{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T13:56:45Z","timestamp":1778507805955,"version":"3.51.4"},"reference-count":43,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,3,15]],"date-time":"2025-03-15T00:00:00Z","timestamp":1741996800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health","award":["N. NET-2016-02361805"],"award-info":[{"award-number":["N. NET-2016-02361805"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Cholecalciferol and Calcifediol are commonly used for oral supplementation in patients with vitamin D deficiency. Several studies have compared these two molecules; however, the studied population has only included healthy postmenopausal women so far. This retrospective observational study aims to evaluate which molecule is more effective and faster in achieving serum 25(oh)D levels within the normal range in post-stroke patients during the subacute phase. Secondary aims include assessing potential differences in functional outcomes and investigating the possible correlation between the degree of hypovitaminosis D and stroke severity. Methods: We observed 85 in-patients who received either Cholecalciferol or Calcifediol during intensive rehabilitation. All subjects underwent functional evaluations, blood tests, and a bone densitometry (DEXA) scan. Results: Four months after starting supplementation, subjects receiving calcifediol achieved significantly higher 25(oh)D levels (p &lt; 0.001) compared to those receiving cholecalciferol. No significant between-group differences were observed in secondary outcomes. Another key finding is that no statistically significant correlation was found between serum of 25(oh)D levels and stroke severity. Conclusions: These results highlight the importance of further investigating bone metabolism in post-stroke patients, though findings should be confirmed in larger studies.<\/jats:p>","DOI":"10.3390\/nu17061035","type":"journal-article","created":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T04:29:28Z","timestamp":1742185768000},"page":"1035","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy of Oral Supplementation with Cholecalciferol Versus Calcifediol in Patients with Hypovitaminosis D After Stroke"],"prefix":"10.3390","volume":"17","author":[{"given":"Stefania","family":"Canneva","sequence":"first","affiliation":[{"name":"IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3536-1602","authenticated-orcid":false,"given":"Anna","family":"De Giovanni","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, 16126 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicita","family":"Pagella","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, 16126 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Pellegrino","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, 16126 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Iencinella","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, 16126 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Maestrini","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, 16126 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4091-4686","authenticated-orcid":false,"given":"Marta","family":"Ponzano","sequence":"additional","affiliation":[{"name":"Department of Health Sciences (DISSAL), University of Genoa, 16126 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3419-0669","authenticated-orcid":false,"given":"Carlo","family":"Trompetto","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, 16126 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2762-8327","authenticated-orcid":false,"given":"Laura","family":"Mori","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genoa, Italy"},{"name":"Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Sciences (DINOGMI), University of Genoa, 16126 Genova, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s12937-025-01076-x","article-title":"Combined 25-hydroxyvitamin D concentrations and physical activity on mortality in US stroke survivors: Findings from the NHANES","volume":"24","author":"Liao","year":"2025","journal-title":"Nutr. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1002\/jbmr.551","article-title":"Oral supplementation with 25(OH)D3 versus vitamin D3: Effects on 25(OH)D levels, lower extremity function, blood pressure, and markers of innate immunity","volume":"27","author":"Sidelnikov","year":"2012","journal-title":"J. Bone Miner. Res."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Marek, K., Cicho\u0144, N., Saluk-Bijak, J., Bijak, M., and Miller, E. (2022). The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review. Nutrients, 14.","DOI":"10.3390\/nu14132761"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.neurobiolaging.2013.07.029","article-title":"Combination of memantine and vitamin D prevents axon degeneration induced by amyloid-beta and glutamate","volume":"35","author":"Annweiler","year":"2014","journal-title":"Neurobiol. Aging"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1001\/archinte.168.15.1629","article-title":"25-hydroxyvitamin D levels and the risk of mortality in the general population","volume":"168","author":"Melamed","year":"2008","journal-title":"Arch. Intern. