Impact of Vitamin D and Calcium Supplementation on Bone Mineral Density and Bone Metabolism Among Thai Adolescents With Perinatally Acquired Human Immunodeficiency Virus (HIV) Infection: A Randomized Clinical Trial.
Clin Infect Dis
; 73(9): 1555-1564, 2021 11 02.
Article
em En
| MEDLINE
| ID: mdl-34125899
ABSTRACT
BACKGROUND:
To evaluate the impact of vitamin D and calcium supplementation (VitD/Ca) on lumbar spine bone mineral density (LSBMD) and bone metabolism among Thai adolescents with perinatally acquired HIV (PHIVA).METHODS:
A multicenter, randomized, active-control, open-labeled trial was conducted. PHIVA (aged 10-20 years) who were on stable cART were enrolled. Baseline LSBMD status was defined as low (z-scoreâ ≤â -2) and normal (> -2). Eligible PHIVA were randomly assigned to receive standard-dose (400 IU/1200 mg/day) or high-dose (400 IU/1200 mg/day plus ergocalciferol 20 000 IU/week) VitD/Ca supplementation for 48 weeks (ratio 11, stratified by baseline LSBMD). Study outcomes were changes in LSBMD, LSBMD z-scores, and bone metabolism-related biomarkers (25-hydroxyvitamin D [25(OH)D], intact parathyroid hormone [iPTH], C-terminal telopeptide [CTX], procollagen type I amino-terminal propeptide [PINP]) from baseline to week 48.RESULTS:
Among 200 enrolled PHIVA, median age was 16 (IQR14-18) years; 61% were on NNRTI-based cART. Median 25(OH)D level was 25.5 (IQR 20.8-33.0) ng/mL. After 48-week VitD/Ca supplementation, LSBMD significantly increased in both treatment groups (high-dose median +0.07 [IQR +0.04 to +0.11] g/cm2; Pâ <â .001; standard-dose +0.09 [+0.03 to +0.13] g/cm2; Pâ <â .001). Notably, the change in LSBMD z-scores was significantly greater in high-dose versus standard-dose groups (median +0.4 [IQR -0.1 to +0.9] vs +0.1 [-0.4 to +0.7]; Pâ =â .02). Levels of 25(OH)D increased, whereas iPTH, CTX, and PINP declined significantly in both groups (Pâ <â .05), but no between-group differences were demonstrated.CONCLUSIONS:
Over 48-week VitD/Ca supplementation, significant increases in LSBMD, and significant decreases in bone metabolism-related markers were observed among our Thai PHIVA in both treatment groups. The improvement in LSBMD z-score was more enhanced with high-dose VitD/Ca supplementation than standard-dose. High-dose VitD/Ca supplementation might be considered to promote bone health in this population. CLINICAL TRIALS REGISTRATION NCT02426840.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Densidade Óssea
/
Infecções por HIV
Tipo de estudo:
Clinical_trials
Limite:
Adolescent
/
Humans
País/Região como assunto:
Asia
Idioma:
En
Revista:
Clin Infect Dis
Assunto da revista:
DOENCAS TRANSMISSIVEIS
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Tailândia