Calarge Chadi A, Mills James A, Ziegler Ekhard E, Schlechte Janet A
1 Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine , Houston, Texas.
2 Department of Pediatrics, Baylor College of Medicine , Houston, Texas.
J Child Adolesc Psychopharmacol. 2018 Mar;28(2):145-150. doi: 10.1089/cap.2017.0104. Epub 2017 Nov 7.
The chronic use of antipsychotics has been associated with impaired bone mineralization, partially mediated by hyperprolactinemia. We examined if calcium and vitamin D supplementation promote bone mineral accrual in boys with risperidone-induced hyperprolactinemia.
Between February 2009 and November 2013, medically healthy, 5- to 17-year-old boys were enrolled in a 36-week double-blind, placebo-controlled study, examining the skeletal effects of supplementation with 1250 mg calcium carbonate and 400 IU of vitamin D3 in risperidone-induced hyperprolactinemia. Anthropometric, dietary, physical activity, and psychiatric assessments were conducted at baseline and week 18 and 36. Plasma prolactin and vitamin D concentrations were measured at baseline and week 36. Total body less head bone mineral content (BMC) and radius trabecular bone mineral density (BMD) were measured at baseline, week 18, and week 36, using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, respectively. Linear mixed-effects regression analysis examined the longitudinal effect of treatment on skeletal outcomes.
Forty-seven boys (mean age: 11.0 ± 2.6 years) were randomized and 38 completed the study. At study entry, the average dietary calcium intake was below the recommended limit, but the average vitamin D concentration was normal. Calcium and vitamin D supplementation failed to significantly increase BMC or trabecular BMD. It also failed to affect several other skeletal and anthropometric outcomes, including plasma vitamin D concentration.
In this 9-month long pilot study, supplementation with a modest dose of calcium and vitamin D did not increase bone mass accrual in risperidone-treated boys with hyperprolactinemia. Alternative approaches should be investigated to optimize bone health in this population to prevent future morbidity and premature mortality. ClinicalTrials.gov Identifier: NCT00799383.
长期使用抗精神病药物与骨矿化受损有关，部分原因是高催乳素血症。我们研究了补充钙和维生素D是否能促进患有利培酮所致高催乳素血症男孩的骨矿物质积累。
2009年2月至2013年11月期间，选取身体健康、年龄在5至17岁的男孩参与一项为期36周的双盲、安慰剂对照研究，该研究旨在探究补充1250毫克碳酸钙和400国际单位维生素D3对利培酮所致高催乳素血症的骨骼影响。在基线期、第18周和第36周进行人体测量、饮食、身体活动和精神状态评估。在基线期和第36周测量血浆催乳素和维生素D浓度。分别使用双能X线吸收法和外周定量计算机断层扫描在基线期、第18周和第36周测量全身（不包括头部）骨矿物质含量（BMC）和桡骨小梁骨矿物质密度（BMD）。线性混合效应回归分析研究了治疗对骨骼结局的纵向影响。
47名男孩（平均年龄：11.0±2.6岁）被随机分组，38名完成了研究。在研究开始时，平均饮食钙摄入量低于推荐限值，但平均维生素D浓度正常。补充钙和维生素D未能显著增加BMC或小梁BMD。它也未能影响其他几个骨骼和人体测量结局，包括血浆维生素D浓度。
在这项为期9个月的初步研究中，补充适量的钙和维生素D并未增加患有高催乳素血症且接受利培酮治疗男孩的骨量积累。应研究其他方法来优化该人群的骨骼健康，以预防未来的发病和过早死亡。ClinicalTrials.gov标识符：NCT00799383。
