Influence of vitamin D supplementation on bone mineral content, bone turnover markers, and fracture risk in South African schoolchildren: multicenter double-blind randomized placebo-controlled trial (ViDiKids)

被引：8

作者：

Middelkoop, Keren ^{[1
,2
]}

Micklesfield, Lisa K. ^{[3
,4
]}

Walker, Neil ^{[5
]}

Stewart, Justine ^{[1
,2
]}

Delport, Carmen ^{[1
]}

Jolliffe, David A. ^{[6
]}

Mendham, Amy E. ^{[3
,4
]}

Coussens, Anna K. ^{[7
,8
]}

van Graan, Averalda ^{[9
,10
]}

Nuttall, James ^{[11
]}

Tang, Jonathan C. Y. ^{[12
,13
,14
,15
,16
]}

Fraser, William D. ^{[12
,13
,14
,15
,16
]}

Cooper, Cyrus ^{[17
,18
,19
]}

Harvey, Nicholas C. ^{[17
,18
,19
]}

Hooper, Richard L. ^{[5
]}

Wilkinson, Robert J. ^{[7
,20
,21
]}

Bekker, Linda-Gail ^{[1
,2
]}

Martineau, Adrian R. ^{[6
]}

机构：

[1] Univ Cape Town, Inst Infect Dis & Mol Med, Desmond Tutu HIV Ctr, ZA-7925 Cape Town, Western Cape, South Africa

[2] Univ Cape Town, Dept Med, ZA-7925 Cape Town, Western Cape, South Africa

[3] Univ Cape Town, Fac Hlth Sci Hlth Phys Act, Lifestyle & Sport Res Ctr HPALS, Div Physiol Sci,Dept Human Biol, ZA-7700 Cape Town, Western Cape, South Africa

[4] Univ Witwatersrand, Dept Paediat, ZA-2193 Johannesburg, Gauteng, South Africa

[5] Queen Mary Univ London, Wolfson Inst Populat Hlth, Barts & London Sch Med & Dent, London EC1M 6BQ, England

[6] Queen Mary Univ London, Blizard Inst, Barts & London Sch Med & Dent, 4 Newark St, London E1 2AT, England

[7] Univ Cape Town, Inst Infect Dis & Mol Med, Wellcome Ctr Infect Dis Res Africa, ZA-7925 Cape Town, Western Cape, South Africa

[8] Walter & Eliza Hall Inst Med Res, Infect Dis & Immune Def Div, Parkville, Vic 3052, Australia

[9] South African Med Res Council, SAFOODS Div, Biostat Unit, ZA-7505 Cape Town, Western Cape, South Africa

[10] Stellenbosch Univ, Fac Med & Hlth Sci, Div Human Nutr, ZA-7505 Cape Town, Western Cape, South Africa

[11] Red Cross War Mem Childrens Hosp, Dept Paediat & Child Hlth, Paediat Infect Dis Unit, ZA-7700 Cape Town, Western Cape, South Africa

[12] Univ East Anglia, Norwich Med Sch, Norwich Res Pk, Norwich NR4 7TJ, England

[13] Norfolk & Norwich Univ Hosp NHS Fdn Trust, Dept Lab Med, Norwich NR4 7UY, England

[14] Norfolk & Norwich Univ Hosp NHS Fdn Trust, Dept Clin Biochem, Norwich NR4 7UY, England

[15] Norfolk & Norwich Univ Hosp NHS Fdn Trust, Dept Diabet, Norwich NR4 7UY, England

[16] Norfolk & Norwich Univ Hosp NHS Fdn Trust, Dept Endocrinol, Norwich NR4 7UY, England

[17] Univ Southampton, MRC Lifecourse Epidemiol Ctr, Southampton SO16 6YD, England

[18] Univ Southampton, NIHR Southampton Biomed Res Ctr, Southampton SO16 6YD, England

[19] Univ Hosp Southampton NHS Fdn Trust, Southampton SO16 6YD, England

[20] Francis Crick Inst, London NW1 1AT, England

[21] Imperial Coll London, London W12 0NN, England

来源：

JOURNAL OF BONE AND MINERAL RESEARCH | 2024年 / 39卷 / 03期

基金：

英国医学研究理事会; 英国惠康基金;

关键词：

cholecalciferol; bone mineral content; parathyroid hormone; bone turnover markers; fracture risk; D DEFICIENCY; DENSITY; ADOLESCENTS; METABOLISM; INFECTION; CHILDREN;

D O I：

10.1093/jbmr/zjae007

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Randomized controlled trials (RCTs) to determine the influence of vitamin D on BMC and fracture risk in children of Black African ancestry are lacking. We conducted a sub-study (n = 450) nested within a phase 3 RCT of weekly oral supplementation with 10 000 IU vitamin D-3 vs placebo for 3 yr in HIV-uninfected Cape Town schoolchildren aged 6-11 yr. Outcomes were BMC at the whole body less head (WBLH) and LS and serum 25-hydroxyvitamin D-3 (25(OH)D-3), PTH, alkaline phosphatase, C-terminal telopeptide, and PINP. Incidence of fractures was a secondary outcome of the main trial (n = 1682). At baseline, mean serum 25(OH)D-3 concentration was 70.0 nmol/L (SD 13.5), and 5.8% of participants had serum 25(OH)D-3 concentrations <50 nmol/L. Among sub-study participants, end-trial serum 25(OH)D-3 concentrations were higher for participants allocated to vitamin D vs placebo (adjusted mean difference [aMD] 39.9 nmol/L, 95% CI, 36.1 to 43.6) and serum PTH concentrations were lower (aMD -0.55 pmol/L, 95% CI, -0.94 to -0.17). However, no interarm differences were seen for WBLH BMC (aMD -8.0 g, 95% CI, -30.7 to 14.7) or LS BMC (aMD -0.3 g, 95% CI, -1.3 to 0.8) or serum concentrations of bone turnover markers. Fractures were rare among participants in the main trial randomized to vitamin D vs placebo (7/755 vs 10/758 attending at least 1 follow-up; adjusted odds ratio 0.70, 95% CI, 0.27 to 1.85). In conclusion, a 3-yr course of weekly oral vitamin D supplementation elevated serum 25(OH)D-3 concentrations and suppressed serum PTH concentrations in HIV-uninfected South African schoolchildren of Black African ancestry but did not influence BMC or serum concentrations of bone turnover markers. Fracture incidence was low, limiting power to detect an effect of vitamin D on this outcome.

引用

页码：211 / 221

页数：11

共 23 条

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