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

Penner, J. E.; Ferrand, Rashida A; Richards, Ceri; Ward, Kate A; Burns, James E.; Gregson, Celia L

doi:10.1371/journal.pone.0207022

Cited by 8 publications

(6 citation statements)

References 86 publications

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“… 39 During childhood, bone formation usually predominates over bone resorption, but the proinflammatory milieu leads to an imbalance in osteoblastic and osteoclastic activity, promoting increased bone resorption relative to formation. Other factors that can compromise skeletal development include inadequate dietary calcium, vitamin D deficiency, 25 and low levels of physical activity. 24 Although in this study, children with HIV reported lower physical activity than uninfected children, low intake of both calcium and vitamin D were common regardless of HIV status.…”

Section: Discussionmentioning

confidence: 99%

“…Associations between potential risk factors and TBLH-BMC LBM and LS-BMAD Z-scores were investigated with linear regression separately for participants with and without HIV. Adjustment was made for a priori confounders (age, sex, and pubertal stage 22 ), potential risk factors (socioeconomic status, 23 physical activity, 24 calcium and vitamin D intake, 25 and, in those with HIV, CD4 cell count, viral load, tenofovir disoproxil fumarate [TDF] exposure, and age at ART initiation 26 ), variables associated in complete case analysis with TBLH-BMC LBM or LS-BMAD Z-score (at p<0·20), and variables associated with missing status.…”

Section: Methodsmentioning

confidence: 99%

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Effect of HIV infection on growth and bone density in peripubertal children in the era of antiretroviral therapy: a cross-sectional study in Zimbabwe

Rukuni

Rehman

Mukwasi-Kahari

et al. 2021

The Lancet Child & Adolescent Health

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Background Faltered linear growth and pubertal delay, which are both common in children with HIV in sub-Saharan Africa, might affect adolescent bone accrual and future fragility fracture risk. We investigated the association of HIV with bone density adjusted for skeletal size in peripubertal children in Zimbabwe. MethodsWe did a cross-sectional study of baseline data from the IMVASK cohort, which enrolled children aged 8-16 years with HIV who had been taking antiretroviral therapy (ART) for at least 2 years, and children of the same age without HIV. Children with HIV were recruited from public sector HIV clinics at Parirenyatwa General Hospital and Harare Central Hospital (Harare, Zimbabwe), and children without HIV were recruited from six schools in the same suburbs that the hospitals serve. Sociodemographic, clinical, and anthropometric data were collected. Dual-energy X-ray absorptiometry (DXA) was used to measure the bone outcomes of total-body less-head bone mineral content for lean mass adjusted for height (TBLH-BMC LBM ), and lumbar spine bone mineral apparent density (LS-BMAD), and we assessed the prevalence of low TBLH-BMC LBM and low LS-BMAD (defined by Z-scores of less than -2•0). Size adjustment techniques were used to overcome the size dependence of DXA measurement. We used linear regression models, with multiple imputation for missing data, to assess relationships between risk factors and TBLH-BMC LBM and LS-BMAD Z-scores in children with and without HIV. Findings We recruited 303 children with HIV (mean age 12•4 years [SD 2•5]; 151 [50%] girls) and 306 children without HIV (mean age 12•5 years [SD 2•5]; 155 [51%] girls). In children with HIV, median age of HIV diagnosis was 3•0 years (IQR 1•2-5•8), and median ART duration was 8•1 years (6•2-9•5); for 102 (34%) children, ART included tenofovir disoproxil fumarate (TDF). Children with HIV had a higher prevalence of low TBLH-BMC LBM Z-score than children without HIV (29 [10%] of 279 children with available data vs 18 [6%] of 292 with available data; p=0•066) and a higher prevalence of low LS-BMAD Z-score (40 [14%] of 279 vs 17 [6%] of 293 with available data; p=0•0007). HIV and male sex were associated with earlier pubertal (Tanner) stage. The negative associations between HIV and Z-scores for TBLH-BMC LBM and LS-BMAD were more pronounced with pubertal maturation, particularly in girls. Among children with HIV, TDF exposure and orphanhood were associated with lower TBLH-BMC LBM Z-score in confounder-adjusted analysis. Current TDF use (vs non-TDF-based ART) was associated with a reduction in TBLH-BMC LBM Z-score of 0•41 (95% CI 0•08-0•74; p=0•015) and in LS-BMAD Z-score of 0•31 (0•08-0•69; p=0•12). Interpretation Despite ART, HIV is associated with substantial skeletal deficits towards the end of puberty. The extent of bone deficits associated with TDF and its widespread use in children in sub-Saharan Africa are a concern for future adult fracture risk. Funding Wellcome Trust.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Effect of HIV infection on growth and bone density in peripubertal children in the era of antiretroviral therapy: a cross-sectional study in Zimbabwe

