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Systematic Review

Relative Efficacy of Vitamin D2 and Vitamin D3 in Improving Vitamin D Status: Systematic Review and Meta-Analysis

1
ICMR-National Institute of Occupational Health, Ahmedabad 380016, India
2
ICMR-National Institute of Nutrition, Hyderabad 500007, India
3
Sitaram Bhartia Institute of Science and Research, New Delhi 110016, India
*
Author to whom correspondence should be addressed.
Academic Editor: Andrea Fabbri
Nutrients 2021, 13(10), 3328; https://doi.org/10.3390/nu13103328
Received: 25 August 2021 / Revised: 17 September 2021 / Accepted: 20 September 2021 / Published: 23 September 2021
(This article belongs to the Section Micronutrients and Human Health)
Background: Widespread prevalence of vitamin D deficiency has been documented globally. Commonly used interventions to address this deficiency include supplementation and/or fortification with either ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3), but the relative efficacy of these two vitamers is unclear. The current study aimed to evaluate the relative efficacy of ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3) for raising the serum levels of vitamin D metabolites and functional indicators including serum parathyroid (PTH) levels, isometric muscle strength, hand grip strength and bone mineral density. Methods: Randomized and non-randomized controlled studies evaluating relative efficacy of ergocalciferol and cholecalciferol were systematically reviewed to synthesize quantitative and qualitative evidence as per the recommendations of according to “Preferred Reporting Items for Systematic reviews and Meta-analysis” guidelines. Search terms were constructed on the basis of the “participants”, “intervention”, “control”, “outcome” and “study type” (PICOS) strategy to systematically search the popular electronic databases. Relevant data from studies meeting inclusion and exclusion criteria were extracted and analyzed. Meta-regression, subgroup and sensitivity analyses were performed to investigate the influence of study-level characteristics including intervention dosage, frequency of dosing, interval between the last dose and test for outcome assessment, participant characteristics and analytical methods. Results: Apparently healthy human participants (n = 1277) from 24 studies were included for meta-analysis. The quantitative analysis suggested higher efficacy of cholecalciferol than ergocalciferol in improving total 25(OH)D (mean difference: 15.69, 95%CI: 9.46 to 21.93 nmol/L) and reducing PTH levels, consistently across variable participant demographics, dosage and vehicle of supplementation. Meta-regression suggested smaller differences in the efficacy of cholecalciferol and ergocalciferol at lower doses. Average daily dose was the single significant predictor of effect size, as revealed by multivariate meta-regression analysis. Conclusions: Compared to ergocalciferol, cholecalciferol intervention was more efficacious in improving vitamin D status (serum levels of total 25(OH)D and 25(OH)D3) and regulating PTH levels, irrespective of the participant demographics, dosage and vehicle of supplementation. View Full-Text
Keywords: ergocalciferol; cholecalciferol; parathyroid hormone; vitamin D; vitamin D2; vitamin D3 ergocalciferol; cholecalciferol; parathyroid hormone; vitamin D; vitamin D2; vitamin D3
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MDPI and ACS Style

Balachandar, R.; Pullakhandam, R.; Kulkarni, B.; Sachdev, H.S. Relative Efficacy of Vitamin D2 and Vitamin D3 in Improving Vitamin D Status: Systematic Review and Meta-Analysis. Nutrients 2021, 13, 3328. https://doi.org/10.3390/nu13103328

AMA Style

Balachandar R, Pullakhandam R, Kulkarni B, Sachdev HS. Relative Efficacy of Vitamin D2 and Vitamin D3 in Improving Vitamin D Status: Systematic Review and Meta-Analysis. Nutrients. 2021; 13(10):3328. https://doi.org/10.3390/nu13103328

Chicago/Turabian Style

Balachandar, Rakesh, Raghu Pullakhandam, Bharati Kulkarni, and Harshpal Singh Sachdev. 2021. "Relative Efficacy of Vitamin D2 and Vitamin D3 in Improving Vitamin D Status: Systematic Review and Meta-Analysis" Nutrients 13, no. 10: 3328. https://doi.org/10.3390/nu13103328

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