Effect of calcium and vitamin D supplementation on bone mineral accrual among HIV-infected Thai adolescents with low bone mineral density
Background: The benefits of calcium and vitamin D supplementation for low bone mass remains controversial. This study assessed the changes in bone mineral density (BMD) during periods without and with calcium and vitamin D supplementation among HIV-infected adolescents with low BMD.Method: Perinatal...
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doaj-e35753407e3142b8bc294018a698d75a2021-05-05T04:04:58ZengElsevierJournal of Virus Eradication2055-66402018-01-0141611Effect of calcium and vitamin D supplementation on bone mineral accrual among HIV-infected Thai adolescents with low bone mineral densityThanyawee Puthanakit0Orasri Wittawatmongkol1Voraporn Poomlek2Tavitiya Sudjaritruk3Chantaphat Brukesawan4Torsak Bunupuradah5Sirintip Sricharoenchai6Thongsuai Chuanjaroen7Wasana Prasitsuebsai8Kulkanya Chokephaibulkit9HIV-NAT, Thai Red Cross AIDS Research Center, Bangkok, Thailand; Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandDepartment of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandDepartment of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandHIV-NAT, Thai Red Cross AIDS Research Center, Bangkok, Thailand; Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, ThailandDepartment of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandHIV-NAT, Thai Red Cross AIDS Research Center, Bangkok, ThailandDepartment of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandHIV-NAT, Thai Red Cross AIDS Research Center, Bangkok, ThailandHIV-NAT, Thai Red Cross AIDS Research Center, Bangkok, ThailandDepartment of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Corresponding author: Kulkanya Chokephaibulkit, 2 Wanglang Road, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, ThailandBackground: The benefits of calcium and vitamin D supplementation for low bone mass remains controversial. This study assessed the changes in bone mineral density (BMD) during periods without and with calcium and vitamin D supplementation among HIV-infected adolescents with low BMD.Method: Perinatally HIV-infected Thai adolescents aged 12–20 years were enrolled into Phase 1 (pre-supplementation) to evaluate longitudinal change of BMD. We provided education about appropriate dietary intake and exercise. Lumbar spine (L2–L4) BMD and vitamin D status (25-hydroxyvitamin D [25(OH)D]) were assessed at baseline and at 12–24 month intervals. Participants with a BMD Z-score≤−2 were enrolled into Phase 2 (supplementation) that provided calcium 600 mg plus cholecalciferol 200 IU twice daily for 6 months. BMD and 25(OH)D were re-assessed at the end of study.Results: Ninety-four participants were enrolled into the Phase 1. Median age (IQR) was 14.3 (13.0–15.5) years, with 67% at Tanner stage 3–5, 89% with a plasma HIV-1 RNA>50 copies/mL. During Phase 1 and a 22.7-month follow-up, median L2–L4 BMD Z-scores remained unchanged (−1.06 vs −1.08, P=0.08), but 25(OH)D levels increased (24.7 vs 26.7 ng/mL, P=0.01). Twenty-six (28%) adolescents had low BMD and were enrolled into Phase 2, with 24 (92%) completing follow-up. The median L2–L4 BMD Z-scores (−2.59 vs −1.70; P>0.001) and calcium level (9.3 vs 9.5 mg/dL, P=0.04) significantly improved. There was an increase in BMD Z-scores during the 6-months post-supplementation as compared to the 21-month pre-supplementation period (0.65 vs −0.50, P=0.03).Conclusion: HIV-infected adolescents with low BMD had improved bone health after calcium and vitamin D supplementation. A randomised controlled trial is warranted to confirm the benefits of these supplements.http://www.sciencedirect.com/science/article/pii/S205566402030234XHIV-infected adolescentsosteoporosisvitamin Dcalcium supplementation |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Thanyawee Puthanakit Orasri Wittawatmongkol Voraporn Poomlek Tavitiya Sudjaritruk Chantaphat Brukesawan Torsak Bunupuradah Sirintip Sricharoenchai Thongsuai Chuanjaroen Wasana Prasitsuebsai Kulkanya Chokephaibulkit |
