Key result
High-dose perioperative vitamin D supplementation significantly reduced the rate of early postoperative vitamin D insufficiency to 14% compared to 56% in untreated controls.
Why the study?
Post-operative vitamin D supplementation improves CRC survival outcomes in randomised trials, but the feasibility, safety, and efficacy of pre- and perioperative vitamin D in patients undergoing CRC surgery remained to be tested.
Does perioperative 3200IU oral cholecalciferol improve 25OHD levels and reduce CRP in patients undergoing colorectal cancer resection?
Cohort (n=122)
No
Does perioperative 3200IU oral cholecalciferol improve 25OHD levels and reduce CRP in patients undergoing colorectal cancer resection?
High-dose perioperative vitamin D supplementation is feasible, increases 25OHD levels, and reduces early postoperative CRP in patients undergoing colorectal cancer resection.
Answers are grounded in this paper and cite their sources.
May support perioperative vitamin D repletion in colorectal resection; leaves open randomized confirmation of CRP and outcome effects.
BACKGROUND Post-operative vitamin D supplementation improves CRC survival outcomes in randomised trials. The aim of this study was to test the feasibility, safety and efficacy of vitamin D in the pre- and perioperative period in patients undergoing CRC surgery. METHODS Patients were given 3200IU oral cholecalciferol per day perioperatively. Serial serum 25OHD was measured by liquid chromatography tandem mass spectrometry and compared to untreated CRC controls. 25OHD/CRP levels were compared using adjusted generalized linear mixed-effects models. RESULTS 122 patients underwent serial perioperative sampling, including 41 patients given high-dose perioperative supplementation. 25OHD was higher in patients given high-dose supplementation compared to controls at all peri-operative timepoints (P<0.001) and supplementation attenuated the post-operative drop in 25OHD (46% vs 24% drop). Rate of vitamin D insufficiency was significantly less in those on supplementation (14% vs . 56%, P=0.003), with multivariate modelling indicating a ∼60nmol/l higher 25OHD compared to control patients (P=1.22E-15). Supplementation was associated with lower peri-operative CRP (P=0.035). DISCUSSIONS High dose pre-operative vitamin D supplementation is associated with higher perioperative 25OHD levels, lower rates of vitamin D insufficiency and reduced early postoperative CRP. These findings provide compelling rationale for early initiation of vitamin D supplementation after a diagnosis of CRC.
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Vaughan-Shaw et al. (2022) conducted a cohort in Colorectal cancer (n=122). Vitamin D3 (Cholecalciferol) vs. Untreated controls was evaluated on Early postoperative vitamin D insufficiency (25OHD < 50nmol/l) (p=0.003). High-dose perioperative vitamin D supplementation significantly reduced the rate of early postoperative vitamin D insufficiency to 14% compared to 56% in untreated controls.
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