2009 Southern Regional Meeting Abstracts

Purpose of Study: A reduction in serum 25(OH)D in keeping with vitamin D deficiency (<30 ng/mL) is quite prevalent in African-Americans (AA) residing in Memphis, TN (latitude 35° N), with or without heart failure (Am J Med Sci 2008;335:292-97). In AA housebound with symptomatic heart failure, the degree of hypovitaminosis D can be of moderate (10-20 ng/mL) to marked (<10 ng/mL) severity. Melanin is a natural sunscreen and hence the darker the skin, the longer sunlight exposure needed to begin vitamin D steroidogenesis. A regimented protocol of outdoor ultraviolet B exposure to correct vitamin D deficiency is not practical in these patients. We therefore turned to an oral vitamin D supplement. However, the dose and duration of treatment required to correct serum 25(OH)D to >30 ng/mL was uncertain. We selected ergocalciferol (50,000 units) given by mouth once weekly for 8 wks.
Methods Used: Over the past several months, we have been enrolling AA patients with heart failure (EF<35%) of diverse etiology and documented hypovitaminosis D (<30 ng/mL) into an open-label study. In addition to today’s standard of care, these patients receive 50,000 units of oral ergocalciferol, once weekly for 8 wks. Serum 25(OH)D is assayed at baseline and 8 wks treatment.
Summary of Results: To date, 5 patients (3 M; 50.4±4.4 yrs) have completed the 8-wk study. At the time of entry, their baseline 25(OH)D was 15.22±2.98 ng/mL; at 8 wks treatment it had risen to 34.88±4.09 ng/mL. No untoward events or side effects have occurred with this regimen. Subjectively, patients report an increased sense of well-being.
Conclusions: These preliminary findings suggest a large oral dose of ergocalciferol given once weekly for 8 wks will raise moderately to severely depressed serum 25(OH)D levels to >30 ng/mL and thereby correct hypovitaminosis D in AA residing in Memphis with heart failure. A regimen that will sustain 25(OH)D at >30 ng/mL needs to be developed and is under investigation. The results of this ongoing study will be collated with current findings for presentation at the 2009 SSCI meeting.