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)

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). Middelkoop, K., Micklesfield, L. K, Walker, N., Stewart, J., Delport, C., Jolliffe, D. A, Mendham, A. E, Coussens, A. K, van Graan, A., Nuttall, J., Tang, J. C Y, Fraser, W. D, Cooper, C., Harvey, N. C, Hooper, R. L, Wilkinson, R. J, Bekker, L., & Martineau, A. R Journal of Bone and Mineral Research, Oxford University Press (OUP), jan, 2024.
$Influence of vitamin D supplementation on bone mineral content, bone turnover markers, and fracture risk in South African schoolchildren: multicenter double-blind randomized placebo-controlled trial (ViDiKids) [link]$ Paper doi abstract bibtex

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 \textless50 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.

@article{Middelkoop2024,
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 {\textless}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.},
author = {Middelkoop, Keren and Micklesfield, Lisa K and Walker, Neil and Stewart, Justine and Delport, Carmen and Jolliffe, David A and Mendham, Amy E and Coussens, Anna K and van Graan, Averalda and Nuttall, James and Tang, Jonathan C Y and Fraser, William D and Cooper, Cyrus and Harvey, Nicholas C and Hooper, Richard L and Wilkinson, Robert J and Bekker, Linda-Gail and Martineau, Adrian R},
doi = {10.1093/JBMR/ZJAE007},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Middelkoop et al. - 2024 - Influence of vitamin D supplementation on bone mineral content, bone turnover markers, and fracture risk in S.pdf:pdf},
issn = {0884-0431},
journal = {Journal of Bone and Mineral Research},
keywords = {OA,bone mineral content,bone turnover markers,cholecalciferol,fracture risk,fund{\_}ack,original,parathyroid hormone},
mendeley-tags = {OA,fund{\_}ack,original},
month = {jan},
pages = {zjae007},
pmid = {38477739},
publisher = {Oxford University Press (OUP)},
title = {{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)}},
url = {https://dx.doi.org/10.1093/jbmr/zjae007},
year = {2024}
}

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