Rukuni

Rehman

Mukwasi-Kahari

et al. 2021

The Lancet Child & Adolescent Health

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“…According to our results, supplementation with vitamin D can increase serum 25OHD levels, although this change does not appear to be related to increases in HGS. Studies conducted in children with health impairments have reported the effects of vitamin D supplementation on muscle strength (38)(39)(40) and concluded that vitamin D supplementation, in combination with a training program, significantly increased muscle strength in children with severe burns. High doses of vitamin D can improve neuromuscular motor skills in HIVpositive children.…”

Section: ' Discussionmentioning

confidence: 99%

The role of serum levels of vitamin D in children’s muscle strength: A systematic review

Silva

Carmo²,

Souza

et al. 2021

Clinics

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This review aims to investigate the different levels of vitamin D and its role in muscle strength in healthy children and non-athletes. A search conducted in three databases (PubMed, Scopus, and Psycinfo) resulted in 655 articles, which were systematically analyzed and selected based on the following criteria: (a) original crosssectional studies and clinical trials; (b) healthy children aged 5-11 years; (c) no language restriction or year of publication; and (d) studies that assessed the possible relationship between vitamin D levels and muscle strength. Six studies were included because they met all the inclusion criteria. According to the findings of this review, factors such as sex, skin color, and vitamin D supplementation early in life modulate the levels of vitamin D in the body, and there is a relationship between muscle strength and vitamin D levels. Interestingly, vitamin D supplementation is not always significantly associated with increased muscle grip strength. However, there is a scarcity of studies that aim to analyze the possible effects of different levels of vitamin D on muscle function and neuromuscular variables in physically inactive children and non-athletes without previously diagnosed disease. Further studies are warranted in the future to address the gap in the literature.

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“…This systematic review was performed following the preferred reporting items for the systematic reviews and meta-analyses (PRISMA) statement [ 20 ]. We defined the study protocol before study initiation and it was submitted to the international prospective register of systematic reviews on 15 May 2022, and accepted on 23 May 2022 (PROSPERO, accessed on 14 October 2022; registration number: CRD42022332980).…”

Section: Methodsmentioning

confidence: 99%

“…This condition could be associated with a number of disorders involving bone, cartilage, and the associated tissues. Furthermore, it could lead to reduced muscle strength and poor physical performance, and studies have shown an association between low vitamin D status and musculoskeletal disorders, such as osteoarthritis, risk of falling, and osteoporosis [ 16 , 17 , 19 , 20 , 21 , 22 ]. Moreover, among the several genes that have been associated with TMDs, the vitamin D receptor (VDR) gene is regarded as one of the most important candidate genes for investigating the genetic factors that contribute to the pathophysiology of TMDs [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

Temporomandibular Disorders and Vitamin D Deficiency: What Is the Linkage between These Conditions? A Systematic Review

Ferrillo

Lippi

Giudice

et al. 2022

JCM

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Although a growing body of literature has been emphasizing the role of vitamin D in oral health, there is still a gap of knowledge regarding the correlation between temporomandibular disorders (TMDs) and vitamin D. Therefore, the aim of this systematic review was to assess the linkage between hypovitaminosis D and TMDs to map the current literature in this field. On 10 September 2022, PubMed, Scopus, and Web of Science databases were systematically searched from the date of their inception to identify the studies that had assessed patients with TMDs. The primary outcome assessed in this review was the relationship between hypovitaminosis D and TMDs. Out of the 329 studies identified, 13 studies met the eligibility criteria and were included in the present work. Seven studies assessed the relationship between vitamin D and TMDs, reporting that vitamin D serum levels are lower in patients with TMDs. Our results suggested that vitamin D receptor (VDR) polymorphisms might have a role in TMDs’ development. However, the quality assessed underlined that only one study did not present a serious risk of bias. Further good-quality studies are needed to clarify the linkage between vitamin D deficiency and TMDs, but the evidence currently available has suggested potential correlations.

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

Cited by 8 publications

References 86 publications

Effect of HIV infection on growth and bone density in peripubertal children in the era of antiretroviral therapy: a cross-sectional study in Zimbabwe

Effect of HIV infection on growth and bone density in peripubertal children in the era of antiretroviral therapy: a cross-sectional study in Zimbabwe

The role of serum levels of vitamin D in children’s muscle strength: A systematic review

Temporomandibular Disorders and Vitamin D Deficiency: What Is the Linkage between These Conditions? A Systematic Review

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