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1111\/nan.12020","article-title":"Review: The role of vitamin D in nervous system health and disease","volume":"39","author":"DeLuca","year":"2013","journal-title":"Neuropathol. Appl. Neurobiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2495","DOI":"10.1161\/ATVBAHA.110.215459","article-title":"Oral administration of an active form of vitamin D3 (calcitriol) decreases atherosclerosis in mice by inducing regulatory T cells and immature dendritic cells with tolerogenic functions","volume":"30","author":"Takeda","year":"2010","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"H1260","DOI":"10.1152\/ajpheart.01068.2009","article-title":"Calcium-independent phospholipase A(2) plays a key role in the endothelium-dependent contractions to acetylcholine in the aorta of the spontaneously hypertensive rat","volume":"298","author":"Wong","year":"2010","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2420","DOI":"10.1210\/en.2011-1783","article-title":"Vitamin D deficiency exacerbates experimental stroke injury and dysregulates ischemia-induced inflammation in adult rats","volume":"153","author":"Balden","year":"2012","journal-title":"Endocrinology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1007\/s11064-014-1316-0","article-title":"Prognostic value of serum 25-hydroxyvitamin D in patients with stroke","volume":"39","author":"Wang","year":"2014","journal-title":"Neurochem. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1016\/j.jstrokecerebrovasdis.2015.03.051","article-title":"Low Serum Vitamin D Is Independently Associated with Larger Lesion Volumes after Ischemic Stroke","volume":"24","author":"Turetsky","year":"2015","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Cichon, N., Saluk-Bijak, J., Miller, E., Gorniak, L., Redlicka, J., Niwald, M., and Bijak, M. (2021). The Role of Supplementation with Natural Compounds in Post-Stroke Patients. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22157893"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1016\/j.numecd.2016.06.009","article-title":"Serum 25-hydroxyvitamin D predicts early recurrent stroke in ischemic stroke patients","volume":"26","author":"Huang","year":"2016","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1007\/s12603-016-0846-3","article-title":"Low Serum Levels of 25-Hydroxyvitamin D Are Associated with Stroke Recurrence and Poor Functional Outcomes in Patients with Ischemic Stroke","volume":"21","author":"Ji","year":"2017","journal-title":"J. Nutr. Health Aging"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Okoye, C., Calsolaro, V., Niccolai, F., Calabrese, A.M., Franchi, R., Rogani, S., Coppini, G., Morelli, V., Caraccio, N., and Monzani, F. (2022). A Randomized, Open-Label Study to Assess Efficacy of Weekly Assumption of Cholecalciferol versus Calcifediol in Older Patients with Hypovitaminosis, D. Geriatrics, 7.","DOI":"10.3390\/geriatrics7010013"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Sosa Henr\u00edquez, M., and G\u00f3mez de Tejada Romero, M.J. (2020). Cholecalciferol or Calcifediol in the Management of Vitamin D Deficiency. Nutrients, 12.","DOI":"10.3390\/nu12061617"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1038\/s41430-020-0697-1","article-title":"Vitamin D supplementation: Cholecalciferol, calcifediol, and calcitriol","volume":"74","author":"Vieth","year":"2020","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_18","first-page":"1967","article-title":"Calcifediol is superior to cholecalciferol in improving vitamin D status in postmenopausal women: A randomized trial","volume":"36","author":"Brandi","year":"2021","journal-title":"J. Bone Miner. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"339","DOI":"10.2174\/15701611113119990024","article-title":"Vitamin D metabolites and\/or analogs: Which D for which patient?","volume":"12","author":"Mazzaferro","year":"2014","journal-title":"Curr. Vasc. Pharmacol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Cesareo, R., Falchetti, A., Attanasio, R., Tabacco, G., Naciu, A.M., and Palermo, A. (2019). Hypovitaminosis D: Is It Time to Consider the Use of Calcifediol?. Nutrients, 11.","DOI":"10.3390\/nu11051016"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1007\/s00198-019-05163-8","article-title":"Cholecalciferol and calcifediol for vitamin D supplementation","volume":"31","year":"2020","journal-title":"Osteoporos. Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1093\/ajcn\/77.1.204","article-title":"Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol","volume":"77","author":"Heaney","year":"2003","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"5111","DOI":"10.3390\/nu7075111","article-title":"Factors Affecting 25-Hydroxyvitamin D Concentration in Response to Vitamin D Supplementation","volume":"7","author":"Mazahery","year":"2015","journal-title":"Nutrients"},{"key":"ref_24","first-page":"344","article-title":"Effects of alendronate and calcifediol compared to alendronate and cholecalciferol in osteoporotic patients","volume":"44","author":"Ferretti","year":"2019","journal-title":"Minerva Endocrinol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1159\/000226578","article-title":"Osteoporosis after stroke: A review of the causes and potential treatments","volume":"28","author":"Carda","year":"2009","journal-title":"Cerebrovasc. