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Loading dose greatly improves subsequent daily Vitamin D if have liver fibrosis – RCT Nov 2016

Vitamin D3 Loading Is Superior to Conventional Supplementation After Weight Loss Surgery in Vitamin D-Deficient Morbidly Obese Patients: a Double-Blind Randomized Placebo-Controlled Trial

Obesity Surgery, pp 1–12 First Online: 12 Nov. 2016, DOI: 10.1007/s11695-016-2437-0
Maria Luger Renate Kruschitz Christian Kienbacher Stefan Traussnigg Felix B. Langer Gerhard Prager Karin Schindler Enikö Kallay Friedrich Hoppichle rMichael Trauner Michael Krebs Rodrig Marculescu Bernhard Ludvik

VitaminDWiki Summary

Bariatric Surgery followed by
3420 IU for 6 months with/without 300,000 IU loading dose
   28% of bariatric surgery patients had non-alcoholic fatty liver disease
   40% of seniors have non-alcoholic fatty liver disease as well - see below
See also VitaminDWiki


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Background
Bariatric patients often suffer from vitamin D deficiency (VDD), and both, morbid obesity and VDD, are related to non-alcoholic fatty liver disease. However, limited data are available regarding best strategies for treating VDD, particularly, in bariatric patients undergoing omega-loop gastric bypass (OLGB). Therefore, we examined the efficacy and safety of a forced vitamin D dosing regimen and intervention effects in liver fibrotic patients.

Methods
In this double-blind, randomized, placebo-controlled trial, 50 vitamin D-deficient patients undergoing OLGB were randomly assigned to receive, in the first month postoperatively, oral vitamin D3 (=3 doses of 100,000 IU; intervention group) or placebo as loading dose (control group) with subsequent maintenance dose (3420 IU/day) in both groups until 6-month visit.

Results
Compared with control group, higher increase of 25(OH)D (67.9 (21.1) vs. 55.7 nmol/L (21.1); p = 0.049) with lower prevalence of secondary hyperparathyroidism (10 vs. 24 %; p = 0.045) was observed in intervention group. No (serious) adverse events related to study medication were found. The loading dose regimen was more effective in increasing 25(OH)D in patients with significant liver fibrosis while this was not the case for conventional supplementation (placebo with maintenance dose) (71.5 (20.5) vs. 22.5 nmol/L (13.8); p = 0.022; n = 14).

Conclusions
Our findings indicate that a high vitamin D3 loading dose, in the first month postoperatively, with subsequent maintenance dose is effective and safe in achieving higher vitamin D concentrations in OLGB patients. Unexpectedly, it is more effective in patients with significant liver fibrosis which is of potentially high clinical relevance and requires further investigation.

Clinicaltrials.gov (NCT02092376) at https://clinicaltrials.gov/

Attached files

ID Name Comment Uploaded Size Downloads
7346 loading dose fibrosis.jpg admin 17 Nov, 2016 10:23 51.52 Kb 566
7345 Loading dose weight loss surgery.pdf PDF 2016 admin 17 Nov, 2016 10:23 674.64 Kb 281
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