Effect of high-dose cholecalciferol (vitamin D3) on bone and body composition in children and young adults with HIV infection: a randomized, double-blind, placebo-controlled trial

Rovner, Alisha J.; Stallings, Virginia A.; Rutstein, Richard M.; Schall, Joan I.; Leonard, Mary B.; Zemel, Babette S.

doi:10.1007/s00198-016-3826-x

Cited by 17 publications

(10 citation statements)

References 42 publications

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“…Intervention studies with vitamin D supplementation have confirmed this lack of correlation. Although daily supplementation with high-dose cholecalciferol (vitamin D3) in children and young adults with HIV infection for 12 months resulted in increased 25(OH)D concentrations, no impact was found on bone density, structure, and strength [42]. Similarly, PTH and bone turnover markers were not associated with 25(OH)D at baseline or with change in 25(OH)D over 12 weeks in black and white children [43].…”

Section: Discussionmentioning

confidence: 99%

Bone Health, Body Composition, and Vitamin D Status of Black Preadolescent Children in South Africa

White

Dalvie

et al. 2019

Nutrients

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Optimal bone health is important in children to reduce the risk of osteoporosis later in life. Both body composition and vitamin D play an important role in bone health. This study aimed to describe bone health, body composition, and vitamin D status, and the relationship between these among a group of conveniently sampled black preadolescent South African children (n = 84) using a cross-sectional study. Body composition, bone mineral density (BMD), and bone mineral content (BMC) were assessed using dual x-ray absorptiometry. Levels of 25-hydroxyvitamin D (25(OH)D) (n = 59) were assessed using dried blood spots. A quarter (25%) of children presented with low bone mass density for their chronological age (BMD Z-score < −2) and 7% with low BMC-for-age (BMC Z-score < −2), while only 34% of the children had sufficient vitamin D status (25(OH)D ≥ 30 ng/mL). Lean mass was the greatest body compositional determinant for variances observed in bone health measures. Body composition and bone health parameters were not significantly different across vitamin D status groups (p > 0.05), except for lumbar spine bone mineral apparent density (LS-BMAD) (p < 0.01). No association was found between bone parameters at all sites and levels of 25(OH)D (p > 0.05). Further research, using larger representative samples of South African children including all race groups is needed before any conclusions and subsequent recommendation among this population group can be made.

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Section: Discussionmentioning

confidence: 99%

Bone Health, Body Composition, and Vitamin D Status of Black Preadolescent Children in South Africa

White

Dalvie

et al. 2019

Nutrients

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“…Although most of the doses increased VitD levels, sufficiency was challenging to achieve due to the severe deficiency suffered by the HIV-1 infected population. The use of 7000 IU daily was the most effective dose (51, 56, 60, 63, 66, 78), and restored sufficiency [defined as calcidiol serum levels >30 ng/mL (4)] in 80% of treated individuals with higher levels seen following 12 months of treatment (61). Only 2 of the 215 individuals treated with this regimen had calcidiol levels >90 ng/mL and hypercalcemia (66).…”

Section: Vitamin D Supplementation In Hiv-1 Infected Individualsmentioning

confidence: 99%

“…VitD supplementation trials can be confounded by several aspects such as the season in which the study is carried out (78) or skin pigmentation since sunlight can affect vitamin levels. A study performed by Dougherty et al showed that calcidiol basal levels were lower in individuals in winter than in other seasons (63).…”

