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Title:
Weekly cholecalciferol supplementation results in significant reductions in infection risk among the vitamin D deficient: results from the CIPRIS pilot RCT | BMC Nutrition
Description:
Observational studies suggest vitamin D deficiency may contribute to the risk of acute infections. We undertook a randomised controlled trial (RCT) of cholecalciferol supplementation as an intervention against acute infections. A cohort of 34 healthy adults was randomised to 20,000 IU/week cholecalciferol or identical placebo and followed for 17 weeks during winter 2012. Acute infections, defined as the occurrence of sustained (at least an hour) infection symptoms, either of severity 2/5 or greater or sustained over 24 h, were monitored by daily online symptom reporting, with potential infections assessed in clinic. No microbiological verification of symptoms was available, however. Primary endpoint was the occurrence of acute infection; secondary endpoints were infection duration and infection severity; and tertiary endpoints were change in serum 25-hydroxyvitamin D (25(OH)D) and adverse events. No treatment effect was observed for infection risk (HR: 0.83, 95% CI: 0.53, 1.31), nor duration or severity. However, on stratification by baseline serum 25(OH)D (levels chosen on the basis of average levels in our cohort and known minimums needed for bone health), a significant treatment effect on infection risk was evident among those who were vitamin D deficient at the start of the study, such that those of baseline 25(OH)D < 40 nmol/L (n = 4) realised a 44% reduction in infection risk (HR: 0.56; 95% CI: 0.32, 0.96; P = 0.007), this increasing to 73% on restriction to clinically verified infections (HR: 0.27; 95% CI: 0.07, 1.00; P = 0.050). A similar but less consistent and nonsignificant effect was seen for infection severity. Treatment was associated with significantly higher 25(OH)D compared to placebo; however, the maximum 25(OH)D was 154 nmol/L and no adverse events occurred. The results of this study suggest a protective effect of vitamin D supplementation against acute infection risk among persons who are vitamin D deficient. Larger studies are needed to validate these findings.
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Keywords {🔍}
infection, vitamin, treatment, infections, article, pubmed, ohd, study, effect, google, scholar, severity, respiratory, participants, cas, acute, supplementation, symptoms, serum, significant, data, cholecalciferol, clinic, duration, placebo, deficient, trial, tract, results, risk, reported, nmoll, research, cohort, baseline, healthy, adults, daily, symptom, assessed, protective, information, randomised, persons, shown, followup, table, bmi, central, occurrence,
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pre-publication history nf-kappab-linked chemokines multiple sclerosis patients camargo ca jr kruskal-wallis rank test article download pdf steve simpson jr open access license vitamin d-dependent mechanism nutrition examination survey prevent seasonal influenza privacy choices/manage cookies full size image 000 iu/week cholecalciferol supplementation daily online surveys double-blind intervention study related subjects online daily questionnaire randomised controlled trials respiratory viral infections double-blind rct anti-viral state article simpson respiratory virus infections van der mei inter-review interval duration randomised controlled trial chronic respiratory condition respiratory tract infection provide informed consent antimicrobial peptide expression respiratory tract infections weekly cholecalciferol supplementation innate immune system regulate antimicrobial peptides march-june 2012 conducted online questionnaire responses acute respiratory infection randomized controlled trials cipris pilot rct tandem mass spectroscopy proportional hazard assumption royal hobart hospital full access daily online follow high-dose cholecalciferol chronic underlying conditions initial manuscript draft acute phase reactants randomized controlled trial
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headline:Weekly cholecalciferol supplementation results in significant reductions in infection risk among the vitamin D deficient: results from the CIPRIS pilot RCT
description:Observational studies suggest vitamin D deficiency may contribute to the risk of acute infections. We undertook a randomised controlled trial (RCT) of cholecalciferol supplementation as an intervention against acute infections. A cohort of 34 healthy adults was randomised to 20,000 IU/week cholecalciferol or identical placebo and followed for 17 weeks during winter 2012. Acute infections, defined as the occurrence of sustained (at least an hour) infection symptoms, either of severity 2/5 or greater or sustained over 24 h, were monitored by daily online symptom reporting, with potential infections assessed in clinic. No microbiological verification of symptoms was available, however. Primary endpoint was the occurrence of acute infection; secondary endpoints were infection duration and infection severity; and tertiary endpoints were change in serum 25-hydroxyvitamin D (25(OH)D) and adverse events. No treatment effect was observed for infection risk (HR: 0.83, 95% CI: 0.53, 1.31), nor duration or severity. However, on stratification by baseline serum 25(OH)D (levels chosen on the basis of average levels in our cohort and known minimums needed for bone health), a significant treatment effect on infection risk was evident among those who were vitamin D deficient at the start of the study, such that those of baseline 25(OH)D < 40 nmol/L (n = 4) realised a 44% reduction in infection risk (HR: 0.56; 95% CI: 0.32, 0.96; P = 0.007), this increasing to 73% on restriction to clinically verified infections (HR: 0.27; 95% CI: 0.07, 1.00; P = 0.050). A similar but less consistent and nonsignificant effect was seen for infection severity. Treatment was associated with significantly higher 25(OH)D compared to placebo; however, the maximum 25(OH)D was 154 nmol/L and no adverse events occurred. The results of this study suggest a protective effect of vitamin D supplementation against acute infection risk among persons who are vitamin D deficient. Larger studies are needed to validate these findings.
datePublished:2015-03-09T00:00:00Z
dateModified:2015-03-09T00:00:00Z
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Acute infection
Randomised controlled trial
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Health Promotion and Disease Prevention
Public Health
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headline:Weekly cholecalciferol supplementation results in significant reductions in infection risk among the vitamin D deficient: results from the CIPRIS pilot RCT
description:Observational studies suggest vitamin D deficiency may contribute to the risk of acute infections. We undertook a randomised controlled trial (RCT) of cholecalciferol supplementation as an intervention against acute infections. A cohort of 34 healthy adults was randomised to 20,000 IU/week cholecalciferol or identical placebo and followed for 17 weeks during winter 2012. Acute infections, defined as the occurrence of sustained (at least an hour) infection symptoms, either of severity 2/5 or greater or sustained over 24 h, were monitored by daily online symptom reporting, with potential infections assessed in clinic. No microbiological verification of symptoms was available, however. Primary endpoint was the occurrence of acute infection; secondary endpoints were infection duration and infection severity; and tertiary endpoints were change in serum 25-hydroxyvitamin D (25(OH)D) and adverse events. No treatment effect was observed for infection risk (HR: 0.83, 95% CI: 0.53, 1.31), nor duration or severity. However, on stratification by baseline serum 25(OH)D (levels chosen on the basis of average levels in our cohort and known minimums needed for bone health), a significant treatment effect on infection risk was evident among those who were vitamin D deficient at the start of the study, such that those of baseline 25(OH)D < 40 nmol/L (n = 4) realised a 44% reduction in infection risk (HR: 0.56; 95% CI: 0.32, 0.96; P = 0.007), this increasing to 73% on restriction to clinically verified infections (HR: 0.27; 95% CI: 0.07, 1.00; P = 0.050). A similar but less consistent and nonsignificant effect was seen for infection severity. Treatment was associated with significantly higher 25(OH)D compared to placebo; however, the maximum 25(OH)D was 154 nmol/L and no adverse events occurred. The results of this study suggest a protective effect of vitamin D supplementation against acute infection risk among persons who are vitamin D deficient. Larger studies are needed to validate these findings.
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Acute infection
Randomised controlled trial
Clinical Nutrition
Health Promotion and Disease Prevention
Public Health
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