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Published in: European Journal of Nutrition 8/2012

01-12-2012 | Original Contribution

Is a daily supplementation with 40 microgram vitamin D3 sufficient? A randomised controlled trial

Authors: Göran Toss, Per Magnusson

Published in: European Journal of Nutrition | Issue 8/2012

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Abstract

Purpose

The effect of 40 μg (1,600 IU) per day of vitamin D3 on serum 25-hydroxyvitamin D (25(OH)D) and markers of bone and mineral metabolism was evaluated.

Methods

This intervention study was designed as a double-blind randomised controlled trial. Forty-five community-dwelling subjects (32 females), age 55–84 years, at 58° North latitude were supplemented for 1 year with 40 μg vitamin D3 plus 1,000 mg calcium per day, or with 1,000 mg calcium per day for controls. Safety parameters and 25(OH)D, intact parathyroid hormone (PTH), ionized calcium, bone-specific alkaline phosphatase (BALP), and tartrate-resistant acid phosphatase isoform 5b (TRACP5b) were measured over the study period.

Results

All subjects supplemented with vitamin D3 reached a 25(OH)D level above 50 nmol/L. Mean (SD) serum 25(OH)D increased from 50.4 (13.5) nmol/L to 84.2 (17.5) nmol/L, range 55.0–125.0 nmol/L in the vitamin D3 supplemented group and the corresponding levels for the control group were 47.3 (14.1) nmol/L and 45.7 (13.4) nmol/L, range 26.0–73.0 nmol/L. No serious adverse event was recorded and the highest 25(OH)D level reached, 125.0 nmol/L, is well below toxic levels. BALP and TRACP5b did not change significantly over the study period.

