Schou A J, Heuck C, Wolthers O D
Children's Clinic Randers, Randers, Denmark.
Acta Paediatr. 2003 Jul;92(7):797-801.
New serum markers have recently been introduced in the assessment of bone turnover. Such measures are osteocalcin, the C-terminal propeptide of type I procollagen (PICP), the N-terminal propeptide of type I procollagen (PINP) and the C-terminal pyridinoline cross-linked telopeptide of type I collagen (ICTP). This study aimed to determine whether supplementation with vitamin D3 to healthy children during the winter affects bone turnover in healthy children measured by serum osteocalcin, PICP, PINP or ICTP.
12 girls and 8 boys aged 6.2-13.7 (mean 9.8) y, all proven healthy by medical examination and history, were enrolled in a double-blind, randomized, placebo-controlled, cross-over study with two 4 wk treatment periods and 2 wk washout. Vitamin D3 600 IU was given in one tablet of ABCDin daily. On the last day of the 4 wk periods blood was sampled for assessment of serum osteocalcin, PICP, PINP, ICTP, 25-OH-vitamin D, 1,25-diOH-vitamin D and parathyroid hormone (PTH).
During supplementation and placebo periods serum osteocalcin (mean +/- SEM) was 53.9 +/- 5.7 and 54.4 +/- 3.8 microg l(-1) (p = 0.70), PICP was 437+/- 44 and 429 +/- 41 microg l(-1) (p = 0.73), PINP was 579 +/- 56 and 619 +/- 64 microg l(-1) (p = 0.33) and ICTP was 13.4 +/- 0.9 and 13.6 +/- 0.7 microg l(-1) (p = 0.52), respectively. Mean +/- SEM serum 25-OH-vitamin D was 47.0 +/- 2.3 and 33.0 +/- 3.0 nmol l(-1) during vitamin D3 supplementation and placebo (p < 0.001, t = 8.10, 95% CI = 10.3 to 17.6 nmol l(-1)), 1,25-diOH-vitamin D and PTH were 87.5 +/- 4.3 and 92.0 +/- 5.3 pmol l(-1) (p = 0.38), and 3.97 +/- 0.5 and 4.21 +/- 0.4 micromol l(-1) (p = 0.37), respectively.
Supplementation with 600 IU vitamin D3 to healthy children in the winter does not affect bone turnover as measured by serum osteocalcin, PICP, PINP or ICTP. Vitamin D supplementation to healthy children may not be recommended on the ground of concern for bone turnover.
最近在骨转换评估中引入了新的血清标志物。这些指标包括骨钙素、I型前胶原C端前肽（PICP）、I型前胶原N端前肽（PINP）和I型胶原C端吡啶啉交联终肽（ICTP）。本研究旨在确定冬季对健康儿童补充维生素D3是否会影响通过血清骨钙素、PICP、PINP或ICTP测量的健康儿童的骨转换。
12名女孩和8名男孩，年龄在6.2 - 13.7岁（平均9.8岁），经医学检查和病史证实均健康，参加了一项双盲、随机、安慰剂对照、交叉研究，有两个4周的治疗期和2周的洗脱期。每天服用一片含600 IU维生素D3的ABCdin。在4周治疗期的最后一天采集血样，用于评估血清骨钙素、PICP、PINP、ICTP、25 - OH - 维生素D、1,25 - 二羟维生素D和甲状旁腺激素（PTH）。
在补充期和安慰剂期，血清骨钙素（均值±标准误）分别为53.9±5.7和54.4±3.8 μg l⁻¹（p = 0.70），PICP分别为437±44和429±41 μg l⁻¹（p = 0.73），PINP分别为579±56和619±64 μg l⁻¹（p = 0.33），ICTP分别为13.4±0.9和13.6±0.7 μg l⁻¹（p = 0.52）。在维生素D3补充期和安慰剂期，血清25 - OH - 维生素D的均值±标准误分别为47.0±2.3和33.0±3.0 nmol l⁻¹（p < 0.001，t = 8.10，95%可信区间 = 10.3至17.6 nmol l⁻¹），1,25 - 二羟维生素D和PTH分别为87.5±4.3和92.0±5.3 pmol l⁻¹（p = 0.38），以及3.97±0.5和4.21±0.4 μmol l⁻¹（p = 0.37）。
冬季对健康儿童补充600 IU维生素D3不会影响通过血清骨钙素、PICP、PINP或ICTP测量的骨转换。基于对骨转换的担忧，可能不建议对健康儿童补充维生素D。
