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  • PMID: 27875288 was deleted because it is a duplicate of PMID: 29505145
JPEN J Parenter Enteral Nutr. 2018 Jan;42(1):87-94. doi: 10.1177/0148607116678197. Epub 2017 Dec 11.

High-Dose Vitamin D3 Administration Is Associated With Increases in Hemoglobin Concentrations in Mechanically Ventilated Critically Ill Adults: A Pilot Double-Blind, Randomized, Placebo-Controlled Trial.

Author information

1
Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, Georgia, USA.
2
Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
3
Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
4
Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana, USA.
5
Department of Microbiology and Immunology, Emory University School of Medicine, Atlanta, Georgia, USA.
6
Atlanta VA Medical Center, Decatur, Georgia, USA.

Abstract

BACKGROUND:

Anemia and vitamin D deficiency are highly prevalent in critical illness, and vitamin D status has been associated with hemoglobin concentrations in epidemiologic studies. We examined the effect of high-dose vitamin D therapy on hemoglobin and hepcidin concentrations in critically ill adults.

MATERIALS AND METHODS:

Mechanically ventilated critically ill adults (N = 30) enrolled in a pilot double-blind, randomized, placebo-controlled trial of high-dose vitamin D3 (D3 ) were included in this analysis. Participants were randomized to receive placebo, 50,000 IU D3 , or 100,000 IU D3 daily for 5 days (totaling 250,000 IU D3 and 500,000 IU D3 , respectively). Blood was drawn weekly throughout hospitalization for up to 4 weeks. Linear mixed-effects models were used to assess change in hemoglobin and hepcidin concentrations by treatment group over time.

RESULTS:

At enrollment, >75% of participants in all groups had plasma 25-hydroxyvitamin D (25(OH)D) concentrations <30 ng/mL, and >85% of participants across groups were anemic. In the 500,000-IU D3 group, hemoglobin concentrations increased significantly over time (Pgroup × time = .01) compared with placebo but did not change in the 250,000-IU D3 group (Pgroup × time = 0.59). Hepcidin concentrations decreased acutely in the 500,000-IU D3 group relative to placebo after 1 week (P = .007). Hepcidin did not change significantly in the 250,000-IU D3 group.

CONCLUSION:

In these critically ill adults, treatment with 500,000 IU D3 was associated with increased hemoglobin concentrations over time and acutely reduced serum hepcidin concentrations. These findings suggest that high-dose vitamin D may improve iron metabolism in critical illness and should be confirmed in larger studies.

KEYWORDS:

anemia; critical illness; hemoglobin; hepcidin; vitamin D

PMID:
29505145
PMCID:
PMC5423855
[Available on 2019-01-01]
DOI:
10.1177/0148607116678197

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