Endocrinol Metab.  2017 Dec;32(4):451-459. 10.3803/EnM.2017.32.4.451.

Effects of Single Vitamin D₃ Injection (200,000 Units) on Serum Fibroblast Growth Factor 23 and Sclerostin Levels in Subjects with Vitamin D Deficiency

• Zhang D
• Seo DH
• Choi HS
• Park HS
• Chung YS
• Lim SK

• KMID: 2406189
• DOI: http://doi.org/10.3803/EnM.2017.32.4.451

Abstract

BACKGROUND
Vitamin D deficiency remains common in all age groups and affects skeletal and non-skeletal health. Fibroblast growth factor 23 is a bone-derived hormone that regulates phosphate and 1,25-dihydroxyvitamin D homeostasis as a counter regulatory factor. 1,25-Dihydroxyvitamin D stimulates fibroblast growth factor 23 synthesis in bone, while fibroblast growth factor 23 suppresses 1,25-dihydroxyvitamin D production in the kidney. The aim of this study was to evaluate the effects of vitamin D₃ intramuscular injection therapy on serum fibroblast growth factor 23 concentrations, and several other parameters associated with bone metabolism such as sclerostin, dickkopf-1, and parathyroid hormone.
METHODS
A total of 34 subjects with vitamin D deficiency (defined by serum 25-hydroxyvitamin D levels below 20 ng/mL) were randomly assigned to either the vitamin D injection group (200,000 units) or placebo treatment group. Serum calcium, phosphate, urine calcium/creatinine, serum 25-hydroxyvitamin D, fibroblast growth factor 23, sclerostin, parathyroid hormone, and dickkopf-1 levels were serially measured after treatment.
RESULTS
Comparing the vitamin D injection group with the placebo group, no significant changes were observed in serum fibroblast growth factor 23, parathyroid hormone, or dickkopf-1 levels. Serum sclerostin concentrations transiently increased at week 4 in the vitamin D group. However, these elevated levels declined later and there were no statistically significant differences as compared with baseline levels.
CONCLUSION
Serum fibroblast factor 23, sclerostin, parathyroid hormone, and dickkopf-1 levels were not affected significantly by single intramuscular injection of vitamin D₃.

Keyword

Vitamin D3; Injections, intramuscular; Fibroblast growth factor 23; Sclerostin

MeSH Terms

Calcium
Cholecalciferol
Fibroblast Growth Factors*
Fibroblasts*
Homeostasis
Humans
Injections, Intramuscular
Kidney
Metabolism
Parathyroid Hormone
Vitamin D Deficiency*
Vitamin D*
Vitamins*
Calcium
Cholecalciferol
Fibroblast Growth Factors
Parathyroid Hormone
Vitamin D
Vitamins

Figure

• 

  Fig. 1 (A) Serum calcium, (B) phosphorus concentrations, and (C) ratio of urine calcium to creatinine in subjects were measured before and after vitamin D3 or placebo treatment.

• 

  Fig. 2 Serum 25-hydroxyvitamin D (25(OH)D) concentrations were increased at different time points after treatment. (A) All subjects, (B) subjects with baseline 25(OH)D below 10 ng/mL, (C) subjects with baseline levels of 10 to 20 ng/mL, and (D) the vitamin D group. aP<0.05; bP<0.01; cP<0.001.

• 

  Fig. 3 Serum parathyroid hormone (PTH) levels were detected at the different time points after treatment. The comparison in (A) all subjects, (B) the subjects with less 10 ng/mL of baseline 25-hydroxyvitamin D (25(OH)D), (C) the subjects with 10 to 20 ng/mL of baseline 25(OH)D, and (D) the vitamin D group.

• 

  Fig. 4 Serum fibroblast growth factor 23 (FGF23) levels were measured at the indicated times. (A) All subjects, (B) subjects with baseline 25(OH)D below 10 ng/mL, (C) subjects with baseline levels of 10 to 20 ng/mL, and (D) the vitamin D group.

• 

  Fig. 5 (A, B) Serum sclerostin and (C, D) dickkopf-1 (DKK1) concentrations were measured at different time points after treatment. Mean±SEM are shown. aP<0.05 compared to placebo.

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