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Middelkoop, Keren, Micklesfield, Lisa K., Walker, Neil, Stewart, Justine, Delport, Carmen, Jolliffe, David A., Mendham, Amy E., Coussens, Anna K., van Graan, Averalda, Nuttall, James, Tang, Jonathan C. Y. 
ORCID: https://orcid.org/0000-0001-6305-6333, Fraser, William D., Cooper, Cyrus, Harvey, Nicholas C., Hooper, Richard L., Wilkinson, Robert J., Bekker, Linda-Gail and Martineau, Adrian R.
(2024)
Influence of vitamin D supplementation on bone mineral content, bone turnover markers and fracture risk in South African schoolchildren: Multicentre double-blind randomised placebo-controlled trial (ViDiKids).
Journal of Bone and Mineral Research, 39 (3).
211–221.
ISSN 0884-0431
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Abstract
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 D3 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 D3 (25(OH)D3), 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)D3 concentration was 70.0 nmol/L (SD 13.5), and 5.8% of participants had serum 25(OH)D3 concentrations <50 nmol/L. Among sub-study participants, end-trial serum 25(OH)D3 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)D3 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.
| Item Type: | Article |
|---|---|
| Additional Information: | Funding information: This research was funded by the UK Medical Research Council (refs MR/R023050/1 and MR/M026639/1, both awarded to A.R.M.). R.J.W. was supported by Wellcome (104803, 203135). He also received support from the Francis Crick Institute which is funded by the Cancer Research UK (FC2112), the UK Medical Research Council (FC2112), and Wellcome (FC2112). |
| Uncontrolled Keywords: | bone mineral content,bone turnover markers,cholecalciferol,fracture risk,parathyroid hormone,endocrinology, diabetes and metabolism,orthopedics and sports medicine,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2712 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Musculoskeletal Medicine Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 24 Jan 2024 01:35 |
| Last Modified: | 07 May 2024 09:31 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/94233 |
| DOI: | 10.1093/jbmr/zjae007 |
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