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Effect of vitamin D2 supplementation on 25-hydroxyvitamin D3 status: a systematic review and meta-analysis of randomised controlled trials

Published online by Cambridge University Press:  03 July 2024

E.I.G. Brown ,
A.L. Darling ,
T.M. Robertson ,
K.H. Hart ,
S.A. Lanham-New ,
R.M. Elliott  and
M.J. Warren
E.I.G. Brown
Affiliation:
Department of Food, Nutrition and Exercise Sciences, University of Surrey, Guildford, UK
A.L. Darling
Affiliation:
Department of Food, Nutrition and Exercise Sciences, University of Surrey, Guildford, UK
T.M. Robertson
Affiliation:
Department of Food, Nutrition and Exercise Sciences, University of Surrey, Guildford, UK
K.H. Hart
Affiliation:
Department of Food, Nutrition and Exercise Sciences, University of Surrey, Guildford, UK
S.A. Lanham-New
Affiliation:
Department of Food, Nutrition and Exercise Sciences, University of Surrey, Guildford, UK
R.M. Elliott
Affiliation:
Department of Food, Nutrition and Exercise Sciences, University of Surrey, Guildford, UK
M.J. Warren
Affiliation:
Quadram Institute Biosciences, Norwich, UK
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Abstract

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There are known differences in biological functionality between vitamin D2 and D3. It is suspected from randomised control trial (RCT) data that vitamin D2 supplementation causes a reduction in serum 25-hydroxyvitamin D3 (25(OH)D3) concentrations (1), but the size of the effect has yet to be fully assessed across multiple studies. The aim of this study was to undertake a systematic review and meta-analysis of the effect of vitamin D2 supplementation on serum 25(OH)D3 concentrations.

PUBMED was searched for publications from 1st January 1975 to 1st February 2023. Of the 182 papers retrieved, 29 were included in the systematic review, and of those, 18 were suitable for meta-analysis.

The meta-analysis found significant reductions in serum D3 after vitamin D2 supplementation compared with control, for both end of trial between groups data (weighted mean difference (WMD) (random) = −13.51 nmol/L; 95% CI: −20.14, −6.89; P < 0.0001) and absolute change over the trial (WMD (random) = −9.25 nmol/L; 95% CI: −14.40, −4.10; P = 0.0004). Similar results were found when D2 supplementation was compared to D3 supplementation, although as expected, the magnitude of the difference was larger, with WMD (random) = −46.20 nmol/L (95% CI: −60.80, −31.60; P < 0.00001) for end of trial data, and WMD (random) = −56.23 nmol/L (95% CI: -69.17, −43.28; P < 0.00001) for absolute change.

Overall, we found that vitamin D2 supplementation produces significant reductions in serum 25(OH)D3 concentrations, when compared to either control or vitamin D3 supplementation. An inverse relationship between vitamin D2 and D3 concentrations has been proposed in the literature (2). A regulatory mechanism that disposes of 25(OH)D after an increase in vitamin D concentrations could explain our results (3). Moreover, supplementation with vitamins D2 and D3 has differential effects on gene expression (4). However, longer-term research is needed to establish whether clinical advice should recommend vitamin D3 supplements over vitamin D2 supplements, where appropriate.

Type
Abstract
Information
Proceedings of the Nutrition Society , Volume 83 , Issue OCE2: Winter Conference 2023, 5-6 December 2023, Diet and lifestyle strategies for prevention and management of multimorbidity , June 2024 , E222
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Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of The Nutrition Society

Footnotes

*

Joint senior authors

References

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