Khadilkar Anuradha V, Sayyad Mehmood G, Sanwalka Neha J, Bhandari Dhanshari R, Naik Sadanand, Khadilkar Vaman V, Mughal M Zulf
Hirabai Cowasji Jehangir Medical Research Institute, Jehangire Hosptial, Pune, India.
Asia Pac J Clin Nutr. 2010;19(4):465-72.
Vitamin D deficiency is common among children and adolescents in India, in spite of abundant sunshine. We conducted a pilot; double blind randomised controlled trial to investigate the effect of vitamin D supplementation on bone mineral content in underprivileged adolescent girls, in Pune, India. Fifty post-menarcheal girls aged 14 to 15 years were randomised to receive 300,000 IU (7.5 mg) of ergocalciferol or placebo orally, 4 times/year. All participants received 250 mg elemental calcium (calcium carbonate) daily. Outcome measures included change in serum 25-hydroxyvitamin D, size adjusted bone area and bone mineral content at total body and lumbar spine. Post supplementation, the median serum concentration of 25-hydroxyvitamin D was 75.2 (64.2-85.5) nmol/L in the intervention group and 28.1 (16.7-34.0) nmol/L in the placebo group. Increment in bone outcome measures was not different in the two groups. However, there was a positive effect of intervention in the size adjusted total body bone area (p<0.05), total body bone mineral content (p<0.05) and lumbar spine bone mineral content (p<0.05), and positive trend in lumbar spine bone area (p=0.07) in girls who were within 2 years of menarche. We conclude that vitamin D supplementation did not have a beneficial effect on skeletal mineralization in girls who were more than 2 years post menarcheal. However, there was a significant positive effect of the intervention on size adjusted total body and lumbar spine bone mineral content and a positive trend in lumbar spine bone area, in girls who were <= 2 years of menarche.
尽管印度阳光充足，但维生素D缺乏在该国儿童和青少年中仍很常见。我们在印度浦那开展了一项试点双盲随机对照试验，以研究补充维生素D对贫困青少年女孩骨矿物质含量的影响。50名年龄在14至15岁的初潮后女孩被随机分为两组，分别口服30万国际单位（7.5毫克）麦角钙化醇或安慰剂，每年4次。所有参与者每天补充250毫克元素钙（碳酸钙）。观察指标包括血清25-羟基维生素D的变化、体型调整后的骨面积以及全身和腰椎的骨矿物质含量。补充后，干预组血清25-羟基维生素D的中位数浓度为75.2（64.2 - 85.5）纳摩尔/升，安慰剂组为28.1（16.7 - 34.0）纳摩尔/升。两组骨观察指标的增加没有差异。然而，对于初潮后2年内的女孩来说，干预对体型调整后的全身骨面积（p<0.05）、全身骨矿物质含量（p<0.05）和腰椎骨矿物质含量（p<0.05）有积极影响，腰椎骨面积有积极趋势（p = 0.07）。我们得出结论，补充维生素D对初潮后超过2年的女孩骨骼矿化没有有益影响。然而，对于初潮≤2年的女孩，干预对体型调整后的全身和腰椎骨矿物质含量有显著的积极影响，腰椎骨面积有积极趋势。
