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The effect of vitamin D supplementation and nutritional intake on skeletal maturity and bone health in socio-economically deprived children

PURPOSE: 1. To determine the effect of vitamin D supplementation on bone age (BA), a marker of skeletal maturity, and Bone Health Index (BHI), a surrogate marker of bone density. 2. To characterise the differences in nutritional intake and anthropometry between children with advanced vs. delayed BA....

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Autores principales: Uday, Suma, Manaseki-Holland, Semira, Bowie, Jessica, Mughal, Mohamed Zulf, Crowe, Francesca, Högler, Wolfgang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8354903/
https://www.ncbi.nlm.nih.gov/pubmed/33611615
http://dx.doi.org/10.1007/s00394-021-02511-5
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author Uday, Suma
Manaseki-Holland, Semira
Bowie, Jessica
Mughal, Mohamed Zulf
Crowe, Francesca
Högler, Wolfgang
author_facet Uday, Suma
Manaseki-Holland, Semira
Bowie, Jessica
Mughal, Mohamed Zulf
Crowe, Francesca
Högler, Wolfgang
author_sort Uday, Suma
collection PubMed
description PURPOSE: 1. To determine the effect of vitamin D supplementation on bone age (BA), a marker of skeletal maturity, and Bone Health Index (BHI), a surrogate marker of bone density. 2. To characterise the differences in nutritional intake and anthropometry between children with advanced vs. delayed BA. METHODS: The current study is a post hoc analysis of radiographs obtained as part of a randomised controlled trial. In this double-blind, placebo-controlled trial, deprived Afghan children (n = 3046) aged 1–11 months were randomised to receive six doses of oral placebo or vitamin D3 (100,000 IU) every 3 months for 18 months. Dietary intake was assessed through semi-quantitative food frequency questionnaires at two time points. Anthropometric measurements were undertaken at baseline and 18 months. Serum 25OHD was measured at five time points on a random subset of 632 children. Knee and wrist radiographs were obtained from a random subset (n = 641), of which 565 wrist radiographs were digitised for post-hoc analysis of BA and BHI using BoneXpert version 3.1. RESULTS: Nearly 93% (522, male = 291) of the images were analysable. The placebo (n = 258) and vitamin D (n = 264) groups were comparable at baseline. The mean (± SD) age of the cohort was 2 (± 0.3) years. At study completion, there was no difference in mean 25-hydroxy vitamin D concentrations [47 (95% CI 41, 56) vs. 55 (95% CI 45, 57) nmol/L, p = 0.2], mean (± SD) BA SDS [− 1.04 (1.36) vs. − 1.14 (1.26) years, p = 0.3] or mean (± SD) BHI SDS [− 0.30 (0.86) vs. − 0.31 (0.80), p = 0.8] between the placebo and vitamin D groups, respectively. Children with advanced skeletal maturity (BA SDS ≥ 0) when compared to children with delayed skeletal maturity (BA SDS < 0), had consumed more calories [mean (± SD) calories 805 (± 346) vs 723 (± 327) kcal/day, respectively, p < 0.05], were significantly less stunted (height SDS − 1.43 vs. − 2.32, p < 0.001) and underweight (weight SDS − 0.82 vs. − 1.45, p < 0.001), with greater growth velocity (11.57 vs 10.47 cm/ year, p < 0.05). CONCLUSION: Deprived children have significant delay in skeletal maturation but no substantial impairment in bone health as assessed by BHI. BA delay was influenced by total calorie intake, but not bolus vitamin D supplementation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00394-021-02511-5.
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spelling pubmed-83549032021-08-25 The effect of vitamin D supplementation and nutritional intake on skeletal maturity and bone health in socio-economically deprived children Uday, Suma Manaseki-Holland, Semira Bowie, Jessica Mughal, Mohamed Zulf Crowe, Francesca Högler, Wolfgang Eur J Nutr Original Contribution PURPOSE: 1. To determine the effect of vitamin D supplementation on bone age (BA), a marker of skeletal maturity, and Bone Health Index (BHI), a surrogate marker of bone density. 2. To characterise the differences in nutritional intake and anthropometry between children with advanced vs. delayed BA. METHODS: The current study is a post hoc analysis of radiographs obtained as part of a randomised controlled trial. In this double-blind, placebo-controlled trial, deprived Afghan children (n = 3046) aged 1–11 months were randomised to receive six doses of oral placebo or vitamin D3 (100,000 IU) every 3 months for 18 months. Dietary intake was assessed through semi-quantitative food frequency questionnaires at two time points. Anthropometric measurements were undertaken at baseline and 18 months. Serum 25OHD was measured at five time points on a random subset of 632 children. Knee and wrist radiographs were obtained from a random subset (n = 641), of which 565 wrist radiographs were digitised for post-hoc analysis of BA and BHI using BoneXpert version 3.1. RESULTS: Nearly 93% (522, male = 291) of the images were analysable. The placebo (n = 258) and vitamin D (n = 264) groups were comparable at baseline. The mean (± SD) age of the cohort was 2 (± 0.3) years. At study completion, there was no difference in mean 25-hydroxy vitamin D concentrations [47 (95% CI 41, 56) vs. 55 (95% CI 45, 57) nmol/L, p = 0.2], mean (± SD) BA SDS [− 1.04 (1.36) vs. − 1.14 (1.26) years, p = 0.3] or mean (± SD) BHI SDS [− 0.30 (0.86) vs. − 0.31 (0.80), p = 0.8] between the placebo and vitamin D groups, respectively. Children with advanced skeletal maturity (BA SDS ≥ 0) when compared to children with delayed skeletal maturity (BA SDS < 0), had consumed more calories [mean (± SD) calories 805 (± 346) vs 723 (± 327) kcal/day, respectively, p < 0.05], were significantly less stunted (height SDS − 1.43 vs. − 2.32, p < 0.001) and underweight (weight SDS − 0.82 vs. − 1.45, p < 0.001), with greater growth velocity (11.57 vs 10.47 cm/ year, p < 0.05). CONCLUSION: Deprived children have significant delay in skeletal maturation but no substantial impairment in bone health as assessed by BHI. BA delay was influenced by total calorie intake, but not bolus vitamin D supplementation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00394-021-02511-5. Springer Berlin Heidelberg 2021-02-20 2021 /pmc/articles/PMC8354903/ /pubmed/33611615 http://dx.doi.org/10.1007/s00394-021-02511-5 Text en © Crown 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Contribution
Uday, Suma
Manaseki-Holland, Semira
Bowie, Jessica
Mughal, Mohamed Zulf
Crowe, Francesca
Högler, Wolfgang
The effect of vitamin D supplementation and nutritional intake on skeletal maturity and bone health in socio-economically deprived children
title The effect of vitamin D supplementation and nutritional intake on skeletal maturity and bone health in socio-economically deprived children
title_full The effect of vitamin D supplementation and nutritional intake on skeletal maturity and bone health in socio-economically deprived children
title_fullStr The effect of vitamin D supplementation and nutritional intake on skeletal maturity and bone health in socio-economically deprived children
title_full_unstemmed The effect of vitamin D supplementation and nutritional intake on skeletal maturity and bone health in socio-economically deprived children
title_short The effect of vitamin D supplementation and nutritional intake on skeletal maturity and bone health in socio-economically deprived children
title_sort effect of vitamin d supplementation and nutritional intake on skeletal maturity and bone health in socio-economically deprived children
topic Original Contribution
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8354903/
https://www.ncbi.nlm.nih.gov/pubmed/33611615
http://dx.doi.org/10.1007/s00394-021-02511-5
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