Conclusions

This trial suggests that a daily supplementation with 40 μg vitamin D3 is sufficient to secure a 25(OH)D level of 50 nmol/L. No side effects were observed in the study group.
Literature
1.
go back to reference Hess AF, Lewis JM (1928) Clinical experience with irradiated ergosterol. JAMA 91:783–788CrossRef Hess AF, Lewis JM (1928) Clinical experience with irradiated ergosterol. JAMA 91:783–788CrossRef
2.
go back to reference Weick MT (1967) A history of rickets in the United States. Am J Clin Nutr 20:1234–1241 Weick MT (1967) A history of rickets in the United States. Am J Clin Nutr 20:1234–1241
3.
go back to reference Lips P, Netelenbos JC, Jongen MJ, van Ginkel FC, Althuis AL, van Schaik CL, van der Vijgh WJ, Vermeiden JP, van der Meer C (1982) Histomorphometric profile and vitamin D status in patients with femoral neck fracture. Metab Bone Dis Relat Res 4:85–93CrossRef Lips P, Netelenbos JC, Jongen MJ, van Ginkel FC, Althuis AL, van Schaik CL, van der Vijgh WJ, Vermeiden JP, van der Meer C (1982) Histomorphometric profile and vitamin D status in patients with femoral neck fracture. Metab Bone Dis Relat Res 4:85–93CrossRef
4.
go back to reference Zittermann A, Scheld K, Stehle P (1998) Seasonal variations in vitamin D status and calcium absorption do not influence bone turnover in young women. Eur J Clin Nutr 52:501–506CrossRef Zittermann A, Scheld K, Stehle P (1998) Seasonal variations in vitamin D status and calcium absorption do not influence bone turnover in young women. Eur J Clin Nutr 52:501–506CrossRef
5.
go back to reference Zittermann A (2006) Vitamin D and disease prevention with special reference to cardiovascular disease. Prog Biophys Mol Biol 92:39–48CrossRef Zittermann A (2006) Vitamin D and disease prevention with special reference to cardiovascular disease. Prog Biophys Mol Biol 92:39–48CrossRef
6.
go back to reference Dawson-Hughes B, Harris SS, Dallal GE (1997) Plasma calcidiol, season, and serum parathyroid hormone concentrations in healthy elderly men and women. Am J Clin Nutr 65:67–71 Dawson-Hughes B, Harris SS, Dallal GE (1997) Plasma calcidiol, season, and serum parathyroid hormone concentrations in healthy elderly men and women. Am J Clin Nutr 65:67–71
7.
go back to reference Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R (2005) Estimates of optimal vitamin D status. Osteoporos Int 16:713–716CrossRef Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R (2005) Estimates of optimal vitamin D status. Osteoporos Int 16:713–716CrossRef
8.
go back to reference Sai A, Walters RW, Fang X, Gallagher JC (2011) Relationship between vitamin D, parathyroid hormone, and bone health. J Clin Endocrinol Metab 96:E436–E446CrossRef Sai A, Walters RW, Fang X, Gallagher JC (2011) Relationship between vitamin D, parathyroid hormone, and bone health. J Clin Endocrinol Metab 96:E436–E446CrossRef
9.
go back to reference Chapuy MC, Pamphile R, Paris E, Kempf C, Schlichting M, Arnaud S, Garnero P, Meunier PJ (2002) Combined calcium and vitamin D3 supplementation in elderly women: confirmation of reversal of secondary hyperparathyroidism and hip fracture risk. The Decalyos II study. Osteoporos Int 13:257–264CrossRef Chapuy MC, Pamphile R, Paris E, Kempf C, Schlichting M, Arnaud S, Garnero P, Meunier PJ (2002) Combined calcium and vitamin D3 supplementation in elderly women: confirmation of reversal of secondary hyperparathyroidism and hip fracture risk. The Decalyos II study. Osteoporos Int 13:257–264CrossRef
10.
go back to reference Lips P, Wiersinga A, van Ginkel FC, Jongen MJ, Netelenbos JC, Hackeng WH, Delmas PD, van der Vijgh WJ (1988) The effect of vitamin D supplementation on vitamin D status and parathyroid function in elderly subjects. J Clin Endocrinol Metab 67:644–650CrossRef Lips P, Wiersinga A, van Ginkel FC, Jongen MJ, Netelenbos JC, Hackeng WH, Delmas PD, van der Vijgh WJ (1988) The effect of vitamin D supplementation on vitamin D status and parathyroid function in elderly subjects. J Clin Endocrinol Metab 67:644–650CrossRef
11.
go back to reference Bischoff-Ferrari HA, Orav EJ, Dawson-Hughes B (2006) Effect of cholecalciferol plus calcium on falling in ambulatory older men and women: a 3-year randomized controlled trial. Arch Intern Med 166:424–430 Bischoff-Ferrari HA, Orav EJ, Dawson-Hughes B (2006) Effect of cholecalciferol plus calcium on falling in ambulatory older men and women: a 3-year randomized controlled trial. Arch Intern Med 166:424–430
12.
