Factors predicting vitamin D response variation in non-Hispanic white postmenopausal women

It is well documented that there is wide variation in the response of serum 25-hydroxyvitamin D [25(OH)D] to a given dose of vitamin D supplementation. Understanding factors affecting the response variation is important for identifying subjects who are susceptible to vitamin D deficiency or toxicity. This study aimed to evaluate potential predictors for vitamin D response variation.

A total of 1179 non-Hispanic white postmenopausal women were enrolled into a 4-yr calcium and vitamin D (1100 IU/d) clinical trial. Among them, serum 25(OH)D level of 1063 subjects were measured at both baseline and after 12 months treatment. Vitamin D response was computed for these 1063 subjects as the difference in levels of serum 25(OH)D concentration at the end of a 12-month vitamin D treatment compared with baseline. Stepwise linear regression was used to identify predictors of vitamin D response variation.

Increase in vitamin D intake, baseline serum 25(OH)D level, baseline blood collection season, baseline serum calcium level, and baseline body mass index were predictors of vitamin D response variation. These five factors explained 46.8% of the vitamin D response variation in the 1063 subjects. The first three factors [increase in vitamin D intake, baseline serum 25(OH)D level, baseline blood collection season] remained as predictors in the 392 subjects with trial vitamin D supplementation. For the first time, our study indicated that season is an important prediction factor for vitamin D response variation. Subjects who started vitamin D treatment in a cold season (autumn and winter) achieved a significantly higher serum 25(OH)D increase than those started in a hot season (summer) (P < 0.001).

Our study suggests that the increase in vitamin D supplementation, baseline serum 25(OH)D level, and the season when initiating the vitamin D supplementation can partially predict vitamin D response variation in non-Hispanic postmenopausal women.