EFFECT OF SINGLE INJECTION OF VITAMIN D (CHOLECALCIFEROL, 6 LAC IU) IN ADULTS: DOES BODY MASS INDEX DETERMINE DOSAGE FREQUENCY AND RISE IN SERUM 25(OH)D3 LEVEL?

  • Vinay Purohit Present - Zydus Cadila Past - Glenmark Pharmaceuticals, IMS, BHU, SP Medical College, Bikaner

Abstract

ABSTRACT
Objective: Vitamin D deficiency (VDD) is a widespread problem in all age groups and socioeconomic strata. Cholecalciferol intramuscular (IM)
injections are often prescribed to treat VDD. Response to cholecalciferol injection is not uniform in all subjects.
Methods: We enrolled 65 ostensibly healthy adult volunteers in a vitamin D awareness camp. They were screened for VDD by measuring their
serum 25(OH)D3 level. Of 65 subjects, 58 were found to be deficient, 2 insufficient and 5 sufficient. Their body mass indices (BMI) were calculated
by measuring height and weight. A total of 31 subjects preferred taking single IM injection of cholecalciferol (6 lac IU) to correct their deficiency and
decided to comply with follow-up 25(OH)D3 measurement at day 15, 60 (2 months) and 180 (6 months).
Results: Mean values for 25(OH)D3 in 31 subjects were 12.88±2.55 ng/ml, 29.33±14.40 ng/ml, 47.27±11.09 ng/ml, and 24.59±8.19 ng/ml at baseline,
day 15, 60, and 180. Mean 25(OH)D3 levels at baseline, day 15, 60, and 180 were 12.80±2.40 ng/ml, 24.85±10.60 ng/ml, 44.76±8.85 ng/ml, and 25.05±9.62
in “obese†subjects, 13.50±3.06 ng/ml, 28.25±11.45 ng/ml, 44.70±10.40 ng/ml, and 24.48±6.81 in “overweight†individuals and 12.43±2.72 ng/ml,
44.06±19.26 ng/ml, 61.16±6.96 ng/ml, and 23.33±5.42 in “normal†subjects. Values between groups were found to be significantly different at day 15
and 60 after applying one-way ANOVA.
Conclusion: All subjects, after taking single cholecalciferol IM injection (6 lac IU), had their 25(OH)D3 levels raised to normal within 2 months but
reached insufficient range in 6 months. Though the rise in 25(OH)D3 was significantly faster in those having normal BMI than in the subjects having
higher BMI. One injection of 6 lac IU cholecalciferol, every 6 months seems to be an effective and safe way of treating VDD.
Keywords: Vitamin D, Cholecalciferol injection, Body Mass Index, BMI, 25(OH)D3

Author Biography

Vinay Purohit, Present - Zydus Cadila Past - Glenmark Pharmaceuticals, IMS, BHU, SP Medical College, Bikaner
Pharmaceutical Physician (Medical Advisor), ZydusCadila