go back to reference Hathcock JN, Shao A, Vieth R, Heaney R (2007) Risk assessment for vitamin D. Am J Clin Nutr 85:6–18 Hathcock JN, Shao A, Vieth R, Heaney R (2007) Risk assessment for vitamin D. Am J Clin Nutr 85:6–18
13.
go back to reference Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA (2011) The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 96:53–58CrossRef Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA (2011) The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 96:53–58CrossRef
14.
go back to reference Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39:142–148 Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39:142–148
15.
go back to reference Dukas L, Staehelin HB, Schacht E, Bischoff HA (2005) Better functional mobility in community-dwelling elderly is related to D-hormone serum levels and to daily calcium intake. J Nutr Health Aging 9:347–351 Dukas L, Staehelin HB, Schacht E, Bischoff HA (2005) Better functional mobility in community-dwelling elderly is related to D-hormone serum levels and to daily calcium intake. J Nutr Health Aging 9:347–351
16.
go back to reference Turpeinen U, Hohenthal U, Stenman U-H (2003) Determination of 25-hydroxyvitamin D in serum by HPLC and immunoassay. Clin Chem 49:1521–1524CrossRef Turpeinen U, Hohenthal U, Stenman U-H (2003) Determination of 25-hydroxyvitamin D in serum by HPLC and immunoassay. Clin Chem 49:1521–1524CrossRef
17.
go back to reference Savoca R, Bock A, Kraenzlin ME, Schmid HR, Huber AR (2004) An automated ‘bio-intact’ PTH assay: a step towards standardisation and improved correlation with parathyroid function in renal disease. Clin Chim Acta 343:167–171CrossRef Savoca R, Bock A, Kraenzlin ME, Schmid HR, Huber AR (2004) An automated ‘bio-intact’ PTH assay: a step towards standardisation and improved correlation with parathyroid function in renal disease. Clin Chim Acta 343:167–171CrossRef
18.
go back to reference Gomez B Jr, Ardakani S, Ju J, Jenkins D, Cerelli MJ, Daniloff GY, Kung VT (1995) Monoclonal antibody assay for measuring bone-specific alkaline phosphatase activity in serum. Clin Chem 41:1560–1566 Gomez B Jr, Ardakani S, Ju J, Jenkins D, Cerelli MJ, Daniloff GY, Kung VT (1995) Monoclonal antibody assay for measuring bone-specific alkaline phosphatase activity in serum. Clin Chem 41:1560–1566
19.
go back to reference Halleen JM, Alatalo SL, Suominen H, Cheng SL, Janckila AJ, Väänänen HK (2000) Tartrate-resistant acid phosphatase 5b: a novel serum marker of bone resorption. J Bone Miner Res 15:1337–1345CrossRef Halleen JM, Alatalo SL, Suominen H, Cheng SL, Janckila AJ, Väänänen HK (2000) Tartrate-resistant acid phosphatase 5b: a novel serum marker of bone resorption. J Bone Miner Res 15:1337–1345CrossRef
20.
go back to reference Souberbielle JC, Body JJ, Lappe JM, Plebani M, Shoenfeld Y, Wang TJ, Bischoff-Ferrari HA, Cavalier E, Ebeling PR, Fardellone P, Gandini S, Gruson D, Guerin AP, Heickendorff L, Hollis BW, Ish-Shalom S, Jean G, von Landenberg P, Largura A, Olsson T, Pierrot-Deseilligny C, Pilz S, Tincani A, Valcour A, Zittermann A (2010) Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: recommendations for clinical practice. Autoimmun Rev 9:709–715CrossRef Souberbielle JC, Body JJ, Lappe JM, Plebani M, Shoenfeld Y, Wang TJ, Bischoff-Ferrari HA, Cavalier E, Ebeling PR, Fardellone P, Gandini S, Gruson D, Guerin AP, Heickendorff L, Hollis BW, Ish-Shalom S, Jean G, von Landenberg P, Largura A, Olsson T, Pierrot-Deseilligny C, Pilz S, Tincani A, Valcour A, Zittermann A (2010) Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: recommendations for clinical practice. Autoimmun Rev 9:709–715CrossRef
21.
go back to reference Heaney RP, Armas LA, Shary JR, Bell NH, Binkley N, Hollis BW (2008) 25-Hydroxylation of vitamin D3: relation to circulating vitamin D3 under various input conditions. Am J Clin Nutr 87:1738–1742 Heaney RP, Armas LA, Shary JR, Bell NH, Binkley N, Hollis BW (2008) 25-Hydroxylation of vitamin D3: relation to circulating vitamin D3 under various input conditions. Am J Clin Nutr 87:1738–1742
22.
go back to reference Viljakainen HT, Palssa A, Kärkkäinen M, Jakobsen J, Lamberg-Allardt C (2006) How much vitamin D3 do the elderly need? J Am Coll Nutr 25:429–435 Viljakainen HT, Palssa A, Kärkkäinen M, Jakobsen J, Lamberg-Allardt C (2006) How much vitamin D3 do the elderly need? J Am Coll Nutr 25:429–435
23.
go back to reference Valdimarsson T, Löfman O, Toss G, Ström M (1996) Reversal of osteopenia with diet in adult coeliac disease. Gut 38:322–327CrossRef Valdimarsson T, Löfman O, Toss G, Ström M (1996) Reversal of osteopenia with diet in adult coeliac disease. Gut 38:322–327CrossRef