Section: Vitamin D Supplementation In Hiv-1 Infected Individualsmentioning

confidence: 99%

The Potential Protective Role of Vitamin D Supplementation on HIV-1 Infection

2019

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HIV infection remains a global and public health issue with the incidence increasing in some countries. Despite the fact that combination antiretroviral therapy (cART) has decreased mortality and increased the life expectancy of HIV-infected individuals, non-AIDS conditions, mainly those associated with a persistent inflammatory state, have emerged as important causes of morbidity, and mortality despite effective antiviral therapy. One of the most common comorbidities in HIV-1 patients is Vitamin D (VitD) insufficiency, as VitD is a hormone that, in addition to its physiological role in mineral metabolism, has pleiotropic effects on immune regulation. Several reports have shown that VitD levels decrease during HIV disease progression and correlate with decreased survival rates, highlighting the importance of VitD supplementation during infection. An extensive review of 29 clinical studies of VitD supplementation in HIV-infected patients showed that regardless of cART, when VitD levels were increased to normal ranges, there was a decrease in inflammation, markers associated with bone turnover, and the risk of secondary hyperparathyroidism while the anti-bacterial response was increased. Additionally, in 3 of 7 studies, VitD supplementation led to an increase in CD4+ T cell count, although its effect on viral load was inconclusive since most patients were on cART. Similarly, previous evidence from our laboratory has shown that VitD can reduce the infection of CD4+ T cells in vitro. The effect of VitD supplementation on other HIV-associated conditions, such as cardiovascular diseases, dyslipidemia or hypertension, warrants further exploration. Currently, the available evidence suggests that there is a potential role for VitD supplementation in people living with HIV-1, however, comprehensive studies are required to define an adequate supplementation protocol for these individuals.

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“…[ 62 ] and Rovner et al . [ 63 ] published a secondary analyses of muscle and bone outcomes generated by Stallings et al . [ 64 ].…”

Section: Resultsmentioning

confidence: 99%

“…Rovner et al . [ 63 ] was the only study to explicitly state that such height adjustments were performed whereas Arpadi et al . was the only study to report supplementary analyses of Tanner stage advancement [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of vitamin D supplementation on musculoskeletal health outcomes in children, adolescents, and young adults living with HIV: A systematic review

et al. 2018

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ObjectiveHIV-positive children, adolescents, and young adults are at increased risk poor musculoskeletal outcomes. Increased incidence of vitamin D deficiency in youth living with HIV may further adversely affect musculoskeletal health. We investigated the impact of vitamin D supplementation on a range of musculoskeletal outcomes among individuals aged 0–25 years living with HIV.MethodsA systematic review was conducted using databases: PubMed/Medline, CINAHL, Web of Knowledge, and EMBASE. Interventional randomised control trials, quasi-experimental trials, and previous systematic reviews/meta-analyses were included. Outcomes included: BMD, BMC, fracture incidence, muscle strength, linear growth (height-for-age Z-score [HAZ]), and biochemical/endocrine biomarkers including bone turnover markers.ResultsOf 497 records, 20 studies met inclusion criteria. Thirteen studies were conducted in North America, one in Asia, two in Europe, and four in Sub-Saharan Africa. High-dose vitamin D supplementation regimens (1,000–7,000 IU/day) were successful in achieving serum 25-hydroxyvitamin-D (25OHD) concentrations above study-defined thresholds. No improvements were observed in BMD, BMC, or in muscle power, force and strength; however, improvements in neuromuscular motor skills were demonstrated. HAZ was unaffected by low-dose (200–400 IU/day) supplementation. A single study found positive effects on HAZ with high-dose supplementation (7,000 vs 4,000IU/day).ConclusionsMeasured bone outcomes were unaffected by high-dose vitamin D supplementation, even when target 25OHD measurements were achieved. This may be due to: insufficient sample size, follow-up, intermittent dosing, non-standardised definitions of vitamin D deficiency, or heterogeneity of enrolment criteria pertaining to baseline vitamin D concentration. High-dose vitamin D may improve HAZ and neuromuscular motor skills. Adequately powered trials are needed in settings where HIV burden is greatest.PROSPERO Number: CRD42016042938.

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Effect of high-dose cholecalciferol (vitamin D3) on bone and body composition in children and young adults with HIV infection: a randomized, double-blind, placebo-controlled trial

Abstract: Despite increasing 25(OH)D concentrations, 12 months of high-dose vitamin D supplementation did not impact bone or body composition in children and young adults with HIV infection.

Cited by 17 publications

References 42 publications

Bone Health, Body Composition, and Vitamin D Status of Black Preadolescent Children in South Africa

Bone Health, Body Composition, and Vitamin D Status of Black Preadolescent Children in South Africa

The Potential Protective Role of Vitamin D Supplementation on HIV-1 Infection

The impact of vitamin D supplementation on musculoskeletal health outcomes in children, adolescents, and young adults living with HIV: A systematic review

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