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/S8756-3282(00)00374-4","article-title":"Ambulatory level and asymmetrical weight bearing after stroke affects bone loss in the upper and lower part of the femoral neck differently: Bone adaptation after decreased mechanical loading","volume":"27","author":"Crabtree","year":"2000","journal-title":"Bone"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/j.jocd.2008.05.097","article-title":"Bone mineral density alterations in upper and lower extremities 12 months after stroke measured by peripheral quantitative computed tomography and DXA","volume":"11","author":"Lazoura","year":"2008","journal-title":"J. Clin. Densitom."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1161\/01.STR.30.4.755","article-title":"Hemiosteoporosis after severe stroke, independent of changes in body composition and weight","volume":"30","author":"Ramnemark","year":"1999","journal-title":"Stroke"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Plantone, D., Primiano, G., Manco, C., Locci, S., Servidei, S., and De Stefano, N. (2022). Vitamin D in Neurological Diseases. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24010087"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.3233\/JAD-230214","article-title":"Vitamin D, a Secosteroid Hormone and Its Multifunctional Receptor, Vitamin D Receptor, in Alzheimer\u2019s Type Neurodegeneration","volume":"95","author":"Dursun","year":"2023","journal-title":"J. Alzheimers Dis."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Grant, W.B. (2024). Follow-Up Period Affects the Association between Serum 25-Hydroxyvitamin D Concentration and Incidence of Dementia, Alzheimer\u2019s Disease, and Cognitive Impairment. Nutrients, 16.","DOI":"10.20944\/preprints202408.0993.v1"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Grant, W.B., and Boucher, B.J. (2024). How Follow-Up Period in Prospective Cohort Studies Affects Relationship Between Baseline Serum 25(OH)D Concentration and Risk of Stroke and Major Cardiovascular Events. Nutrients, 16.","DOI":"10.20944\/preprints202410.0486.v2"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Alharbi, A.R., Alali, A.S., Samman, Y., Alghamdi, N.A., Albaradie, O., Almaghrabi, M., Makkawi, S., Alghamdi, S., Alzahrani, M.S., and Alsalmi, M. (2022). Vitamin D serum level predicts stroke clinical severity, functional independence, and disability-A retrospective cohort study. Front. Neurosci., 16.","DOI":"10.3389\/fnins.2022.951283"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"154434","DOI":"10.1016\/j.metabol.2020.154434","article-title":"Letter to the Editor: Vitamin D deficiency in COVID-19: Mixing up cause and consequence","volume":"115","author":"Smolders","year":"2021","journal-title":"Metabolism"},{"key":"ref_35","first-page":"CC06","article-title":"Role of Vitamin D in the Outcome of Ischemic Stroke- A Randomized Controlled Trial","volume":"11","author":"Narasimhan","year":"2017","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1111\/ijcp.12866","article-title":"Effect of Vitamin D and calcium supplementation on ischaemic stroke outcome: A randomised controlled open-label trial","volume":"70","author":"Gupta","year":"2016","journal-title":"Int. J. Clin. Pract."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.3906\/sag-2010-287","article-title":"Effect of vitamin D supplementation on lower extremity motor function and ambulation in stroke patients","volume":"51","year":"2021","journal-title":"Turk. J. Med. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Momosaki, R., Abo, M., and Urashima, M. (2019). Vitamin D Supplementation and Post-Stroke Rehabilitation: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients, 11.","DOI":"10.3390\/nu11061295"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e27747","DOI":"10.1097\/MD.0000000000027747","article-title":"The role of rehabilitation and vitamin D supplementation on motor and psychological outcomes in poststroke patients","volume":"100","author":"Torrisi","year":"2021","journal-title":"Medicine"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1589\/jpts.30.874","article-title":"A randomized, double-blind study to assess if vitamin D treatment affects the outcomes of rehabilitation and balance in hemiplegic patients","volume":"30","author":"Sari","year":"2018","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1038\/s41574-021-00593-z","article-title":"The health effects of vitamin D supplementation: Evidence from human studies","volume":"18","author":"Bouillon","year":"2022","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1093\/oxfordjournals.aje.a010013","article-title":"Underestimation of risk associations due to regression dilution in long-term follow-up of prospective studies","volume":"150","author":"Clarke","year":"1999","journal-title":"Am. J. Epidemiol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Aghajafari, F., Field, C.J., Kaplan, B.J., Rabi, D.M., Maggiore, J.A., O\u2019Beirne, M., Hanley, D.A., Eliasziw, M., Dewey, D., and Weinberg, A. (2016). APrON Study Team. The Current Recommended Vitamin D Intake Guideline for Diet and Supplements During Pregnancy Is Not Adequate to Achieve Vitamin D Sufficiency for Most Pregnant Women. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0157262"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/6\/1035\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:54:19Z","timestamp":1760028859000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/6\/1035"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,15]]},"references-count":43,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["nu17061035"],"URL":"https:\/\/doi.org\/10.3390\/nu17061035","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,15]]}}}