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. Issue 1 (11th December 2017)

• Record Type: Journal Article
• Authors: Smith, Ellen M.; Jones, Jennifer L.; Han, Jenny E.; Alvarez, Jessica A.; Sloan, John H.; Konrad, Robert J.; Zughaier, Susu M.; Martin, Greg S.; Ziegler, Thomas R.; Tangpricha, Vin
• Is Part Of: JPEN, Journal of parenteral and enteral nutrition. Volume 42:Issue 1(2018)
• Page Start: 87
• Page End: 94
• Publication Date: 2017-12-11
• Subjects: vitamin D -- hemoglobin -- hepcidin -- anemia -- critical illness; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; 615.85484
• DOI: 10.1177/0148607116678197
• Languages: English
• ISSNs: 0148-6071

Abstract

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 ( P group × time = .01) compared with placebo but did not change in the 250, 000‐IU D3 group ( P group × 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.