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Randomized, double-blind, placebo-controlled trial of vitamin D supplementation in Parkinson disease.

The American journal of clinical nutrition (2013-03-15)
Masahiko Suzuki, Masayuki Yoshioka, Masaya Hashimoto, Maiko Murakami, Miki Noya, Daisuke Takahashi, Mitsuyoshi Urashima
ABSTRACT

In our previous study, higher serum 25-hydroxyvitamin D [25(OH)D] concentrations and the vitamin D receptor (VDR) FokI CC genotype were associated with milder Parkinson disease (PD). We evaluated whether vitamin D3 supplementation inhibits the progression of PD on the basis of patient VDR subgroups. Patients with PD (n = 114) were randomly assigned to receive vitamin D3 supplements (n = 56; 1200 IU/d) or a placebo (n = 58) for 12 mo in a double-blind setting. Outcomes were clinical changes from baseline and the percentage of patients who showed no worsening of the modified Hoehn and Yahr (HY) stage and Unified Parkinson's Disease Rating Scale (UPDRS). Compared with the placebo, vitamin D3 significantly prevented the deterioration of the HY stage in patients [difference between groups: P = 0.005; mean ± SD change within vitamin D3 group: +0.02 ± 0.62 (P = 0.79); change within placebo group: +0.33 ± 0.70 (P = 0.0006)]. Interaction analyses showed that VDR FokI genotypes modified the effect of vitamin D3 on changes in the HY stage (P-interaction = 0.045), UPDRS total (P-interaction = 0.039), and UPDRS part II (P-interaction = 0.021). Compared with the placebo, vitamin D3 significantly prevented deterioration of the HY stage in patients with FokI TT [difference between groups: P = 0.009; change within vitamin D3 group: -0.38 ± 0.48 (P = 0.91); change within placebo group, +0.63 ± 0.77 (P = 0.009)] and FokI CT [difference between groups: P = 0.020; change within vitamin D3 group: ±0.00 ± 0.60 (P = 0.78); change within placebo group: +0.37 ± 0.74 (P = 0.014)] but not FokI CC. Similar trends were observed in UPDRS total and part II. Vitamin D3 supplementation may stabilize PD for a short period in patients with FokI TT or CT genotypes without triggering hypercalcemia, although this effect may be nonspecific for PD. This trial was registered at UMIN Clinical Trials Registry as UMIN000001841.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
Cholecalciferol, ≥98% (HPLC)
Supelco
Cholecalciferol (Vitamin D3), Pharmaceutical Secondary Standard; Certified Reference Material
Supelco
Cholecalciferol (D3), analytical standard
Cholecalciferol, European Pharmacopoeia (EP) Reference Standard
Cholecalciferol for system suitability, European Pharmacopoeia (EP) Reference Standard
Sigma-Aldrich
Cholecalciferol, meets USP testing specifications
Sigma-Aldrich
Cholecalciferol, analytical standard