International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan; Division of Infectious Disease, Department of Pediatrics, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam; Infectious Disease Department, Children's Hospital 2, Ho Chi Minh City, Vietnam.
International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan.
J Nutr. 2023 Jan;153(1):138-147. doi: 10.1016/j.tjnut.2022.10.008. Epub 2022 Dec 20.
Children and young adults with HIV infection may exhibit vitamin D deficiency, which is harmful to bone health as well as the endocrine and immune systems.
This study sought to investigate the effect of vitamin D supplementation on children and young adults with HIV infection.
The PubMed, Embase, and Cochrane databases were searched. Randomized controlled trials that have evaluated the effects of vitamin D supplementation (ergocalciferol or cholecalciferol) at any dose or for any duration in children and young adults with HIV infection, aged 0-25 y, were included. A random-effects model was used, and the standardized mean difference (SMD) and 95% CI were calculated.
Ten trials, with 21 publications and 966 participants (mean age: 17.9 y), were included in the meta-analysis. The supplementation dose and the duration of the studies included ranged from 400 to 7000 IU/d and from 6 to 24 mo, respectively. Vitamin D supplementation was associated with a significantly higher serum 25(OH)D concentration at 12 mo (SMD: 1.14; 95% CI: 0.64, 1.65; P < 0.00001) compared with a placebo. No significant difference was observed in spine BMD (SMD: -0.09; 95% CI: -0.47, 0.3; P = 0.65) at 12 mo between these 2 groups. However, participants who received higher doses (1600-4000 IU/d) had significantly higher total BMD (SMD: 0.23; 95% CI: 0.02, 0.44; P = 0.03) and nonsignificantly higher spine BMD (SMD: 0.3; 95% CI: -0.02, 0.61; P = 0.07) at 12 mo compared with those who received standard doses (400-800 IU/d).
Vitamin D supplementation in children and young adults with HIV infection increases the serum 25(OH)D concentration. A relatively high daily dose of vitamin D (1600-4000 IU) improves total BMD at 12 mo and results in sufficient 25(OH)D concentrations.
儿童和青少年艾滋病毒感染者可能存在维生素 D 缺乏，这对骨骼健康以及内分泌和免疫系统都有害。
本研究旨在探讨维生素 D 补充对艾滋病毒感染儿童和青少年的影响。
检索了 PubMed、Embase 和 Cochrane 数据库。纳入了评估任何剂量或任何时间的维生素 D 补充（麦角钙化醇或胆钙化醇）对 0-25 岁艾滋病毒感染儿童和青少年影响的随机对照试验。采用随机效应模型，计算标准化均数差（SMD）和 95%置信区间。
10 项试验，共 21 篇文献和 966 名参与者（平均年龄：17.9 岁）纳入荟萃分析。补充剂量和研究持续时间分别为 400-7000 IU/d 和 6-24 个月。与安慰剂相比，维生素 D 补充在 12 个月时血清 25（OH）D 浓度显著升高（SMD：1.14；95%CI：0.64，1.65；P<0.00001）。两组间在 12 个月时脊柱骨密度（SMD：-0.09；95%CI：-0.47，0.3；P=0.65）无显著差异。然而，接受较高剂量（1600-4000 IU/d）的参与者总骨密度显著升高（SMD：0.23；95%CI：0.02，0.44；P=0.03），脊柱骨密度虽无显著升高（SMD：0.3；95%CI：-0.02，0.61；P=0.07），但也有升高趋势。
在艾滋病毒感染儿童和青少年中补充维生素 D 可提高血清 25（OH）D 浓度。较高剂量的维生素 D（1600-4000 IU）每日补充可在 12 个月时改善总骨密度，并可获得足够的 25（OH）D 浓度。
