Oral Cholecalciferol versus Ultraviolet Radiation B: Effect on Vitamin D Metabolites in Patients with Chronic Pancreatitis and Fat Malabsorption - A Randomized Clinical Trial

Background: Patients with chronic pancreatitis (CP) often develop fat malabsorption and are susceptible to hypovitaminosis D. Aim: We wanted to evaluate the intestinal uptake of cholecalciferol in patients with CP and fat malabsorption. Methods: We did a prospective placebo-controlled study including patients with verified CP and fat malabsorption. They were randomized to 10 weeks of (A) ultraviolet radiation B (UVB) 6 min weekly in a commercial tanning bed, (B) vitamin D supplement 1,520 IU/daily, or (C) placebo. The vitamin D metabolites 25-hydroxyvitamin D (25OHD) and 1,25-dihydroxyvitamin D (calcitriol) were quantified at the start and end of the study. Results: In total 30 patients were randomized and 27 completed the study. Compliance to tablets and tanning sessions was >80%. The changes in 25OHD levels in group B (32.3 nmol/l; 95% CI 15-50) were significantly greater than changes in group A (p<0.001) and group C (p < 0.001). Changes in group A (1.1 nmol/l) did not differ from the placebo group (p = 0.9). Changes in calcitriol levels were identical between groups. Conclusions: Daily vitamin D supplements increased 25OHD in patients with CP compared to placebo whereas weekly tanning bed sessions did not.