24.
go back to reference Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF (2000) Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 72:690–693 Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF (2000) Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 72:690–693
25.
go back to reference Wang TJ, Zhang F, Richards JB, Kestenbaum B, van Meurs JB, Berry D, Kiel DP, Streeten EA, Ohlsson C, Koller DL, Peltonen L, Cooper JD, O’Reilly PF, Houston DK, Glazer NL, Vandenput L, Peacock M, Shi J, Rivadeneira F, McCarthy MI, Anneli P, de Boer IH, Mangino M, Kato B, Smyth DJ, Booth SL, Jacques PF, Burke GL, Goodarzi M, Cheung CL, Wolf M, Rice K, Goltzman D, Hidiroglou N, Ladouceur M, Wareham NJ, Hocking LJ, Hart D, Arden NK, Cooper C, Malik S, Fraser WD, Hartikainen AL, Zhai G, Macdonald HM, Forouhi NG, Loos RJ, Reid DM, Hakim A, Dennison E, Liu Y, Power C, Stevens HE, Jaana L, Vasan RS, Soranzo N, Bojunga J, Psaty BM, Lorentzon M, Foroud T, Harris TB, Hofman A, Jansson JO, Cauley JA, Uitterlinden AG, Gibson Q, Järvelin MR, Karasik D, Siscovick DS, Econs MJ, Kritchevsky SB, Florez JC, Todd JA, Dupuis J, Hyppönen E, Spector TD (2010) Common genetic determinants of vitamin D insufficiency: a genome-wide association study. Lancet 376:180–188CrossRef Wang TJ, Zhang F, Richards JB, Kestenbaum B, van Meurs JB, Berry D, Kiel DP, Streeten EA, Ohlsson C, Koller DL, Peltonen L, Cooper JD, O’Reilly PF, Houston DK, Glazer NL, Vandenput L, Peacock M, Shi J, Rivadeneira F, McCarthy MI, Anneli P, de Boer IH, Mangino M, Kato B, Smyth DJ, Booth SL, Jacques PF, Burke GL, Goodarzi M, Cheung CL, Wolf M, Rice K, Goltzman D, Hidiroglou N, Ladouceur M, Wareham NJ, Hocking LJ, Hart D, Arden NK, Cooper C, Malik S, Fraser WD, Hartikainen AL, Zhai G, Macdonald HM, Forouhi NG, Loos RJ, Reid DM, Hakim A, Dennison E, Liu Y, Power C, Stevens HE, Jaana L, Vasan RS, Soranzo N, Bojunga J, Psaty BM, Lorentzon M, Foroud T, Harris TB, Hofman A, Jansson JO, Cauley JA, Uitterlinden AG, Gibson Q, Järvelin MR, Karasik D, Siscovick DS, Econs MJ, Kritchevsky SB, Florez JC, Todd JA, Dupuis J, Hyppönen E, Spector TD (2010) Common genetic determinants of vitamin D insufficiency: a genome-wide association study. Lancet 376:180–188CrossRef
26.
go back to reference Binkley N, Krueger D, Cowgill CS, Plum L, Lake E, Hansen KE, DeLuca HF, Drezner MK (2004) Assay variation confounds the diagnosis of hypovitaminosis D: a call for standardization. J Clin Endocrinol Metab 89:3152–3157CrossRef Binkley N, Krueger D, Cowgill CS, Plum L, Lake E, Hansen KE, DeLuca HF, Drezner MK (2004) Assay variation confounds the diagnosis of hypovitaminosis D: a call for standardization. J Clin Endocrinol Metab 89:3152–3157CrossRef
27.
go back to reference Cashman KD, Hill TR, Lucey AJ, Taylor N, Seamans KM, Muldowney S, Fitzgerald AP, Flynn A, Barnes MS, Horigan G, Bonham MP, Duffy EM, Strain JJ, Wallace JM, Kiely M (2008) Estimation of the dietary requirement for vitamin D in healthy adults. Am J Clin Nutr 88:1535–1542CrossRef Cashman KD, Hill TR, Lucey AJ, Taylor N, Seamans KM, Muldowney S, Fitzgerald AP, Flynn A, Barnes MS, Horigan G, Bonham MP, Duffy EM, Strain JJ, Wallace JM, Kiely M (2008) Estimation of the dietary requirement for vitamin D in healthy adults. Am J Clin Nutr 88:1535–1542CrossRef
28.
go back to reference Vieth R, Chan P-CR, MacFarlane GD (2001) Efficacy and safety of vitamin D3 intake exceeding the lowest observed adverse effect level. Am J Clin Nutr 73:288–294 Vieth R, Chan P-CR, MacFarlane GD (2001) Efficacy and safety of vitamin D3 intake exceeding the lowest observed adverse effect level. Am J Clin Nutr 73:288–294
29.
go back to reference Need AG, O’Loughlin PD, Morris HA, Coates PS, Horowitz M, Nordin BE (2008) Vitamin D metabolites and calcium absorption in severe vitamin D deficiency. J Bone Miner Res 23:1859–1863CrossRef Need AG, O’Loughlin PD, Morris HA, Coates PS, Horowitz M, Nordin BE (2008) Vitamin D metabolites and calcium absorption in severe vitamin D deficiency. J Bone Miner Res 23:1859–1863CrossRef
30.
go back to reference Roux C, Bischoff-Ferrari HA, Papapoulos SE, de Papp AE, West JA, Bouillon R (2008) New insights into the role of vitamin D and calcium in osteoporosis management: an expert roundtable discussion. Curr Med Res Opin 24:1363–1370CrossRef Roux C, Bischoff-Ferrari HA, Papapoulos SE, de Papp AE, West JA, Bouillon R (2008) New insights into the role of vitamin D and calcium in osteoporosis management: an expert roundtable discussion. Curr Med Res Opin 24:1363–1370CrossRef
