Marwaha Raman K, Garg M K, Mithal A, Gupta Sushil, Shukla Manoj, Chadha Aditi
International Life Science-India, Lajpat Nagar, New Delhi, India.
Department of Medicine and Endocrinology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Indian J Endocrinol Metab. 2019 Jan-Feb;23(1):27-34. doi: 10.4103/ijem.IJEM_149_18.
Vitamin D is known to play an important role in bone mineral metabolism. Its deficiency may affect growth and status of bone markers in children. Hence, we undertook to study the status of bone markers in children with vitamin D deficiency (VDD) and impact of vitamin D3 supplementation on them.
Total 468 out of 615 children and adolescents with VDD, who were given either of the three doses (600, 1000, and 2000) of vitamin D supplementation, were included in the study. These 468 children with pre- and postsupplementation preserved samples with available anthropometry, serum biochemistry, 25-hydroxy-vitamin D, and parathormone were evaluated for bone formation (procollagen type 1 amino-terminal propeptide [P1NP]) and resorption (β-cross laps [CTx]) markers.
The mean age and body mass index of these children were 11.3 ± 2.3 years (boys: 11.5 ± 2.4; girls: 12.2 ± 1.2 years; = 0.03) and 18.1 ± 3.8 kg/m (boys: 18.2 ± 3.9; girls: 17.6 ± 3.2 kg/m; = 0.208), respectively. There were 8.8% subjects with severe, 42.7% with moderate, and 48.5% with mild VDD. There was a significant decline in serum P1NP (from 691 ± 233 ng/ml to 640 ± 259 ng/ml, < 0.001) and CTx (from 1.67 ± 0.53 ng/ml to 1.39 ± 0.51 ng/ml, < 0.001) following supplementation. Though decline in serum P1NP and CTx levels was observed in both boys and girls, among all three supplementation groups and VDD categories, the effect was more marked in serum CTx than P1NP levels.
Vitamin D supplementation in VDD children resulted in decrease in both bone formation (P1NP) and resorption (CTx). The impact, however, was more marked on bone resorption than bone formation.
已知维生素D在骨矿物质代谢中起重要作用。其缺乏可能影响儿童骨骼标志物的生长和状态。因此，我们着手研究维生素D缺乏（VDD）儿童的骨骼标志物状态以及维生素D3补充剂对其的影响。
在615名VDD儿童和青少年中，共有468名接受了三种剂量（600、1000和2000）之一的维生素D补充，被纳入研究。对这468名补充前后保存了样本且有可用人体测量学、血清生物化学、25-羟基维生素D和甲状旁腺激素数据的儿童，评估其骨形成（I型前胶原氨基端前肽[P1NP]）和骨吸收（β-交联C端肽[CTx]）标志物。
这些儿童的平均年龄和体重指数分别为11.3±2.3岁（男孩：11.5±2.4；女孩：12.2±1.2岁；P = 0.03）和18.1±3.8kg/m²（男孩：18.2±3.9；女孩：17.6±3.2kg/m²；P = 0.208）。有8.8%的受试者为重度VDD，42.7%为中度，48.5%为轻度。补充后血清P1NP（从691±233ng/ml降至640±259ng/ml，P<0.001）和CTx（从1.67±0.53ng/ml降至1.39±0.51ng/ml，P<0.001）显著下降。尽管在男孩和女孩中均观察到血清P1NP和CTx水平下降，但在所有三个补充组和VDD类别中，血清CTx的下降效果比P1NP水平更明显。
VDD儿童补充维生素D导致骨形成（P1NP）和骨吸收（CTx）均下降。然而，对骨吸收的影响比对骨形成的影响更明显。
