Effect of Calcium and Vitamin D Supplementation (Dairy vs. Pharmacological) on Bone Health of Underprivileged Indian Children and Youth with Type-1 Diabetes: A Randomized Controlled Trial.
J Clin Densitom
; 27(2): 101468, 2024.
Article
en En
| MEDLINE
| ID: mdl-38325238
ABSTRACT
BACKGROUND:
Bone health is affected by chronic childhood disorders including type-1 diabetes mellitus (T1DM). We conducted this randomized controlled trial with the objective of investigating the effect of 1-year supplementation of vitamin-D with milk or with pharmacological calcium on bone mass accrual in underprivileged Indian children and youth with T1DM.METHODS:
5 to 23year old (nâ¯=â¯203) underprivileged children and youth with T1DM were allocated to one of three groups Milk (group A-received 200 ml milk + 1000 international unit (IU) vitamin-D3/day), Calcium supplement (group B-received 500 mg of calcium carbonate + 1000 IU of vitamin-D3/day) or standard of care/control (group C). Anthropometry, clinical details, biochemistry, diet (3-day 24-h recall), physical activity (questionnaires adapted for Indian children) and bone health parameters (using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography- DXA and pQCT respectively) were evaluated at enrolment and end of 12 month intervention.RESULTS:
Total body less head(TBLH) bone mineral content (BMC(g)) and bone mineral density (BMD(gm/cm2)) were significantly higher at end of study in girls in both supplemented groups (TBLHBMC-A-1011.8⯱â¯307.8, B-983.2⯱â¯352.9, C-792.8⯱â¯346.8. TBLHBMD-A-± 0.2, B-0.8⯱â¯0.2, C-0.6⯱â¯0.2, pâ¯<â¯0.05). Z score of lumbar spine bone mineral apparent density of supplemented participants of both sexes was significantly higher than controls (Boys- A-0.7⯱â¯1.1, B-0.6⯱â¯1.4, C- -0.7⯱â¯1.1; Girls- A-1.1⯱â¯1.1, B-0.9⯱â¯3.4, C- -1.7⯱â¯1.3, pâ¯<â¯0.05). A significantly higher percentage increase was found in cortical thickness in girls in both supplemented groups (A-17.9⯱â¯28.6, B-15.3⯱â¯16.5, C-7.6⯱â¯26.2); the differences remained after adjusting for confounders.CONCLUSION:
Supplementation with milk or pharmacological calcium (+vitaminD3) improved bone outcomes-particularly geometry in children with T1DM with more pronounced effect in girls. Pharmacological calcium may be more cost effective in optimising bone health in T1DM in resource limited settings.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Absorciometría de Fotón
/
Densidad Ósea
/
Suplementos Dietéticos
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Diabetes Mellitus Tipo 1
Tipo de estudio:
Clinical_trials
Límite:
Adolescent
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Adult
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Animals
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Child
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Child, preschool
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Female
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Humans
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Male
País/Región como asunto:
Asia
Idioma:
En
Revista:
J Clin Densitom
Asunto de la revista:
ORTOPEDIA
Año:
2024
Tipo del documento:
Article
Pais de publicación:
Estados Unidos