31.
go back to reference Steingrimsdottir L, Gunnarsson O, Indridason OS, Franzson L, Sigurdsson G (2005) Relationship between serum parathyroid hormone levels, vitamin D sufficiency, and calcium intake. JAMA 294:2336–2341CrossRef Steingrimsdottir L, Gunnarsson O, Indridason OS, Franzson L, Sigurdsson G (2005) Relationship between serum parathyroid hormone levels, vitamin D sufficiency, and calcium intake. JAMA 294:2336–2341CrossRef
32.
go back to reference Narang NK, Gupta RC, Jain MK (1984) Role of vitamin D in pulmonary tuberculosis. J Assoc Physicians India 32:185–188 Narang NK, Gupta RC, Jain MK (1984) Role of vitamin D in pulmonary tuberculosis. J Assoc Physicians India 32:185–188
33.
go back to reference Sharma OP (2000) Hypercalcemia in granulomatous disorders: a clinical review. Curr Opin Pulm Med 6:442–447CrossRef Sharma OP (2000) Hypercalcemia in granulomatous disorders: a clinical review. Curr Opin Pulm Med 6:442–447CrossRef
34.
go back to reference Sanders KM, Stuart AL, Williamson EJ, Simpson JA, Kotowicz MA, Young D, Nicholson GC (2010) Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA 303:1815–1822CrossRef Sanders KM, Stuart AL, Williamson EJ, Simpson JA, Kotowicz MA, Young D, Nicholson GC (2010) Annual high-dose oral vitamin D and falls and fractures in older women: a randomized controlled trial. JAMA 303:1815–1822CrossRef
35.
go back to reference Ooms ME, Roos JC, Bezemer PD, van der Vijgh WJ, Bouter LM, Lips P (1995) Prevention of bone loss by vitamin D supplementation in elderly women: a randomized double-blind trial. J Clin Endocrinol Metab 80:1052–1058CrossRef Ooms ME, Roos JC, Bezemer PD, van der Vijgh WJ, Bouter LM, Lips P (1995) Prevention of bone loss by vitamin D supplementation in elderly women: a randomized double-blind trial. J Clin Endocrinol Metab 80:1052–1058CrossRef
36.
go back to reference Meyer HE, Smedshaug GB, Kvaavik E, Falch JA, Tverdal A, Pedersen JI (2002) Can vitamin D supplementation reduce the risk of fracture in the elderly? A randomized controlled trial. J Bone Miner Res 17:709–715CrossRef Meyer HE, Smedshaug GB, Kvaavik E, Falch JA, Tverdal A, Pedersen JI (2002) Can vitamin D supplementation reduce the risk of fracture in the elderly? A randomized controlled trial. J Bone Miner Res 17:709–715CrossRef
37.
go back to reference Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ (1992) Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 327:1637–1642CrossRef Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ (1992) Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 327:1637–1642CrossRef
38.
go back to reference Pekkarinen T, Välimäki V–V, Aarum S, Turpeinen U, Hämäläinen E, Löyttyniemi E, Välimäki MJ (2010) The same annual dose of 292000 IU of vitamin D (cholecalciferol) on either daily or four monthly basis for elderly women: 1-year comparative study of the effects on serum 25(OH)D concentrations and renal function. Clin Endocrinol 72:455–461CrossRef Pekkarinen T, Välimäki V–V, Aarum S, Turpeinen U, Hämäläinen E, Löyttyniemi E, Välimäki MJ (2010) The same annual dose of 292000 IU of vitamin D (cholecalciferol) on either daily or four monthly basis for elderly women: 1-year comparative study of the effects on serum 25(OH)D concentrations and renal function. Clin Endocrinol 72:455–461CrossRef
39.
go back to reference Schleithoff SS, Zittermann A, Tenderich G, Berthold HK, Stehle P, Koerfer R (2006) Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr 83:754–759 Schleithoff SS, Zittermann A, Tenderich G, Berthold HK, Stehle P, Koerfer R (2006) Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr 83:754–759
40.
go back to reference Mocanu V, Stitt PA, Costan AR, Voroniuc O, Zbranca E, Luca V, Vieth R (2009) Long-term effects of giving nursing home residents bread fortified with 125 microg (5000 IU) vitamin D3 per daily serving. Am J Clin Nutr 89:1132–1137CrossRef Mocanu V, Stitt PA, Costan AR, Voroniuc O, Zbranca E, Luca V, Vieth R (2009) Long-term effects of giving nursing home residents bread fortified with 125 microg (5000 IU) vitamin D3 per daily serving. Am J Clin Nutr 89:1132–1137CrossRef
Metadata
Title
Is a daily supplementation with 40 microgram vitamin D3 sufficient? A randomised controlled trial
Authors
Göran Toss
Per Magnusson
Publication date
01-12-2012
Publisher
Springer-Verlag
Published in
European Journal of Nutrition / Issue 8/2012
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI
https://doi.org/10.1007/s00394-011-0271-7

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