ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Pediatric Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1585898
Effects of High-Dose Vitamin D Supplementation on Bone Mineral Density in Very Low Birth Weight Preterm Infants
Provisionally accepted
- Hanyang University Seoul Hospital, Seoul, Republic of Korea
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Background: Vitamin D deficiency is common among very low birth weight (VLBW) preterm infants due to challenges in achieving adequate enteral nutrition and reduced transplacental transfer. Supplementation with 800 IU/day of vitamin D has been shown to safely and effectively increase serum 25-hydroxyvitamin D [25(OH)D] levels above 30 ng/mL when initiated at two weeks of age and continued until hospital discharge. Objective: This study aimed to evaluate whether daily supplementation with 800 IU of vitamin D significantly improves bone mineral density, as measured by dual-energy X-ray Dual Energy X-ray Absorptiometry in Preterm Infants 2 absorptiometry (DEXA), in VLBW infants at discharge, compared to supplementation with 400 IU/day.We retrospectively reviewed the medical records of 215 VLBW infants with birth weights under 1,500 g who were admitted to the neonatal intensive care unit at Hanyang University Seoul Hospital between January 2010 and December 2023. The infants were divided into two groups based on their daily vitamin D intake of either 400 IU or 800 IU, initiated on day 14 of life after trophic feeding was established. Bone mineral apparent density (BMAD) was assessed at discharge using whole-body DEXA (Hologic QDR-4500, infant mode).Results: Maternal age (32.01 ± 3.43 vs. 33.34 ± 4.39 years, p = 0.017) and birth weight (812.86 ± 141.19 vs. 883.76 ± 260.09 g, p = 0.010) were significantly higher in the 800 IU group, which also had a longer duration of total parenteral nutrition. After adjusting for birth weight and duration of parenteral nutrition, total body BMAD was significantly higher in the 800 IU group (p = 0.008). A general linear model further demonstrated that 800 IU supplementation was positively associated with femoral BMAD at discharge (β = 0.267, p = 0.001).Daily supplementation of 800 IU of vitamin D was associated with improved bone mineralization, as measured by DEXA, at discharge in VLBW infants.
Keywords: Vitamin D, bone mineral density, VLBW (very low birth weight), DEXA, preterm
Received: 01 Mar 2025; Accepted: 14 Jul 2025.
Copyright: © 2025 Yoo, Seo, Lee, Kim, Choi, Choe, Lee and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Seung Yang, Hanyang University Seoul Hospital, Seoul, Republic of Korea
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