SH Ho Scoliosis Research Lab, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China.
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
Stud Health Technol Inform. 2021 Jun 28;280:31-34. doi: 10.3233/SHTI210429.
Adolescent idiopathic scoliosis (AIS) is associated with osteopenia which could persist into adulthood affecting attainment of Peak Bone Mass thus resulting in osteoporosis in late adulthood. We previously reported a randomized double-blinded placebo-controlled trial(the Cal study) showing significant bone health improvement with 2-year calcium(Ca)+Vit-D supplementation for AIS girls. This study addressed the important issue whether bone health improvement from the initial 2-year Ca+Vit-D supplementation could persist as subjects approached towards Peak Bone Mass at 6-year ie after 4-year of supplement discontinuation. This was an extension of the Cal study on AIS girls (11-14 years old, mean age=12.9 years, Tanner stage<IV) with femoral neck aBMD Z-score<0 and Cobb angle≥15∘. 330 subjects were randomized to Group1(placebo), Group2(600mgCa+400-IU-Vit-D3/day) or Group3(600mgCa+800-IU-Vit-D3/day) for 2-year supplementation after which supplementation was stopped. Investigations at baseline, 2-year and 6-year included High-resolution Peripheral Quantitative Computed Tomography(HR-pQCT) at distal radius and Dual Energy X-ray Absorptiometry(DXA) at both hips. 270(81.8%) subjects completed 2-year supplementation when changes in left femoral neck aBMD, trabecular vBMD, Trabecular BV/TV, Trabecular Number and Trabecular Separation indicated significant bone health improvement with Ca+Vit-D supplementation(p<0.05). At 6-year(mean age=19.2 years), no between-group difference on bone parameters was noted except increase in Cortical Thickness being greater only in Group3 than in Group1. After 4-year supplement discontinuation, the treatment effect from the initial 2-year supplementation mostly dissipated indicating the need of continued supplementation in AIS girls to sustain therapeutic improvement on bone health as subjects approach towards Peak Bone Mass.
青少年特发性脊柱侧凸（AIS）与骨质疏松症有关，这种骨质疏松症可能会持续到成年期，影响峰值骨量的获得，从而导致成年后期骨质疏松症。我们之前报告了一项随机、双盲、安慰剂对照试验（Cal 研究），结果显示，对于 AIS 女孩，2 年钙（Ca）+维生素 D 补充治疗可显著改善骨骼健康。这项研究解决了一个重要问题，即初始 2 年 Ca+Vit-D 补充治疗后，随着受试者接近峰值骨量（6 年，即停止补充 4 年后），骨骼健康的改善是否能够持续。这是 AIS 女孩 Cal 研究的延伸（11-14 岁，平均年龄 12.9 岁，Tanner 分期<IV），股骨颈 aBMD Z 评分<0 和 Cobb 角≥15°。330 名受试者被随机分为 3 组：第 1 组（安慰剂）、第 2 组（600mgCa+400-IU-Vit-D3/天）和第 3 组（600mgCa+800-IU-Vit-D3/天），进行 2 年的补充治疗，之后停止补充。基线、2 年和 6 年的检查包括远端桡骨的高分辨率外周定量计算机断层扫描（HR-pQCT）和双侧髋关节的双能 X 射线吸收测定法（DXA）。270 名（81.8%）受试者完成了 2 年的补充治疗，此时左股骨颈 aBMD、小梁 vBMD、小梁 BV/TV、小梁数量和小梁分离的变化表明 Ca+Vit-D 补充有显著的骨骼健康改善（p<0.05）。在 6 年（平均年龄 19.2 岁）时，除了第 3 组的皮质厚度增加大于第 1 组外，各组之间的骨骼参数没有差异。停止补充 4 年后，初始 2 年补充治疗的治疗效果大多消失，表明需要继续为 AIS 女孩补充钙，以维持骨骼健康的治疗改善，因为受试者正在接近峰值骨量。
