamin D - many studies
Obese need more Vitamin D
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  • Normal weight     Obese     (50 ng = 125 nanomole)

Click here for 2014 study

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  • Normal weight     Obese     (50 ng = 125 nanomole)

VitaminDWiki - 36 studies in both categories Obesity and Infant-Child

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Attached files

ID Name Comment Uploaded Size Downloads
20044 LD 8K everyone.jpg admin 31 Aug, 2023 38.08 Kb 114
20043 LD 10K simulation.jpg admin 31 Aug, 2023 36.00 Kb 118
20042 No LD.jpg admin 31 Aug, 2023 23.95 Kb 137
20041 LD 10K, 8K.jpg admin 31 Aug, 2023 47.34 Kb 125
20040 Pharmacokinetics of Oral Vitamin D - with loading dose_CompressPdf.pdf admin 31 Aug, 2023 368.10 Kb 116