spellingShingle |
Thanyawee Puthanakit Orasri Wittawatmongkol Voraporn Poomlek Tavitiya Sudjaritruk Chantaphat Brukesawan Torsak Bunupuradah Sirintip Sricharoenchai Thongsuai Chuanjaroen Wasana Prasitsuebsai Kulkanya Chokephaibulkit Effect of calcium and vitamin D supplementation on bone mineral accrual among HIV-infected Thai adolescents with low bone mineral density Journal of Virus Eradication HIV-infected adolescents osteoporosis vitamin D calcium supplementation |
author_facet |
Thanyawee Puthanakit Orasri Wittawatmongkol Voraporn Poomlek Tavitiya Sudjaritruk Chantaphat Brukesawan Torsak Bunupuradah Sirintip Sricharoenchai Thongsuai Chuanjaroen Wasana Prasitsuebsai Kulkanya Chokephaibulkit |
author_sort |
Thanyawee Puthanakit |
title |
Effect of calcium and vitamin D supplementation on bone mineral accrual among HIV-infected Thai adolescents with low bone mineral density |
title_short |
Effect of calcium and vitamin D supplementation on bone mineral accrual among HIV-infected Thai adolescents with low bone mineral density |
title_full |
Effect of calcium and vitamin D supplementation on bone mineral accrual among HIV-infected Thai adolescents with low bone mineral density |
title_fullStr |
Effect of calcium and vitamin D supplementation on bone mineral accrual among HIV-infected Thai adolescents with low bone mineral density |
title_full_unstemmed |
Effect of calcium and vitamin D supplementation on bone mineral accrual among HIV-infected Thai adolescents with low bone mineral density |
title_sort |
effect of calcium and vitamin d supplementation on bone mineral accrual among hiv-infected thai adolescents with low bone mineral density |
publisher |
Elsevier |
series |
Journal of Virus Eradication |
issn |
2055-6640 |
publishDate |
2018-01-01 |
description |
Background: The benefits of calcium and vitamin D supplementation for low bone mass remains controversial. This study assessed the changes in bone mineral density (BMD) during periods without and with calcium and vitamin D supplementation among HIV-infected adolescents with low BMD.Method: Perinatally HIV-infected Thai adolescents aged 12–20 years were enrolled into Phase 1 (pre-supplementation) to evaluate longitudinal change of BMD. We provided education about appropriate dietary intake and exercise. Lumbar spine (L2–L4) BMD and vitamin D status (25-hydroxyvitamin D [25(OH)D]) were assessed at baseline and at 12–24 month intervals. Participants with a BMD Z-score≤−2 were enrolled into Phase 2 (supplementation) that provided calcium 600 mg plus cholecalciferol 200 IU twice daily for 6 months. BMD and 25(OH)D were re-assessed at the end of study.Results: Ninety-four participants were enrolled into the Phase 1. Median age (IQR) was 14.3 (13.0–15.5) years, with 67% at Tanner stage 3–5, 89% with a plasma HIV-1 RNA>50 copies/mL. During Phase 1 and a 22.7-month follow-up, median L2–L4 BMD Z-scores remained unchanged (−1.06 vs −1.08, P=0.08), but 25(OH)D levels increased (24.7 vs 26.7 ng/mL, P=0.01). Twenty-six (28%) adolescents had low BMD and were enrolled into Phase 2, with 24 (92%) completing follow-up. The median L2–L4 BMD Z-scores (−2.59 vs −1.70; P>0.001) and calcium level (9.3 vs 9.5 mg/dL, P=0.04) significantly improved. There was an increase in BMD Z-scores during the 6-months post-supplementation as compared to the 21-month pre-supplementation period (0.65 vs −0.50, P=0.03).Conclusion: HIV-infected adolescents with low BMD had improved bone health after calcium and vitamin D supplementation. A randomised controlled trial is warranted to confirm the benefits of these supplements. |
topic |
HIV-infected adolescents osteoporosis vitamin D calcium supplementation |
url |
http://www.sciencedirect.com/science/article/pii/S205566402030234X |
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