Academic Unit of Child Health, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
Hull York Medical School, Faculty of Health, University of Hull, Hull, UK.
J Musculoskelet Neuronal Interact. 2020 Mar 3;20(1):4-11.
The Maternal Vitamin D Osteoporosis (MAVIDOS) trial reported higher total body bone mineral content in winter-born infants of mothers receiving vitamin D supplementation [1000 IU/day cholecalciferol] compared with placebo from 14 weeks gestation until delivery. This sub-study aimed to determine whether antenatal vitamin D supplementation altered postnatal bone formation in response to mechanical stimulation. Thirty-one children born to MAVIDOS participants randomised to either placebo (n=19) or cholecalciferol (n=12) were recruited at age 4-5 years. Children received whole body vibration (WBV) for 10 minutes on 5 consecutive days. Fasting blood samples for bone homeostasis, 25 hydroxyvitamin D (25OHD), parathyroid hormone (PTH), and bone turnover markers (Pro-collagen Type 1 N-terminal propeptide, P1NP; Cross-linked C-telopeptide of Type I Collagen, CTX) were collected pre-WBV and on day 8 (D8). Mean changes (D) in P1NP (ng/ml) between baseline and D8 in the vitamin-D intervention and placebo groups were 40.6 and -92.6 respectively and mean changes (Δ) in CTX (ng/ml) were 0.034 (intervention) and -0.084 (placebo) respectively. Between-group DP1NP difference was 133.2ng/ml [95% CI 0.4, 266.0; p=0.049] and ΔCTX 0.05ng/ml (95% CI -0.159, 0.26ng/mL; p=0.62). Antenatal vitamin-D supplementation resulted in increased P1NP in response to WBV, suggesting early life vitamin D supplementation increases the anabolic response of bone to mechanical loading in children.
Maternal Vitamin D Osteoporosis (MAVIDOS) 试验报告称，从妊娠 14 周开始至分娩，接受维生素 D 补充（每天 1000IU 胆钙化醇）的母亲所生的冬季出生婴儿的全身骨矿物质含量高于安慰剂组 [1000IU/day cholecalciferol]。本研究旨在确定产前维生素 D 补充是否改变了产后对机械刺激的骨形成。从 MAVIDOS 参与者中招募了 31 名随机分配至安慰剂（n=19）或胆钙化醇（n=12）的儿童，他们的年龄在 4-5 岁之间。儿童接受全身振动（WBV）治疗，连续 5 天，每天 10 分钟。在 WBV 前和第 8 天（D8）采集空腹血液样本，用于骨稳态、25 羟基维生素 D（25OHD）、甲状旁腺激素（PTH）和骨转换标志物（原胶原 1 N 端前肽，P1NP；I 型胶原交联 C 端肽，CTX）。维生素 D 干预组和安慰剂组的 P1NP（ng/ml）在基线和 D8 之间的平均变化（D）分别为 40.6 和-92.6，CTX（ng/ml）的平均变化（Δ）分别为 0.034（干预组）和-0.084（安慰剂组）。组间 DP1NP 差异为 133.2ng/ml[95%CI 0.4, 266.0;p=0.049]，ΔCTX 为 0.05ng/ml（95%CI-0.159, 0.26ng/mL;p=0.62）。产前维生素 D 补充导致 WBV 后 P1NP 增加，这表明生命早期维生素 D 补充可增加儿童骨骼对机械负荷的合成代谢反应。
