Vitamin D status after a high dose of cholecalciferol in healthy and burn subjects

Anne-Françoise Rousseau; Pierre Damas; Didier Ledoux; Pierre Lukas; Agnès Carlisi; Caroline Le Goff; Romy Gadisseur; Etienne Cavalier

doi:10.1016/j.burns.2014.11.011

Vitamin D status after a high dose of cholecalciferol in healthy and burn subjects

Burns. 2015 Aug;41(5):1028-34. doi: 10.1016/j.burns.2014.11.011. Epub 2014 Dec 17.

Authors

Anne-Françoise Rousseau¹, Pierre Damas², Didier Ledoux², Pierre Lukas³, Agnès Carlisi³, Caroline Le Goff³, Romy Gadisseur³, Etienne Cavalier³

Affiliations

¹ Burn Centre and General Intensive Care Department, University of Liège, University Hospital, Sart-Tilman B35, B-4000 Liège, Belgium. Electronic address: afrousseau@chu.ulg.ac.be.
² Burn Centre and General Intensive Care Department, University of Liège, University Hospital, Sart-Tilman B35, B-4000 Liège, Belgium.
³ Clinical Chemistry Department, University of Liège, University Hospital, Sart-Tilman, Liège, Belgium.

PMID: 25529268
DOI: 10.1016/j.burns.2014.11.011

Abstract

Background: Burn patients are at risk of vitamin D (VD) deficiency and may benefit from its pleiotropic effects as soon as acute phase. Aim of this observational study was to assess effects of a cholecalciferol (VD3) bolus on VD status in adult burn patients (Group B, GB) after admission, compared to healthy subjects (Group H, GH).

Methods: Both groups received an oral dose of 100,000 IU VD3. Blood samples were collected before (D0) and 7 days (D7) after bolus to measure 250H-D, 1,25(OH)2-D, parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23). Albumin (ALB) and VD binding protein (DBP) were measured and used to calculate free 25OH-D level. Data were expressed as median (min-max) or proportions.

Results: A total of 49 subjects were included: 29 in GH and 20 in GB. At D0, prevalence of VD deficiency was higher in GB: 25OH-D was 21.5 (10.1-46.3) ng/ml in GH vs 11 (1.8-31.4) ng/ml in GB. DBP and ALB were lower in GB. At D7, DBP was stable in both groups while ALB decreased in GB. 25OH-D increased by 66.6 (13.5-260.3)% in GH. In GB, changes in 25OH-D extended from -36.7% to 333.3% with a median increase of 33.1%. Similar changes were observed in each group for free 25OH-D. High FGF23 levels were observed in GB.

Conclusions: This study highlighted the differences in VD status and in response to a high dose VD3 in burn patients when compared to healthy patients. Pitfalls in VD status assessment are numerous during acute burn care: 25OH-D measurement needs cautious interpretation and interest of free 25OH-D is still questionable. They should not prevent burn patients to receive VD supplements during acute care. Higher doses than general recommendations should probably be considered.

Keywords: Burn; Cholecalciferol; Fibroblast growth factor 23; Free 25-hydroxyvitamin D; Vitamin D; Vitamin D binding protein.

Publication types

Observational Study

MeSH terms

Adolescent
Adult
Aged
Burns / blood*
Case-Control Studies
Cholecalciferol / pharmacology*
Female
Fibroblast Growth Factor-23
Fibroblast Growth Factors / blood
Fibroblast Growth Factors / drug effects*
Humans
Male
Middle Aged
Parathyroid Hormone / blood*
Serum Albumin
Vitamin D / analogs & derivatives*
Vitamin D / blood
Vitamin D Deficiency / blood*
Vitamin D-Binding Protein / blood
Vitamins / pharmacology*
Young Adult

Substances

FGF23 protein, human
Parathyroid Hormone
Serum Albumin
Vitamin D-Binding Protein
Vitamins
Vitamin D
Cholecalciferol
Fibroblast Growth Factors
1,25-dihydroxyvitamin D
Fibroblast Growth Factor-23
25-hydroxyvitamin D