Effect of vitamin D supplementation on bone turnover markers in children and adolescents from North India

Abstract

Objectives: Vitamin D is known to play an important role in bone mineral metabolism. Its deficiency may affect growth and status of bone markers in children. Hence, we undertook to study the status of bone markers in children with vitamin D deficiency (VDD) and impact of vitamin D3 supplementation on them. Materials and Methods: Total 468 out of 615 children and adolescents with VDD, who were given either of the three doses (600, 1000, and 2000) of vitamin D supplementation, were included in the study. These 468 children with pre- and postsupplementation preserved samples with available anthropometry, serum biochemistry, 25-hydroxy-vitamin D, and parathormone were evaluated for bone formation (procollagen type 1 amino-terminal propeptide [P1NP]) and resorption (β-cross laps [CTx]) markers. Results: The mean age and body mass index of these children were 11.3 ± 2.3 years (boys: 11.5 ± 2.4; girls: 12.2 ± 1.2 years; P = 0.03) and 18.1 ± 3.8 kg/m 2 (boys: 18.2 ± 3.9; girls: 17.6 ± 3.2 kg/m 2 ; P = 0.208), respectively. There were 8.8% subjects with severe, 42.7% with moderate, and 48.5% with mild VDD. There was a significant decline in serum P1NP (from 691 ± 233 ng/ml to 640 ± 259 ng/ml, P < 0.001) and CTx (from 1.67 ± 0.53 ng/ml to 1.39 ± 0.51 ng/ml, P < 0.001) following supplementation. Though decline in serum P1NP and CTx levels was observed in both boys and girls, among all three supplementation groups and VDD categories, the effect was more marked in serum CTx than P1NP levels. Conclusions: Vitamin D supplementation in VDD children resulted in decrease in both bone formation (P1NP) and resorption (CTx). The impact, however, was more marked on bone resorption than bone formation.

Effect of Vitamin D Levels on Bone Remodeling in Healthy Women

“…Hence, the increase in PINP levels is due to the increase in PTH levels. Unlike other studies, which showed either negative (8) or no (29) correlation of CTX with vitamin D, we observed a positive correlation between sCTX and vitamin D with a marked effect observed in premenopausal women. This is in line with a study carried out in Tehran on healthy adolescents (30).…”

“…A significant negative correlation was observed between vitamin D and PINP. An increase in PTH levels leads to an increase in PINP levels, indicating that bone remodeling requires an adequate amount of PTH (8,28). Hence, the increase in PINP levels is due to the increase in PTH levels.…”

“…The relationship between serum 25(OH)D levels with bone turnover markers and bone mineral density (BMD) in women residing in different geographical areas is debatable. A recent study has shown a negative correlation of only the bone formation marker with vitamin D (8). In contrast, another study has shown a negative correlation of both bone resorption and formation markers with vitamin D levels, post supplementation (9).…”

Correlation between bone turnover and metabolic markers with age and gender: a cross-sectional study of hospital information system data

“…The present study focused on bone metabolism indicators in patients of different age and gender using HIS data from one hospital, providing mathematical modeling to assist the future study of age and gender in disease research. Although multiple studies have been published that provide a reference for differences in children and adolescents [2][3][4][5][6][7][8], those studies did not provide a precise breakdown of age and gender, namely at what patient age does parameters require precise matching and which age does they not. Researchers believe that age matching should be performed on all subjects in disease control research, but strict age-matching substantially increases the cost and di culty of conducting the study.…”

Correlation between bone turnover and metabolic markers with age and gender: a cross-sectional study of hospital information system data

“…Statistical test was made by Mann-Whitney test.DiscussionThe present study focused on bone metabolism indicators in patients of different age and gender using HIS data from one hospital, providing mathmatical modeling to assist the future study of age and gender in disease research. Although multiple studies have been published that provide a reference for differences in children and adolescents[2][3][4][5][6][7][8], those studies did not provide a precise breakdown of age and gender, namely at what patient age does parameters require precise matching and which age does they not. Researchers believe that age matching should be performed on all subjects in disease control research, but strict age-matching substantially increases the cost and The biological data for young individuals is very complicated, and so we established mathematical models to correlate data for people under the age of 20.…”