الفهرس 
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Abstract
SUMMARY
B
oth the D2 and D3 forms of vitamin D are commonly used in human supplementation. But there is controversy regarding the effect of vitamin D2 and D3 in elevating and sustaining 25 (OH) D.
This study aims to evaluate the difference between the effect of parenteral vitamin D2 and vitamin D3 administration in raising serum 25(OH)D in pediatric patients.
A randomized controlled clinical trial, conducted in pediatric endocrinology unit, Ain Shams University, Cairo, Egypt, where 50 participants who had vitamin D deficiency were recruited. Subjects were divided into two groups, 25 patients per group (group A received a single dose of 200,000 IU of intramuscular vitamin D2 and group B received 200,000 IU of intramuscular vitamin D3). History of sun exposure and dietary intake of calcium, assessment of anthropometric measures, Tanner staging, and laboratory investigations were documented. Follow up of serum level of 25(OH)D was done every month for three consecutive months.
The mean age of the included subjects was 7.73 ± 1.89 years ranging from 5 to 10 years, 50% of the included subjects were males and 50% were females with a male to female ratio of 1:1, around 20% to 45% of their bodies were exposed to sunlight (30.58 ± 5.91) with dietary intake of calcium ranging from 190 to 520 mg/day (327.16 ± 73.86).
The BMI SDS in our study was 0.01 (-0.26 - 0.71). ninety-eight% of the participants had Tanner stage I and 2% had Tanner stage II.
All the included subjects in both groups had normal baseline total serum calcium, serum phosphorus, serum alkaline phosphatase, and serum parathyroid hormone measured using commercially available kits and compared to age-adjusted references. While all the included subjects had inadequate serum levels of total 25 (OH) D upon enrollment (< 30 ng/ml).
The results of our present study can be summarized as follows:
- Parenteral vitamin D3 supplementation in group B patients resulted in significantly higher increments in 25(OH)D level than that achieved by parenteral vitamin D2 supplementation in group A after 1st, 2nd, and 3rd months (p=0.000).
- The mean 25 (OH) D in group B after 1 month was 50.84 ± 7.56 ng/ml while in group A was 35.92 ± 8.61 ng/ml, after 2 months the mean 25 (OH) D in group B was 62.68 ± 7.82 ng/ml while in group A was 46.16 ± 9.03 ng/ml and after 3 months the mean 25 (OH) D in group B was 71.32 ± 8.86 ng/ml while in group A was 53.92 ± 7.65 ng/ml (P =0.000).
- Vitamin D3 supplementation resulted in a significantly greater increment in serum 25(OH)D levels from 1st to 2nd month and from 1st to 3rd month than Vitamin D2 supplementation with a P value of 0.039 and 0.018 respectively.
- One hundred percent of group B participants who received vitamin D3 reached sufficient level (41.04 ± 10.04) after 1 month while 80% of participants in group A who received vitamin D2 reached a sufficient level after 1 month and 20% of participants after 2 months (P= 0.018).