References

REFERENCES
1. Moore DD, Kato S, Xie W, Mangelsdorf DJ, Schmidt DR, Xiao R, et al. International Union of Pharmacology. LXII. The NR1H and NR1I receptors: Constitutive androstane receptor, pregnene X receptor, farnesoid X receptor alpha, farnesoid X receptor beta, liver X receptor alpha, liver X receptor beta, and vitamin D receptor. Pharmacol Rev 2006;58(4):742-59.
2. Norman AW. From vitamin D to hormone D: Fundamentals of the vitamin D endocrine system essential for good health. Am J Clin Nutr 2008;88(2):491S-99.
3. Management of osteoporosis in postmenopausal women:2010 position statement of The North American Menopause Society. Menopause 2010;17(1):25-54.
4. Kennel KA, Drake MT. Adverse effects of bisphosphonates: Implications for osteoporosis management. Mayo Clin Proc 2009;84(7):632-7.
5. Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 2000;72(3):690‑3.
6. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357(3):266-81.
7. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 2011;96(7):1911-30.
8. Marwaha RK, Tandon N, Garg MK, Kanwar R, Narang A, Sastry A, et al. Vitamin D status in healthy Indians aged 50 years and above. J Assoc Physicians India 2011;59:706-9.
9. Holick MF, Chen TC. Vitamin D deficiency: A worldwide problem with health consequences. Am J Clin Nutr 2008;87(4):1080S-6S.
10. Body JJ, Bergmann P, Boonen S, Devogelaer JP, Gielen E, Goemaere S, et al. Extraskeletal benefits and risks of calcium, vitamin D and anti-osteoporosis medications. Osteoporos Int 2012;23 Suppl 1:S1-23.
11. Giusti A, Barone A, Razzano M, Oliveri M, Pizzonia M, Palummeri E, et al. Persistence with calcium and vitamin D in elderly patients after hip fracture. J Bone Miner Metab 2009;27(1):95-100.
12. Tellioglu A, Basaran S, Guzel R, Seydaoglu G. Efficacy and safety of high dose intramuscular or oral cholecalciferol in vitamin D deficient/insufficient elderly. Maturitas 2012;72(4):332-8.
13. Garg G, Khadgwat R, Khandelwal D, Gupta N. Vitamin D toxicity presenting as hypercalcemia and complete heart block: An interesting case report. Indian J Endocrinol Metab 2012;16:S423-5.
14. Cipriani C, Romagnoli E, Scillitani A, Chiodini I, Clerico R, Carnevale V, et al. Effect of a single oral dose of 600,000 IU of cholecalciferol on serum calciotropic hormones in young subjects with vitamin D deficiency: A prospective intervention study. J Clin Endocrinol Metab 2010;95(10):4771-7.
15. Misra A, Chowbey P, Makkar BM, Vikram NK, Wasir JS, Chadha D, et al. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India 2009;57:163-70.
16. Ritu G, Gupta A. Vitamin D deficiency in India: Prevalence, causalities and interventions. Nutrients 2014;6(2):729-75.
17. Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: Consequences for bone loss and fractures and therapeutic implications. Endocr Rev 2001;22(4):477-501.
18. Heaney RP, Dowell MS, Hale CA, Bendich A. Calcium absorption varies within the reference range for serum 25-hydroxyvitamin D. J Am Coll Nutr 2003;22(2):142-6.
19. Castelo-Branco C, Cortés X, Ferrer M, UNICAD study investigators. Treatment persistence and compliance with a combination of calcium and vitamin D. Climacteric 2010;13(6):578-84.
20. Tandon VR, Sharma S, Mahajan S, Mahajan A, Khajuria V, Gillani Z. First Indian prospective randomized comparative study evaluating adherence and compliance of postmenopausal osteoporotic patients for daily alendronate, weekly risedronate and monthly ibandronate regimens of bisphosphonates. J Midlife Health 2014;5(1):29-33.
21. Dawson-Hughes B, Harris SS, Krall EA, Dallal GE. Effect of withdrawal of calcium and vitamin D supplements on bone mass in elderly men and women. Am J Clin Nutr 2000;72(3):745-50.
22. Nugent C, Roche K, Wilson S, Fitzgibbon M, Griffin D, Nichaidhin N, et al. The effect of intramuscular vitamin D (cholecalciferol) on serum 25OH vitamin D levels in older female acute hospital admissions. Ir J Med Sci 2010;179(1):57-61.
23. Soliman AT, Adel A, Wagdy M, Alali M, Aziz Bedair EM. Manifestations of severe vitamin D deficiency in adolescents: Effects of intramuscular injection of a megadose of cholecalciferol. J Trop Pediatr 2011;57(4):303-6.
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Purohit, V. “EFFECT OF SINGLE INJECTION OF VITAMIN D (CHOLECALCIFEROL, 6 LAC IU) IN ADULTS: DOES BODY MASS INDEX DETERMINE DOSAGE FREQUENCY AND RISE IN SERUM 25(OH)D3 LEVEL?”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 8, no. 4, July 2015, pp. 192-4, https://innovareacademics.in/journals/index.php/ajpcr/article/view/6344.
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