Effect of high-dose cholecalciferol (vitamin D3) on bone and body composition in children and young adults with HIV infection: a randomized, double-blind, placebo-controlled trial
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It is unknown whether vitamin D supplementation positively impacts body composition and bone outcomes in children and young adults with HIV. This RCT found that despite increasing 25(OH)D concentrations, high dose vitamin D3 supplementation did not impact bone or body composition in children and young adults with HIV infection.
The objective of this paper was to determine the impact of high-dose daily cholecalciferol (vitamin D3) supplementation on body composition and bone density, structure, and strength in children and young adults with perinatally acquired (PHIV) or behaviorally acquired (BHIV) HIV infection.
Participants were randomized to receive vitamin D3 supplementation (7000 IU/day) or placebo for 12 months. Serum 25-hydroxyvitamin D [25(OH)D] concentrations, dual energy X-ray absorptiometry (DXA) of the whole body and lumbar spine, and peripheral quantitative computed tomography (pQCT) of tibia sites were acquired at 0, 6, and 12 months. DXA and pQCT outcomes were expressed as sex- and population-ancestry specific Z-scores relative to age and adjusted for height or tibia length, as appropriate.
Fifty-eight participants (5.0 to 24.9 years) received vitamin D3 supplements (n = 30) or placebo (n = 28). At enrollment, groups were similar in age, sex, population ancestry, growth status, serum 25(OH)D concentrations, body composition, and size-adjusted bone measures. Median 25(OH)D concentrations were similar (17.3 ng/mL in the vitamin D3 supplementation group vs 15.6 ng/mL in the placebo group), and both groups had mild bone deficits. At 12 months, 25(OH)D rose significantly in the vitamin D supplementation group but not in the placebo group (26.4 vs 14.8 ng/mL, respectively, p < 0.008). After adjusting for population ancestry, sex, antiretroviral therapy use, and season, there were no significant treatment group differences in bone or body composition outcomes.
Despite increasing 25(OH)D concentrations, 12 months of high-dose vitamin D3 supplementation did not impact bone or body composition in children and young adults with HIV infection.
KeywordsCholecalciferol Dual energy X-ray absorptiometry HIV Peripheral quantitative computed tomography
We are grateful to the study participants and their families. We would like to thank Julia L. Samuel and Savannah Knell, as the lead study staff members. In addition, we would like to acknowledge the Clinical Translational Research Center, the Special Immunology Family Care Clinic, Adolescent Initiative Program at CHOP, Jonathan Lax Treatment Center, Cooper University Hospital, Alfred I. duPont Hospital for Children, Hospital of the University of Pennsylvania, Temple University Hospital, and Drexel University Hospital.
This work was supported by the NIH/National Center for Complementary and Alternative Medicine, Grant R01AT005531, the National Center for Research Resources, Grant UL1RR024134, and is now at the National Center for Advancing Translational Sciences, Grant UL1TR000003. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. This publication was made possible through core services and support from the University of Pennsylvania Center for AIDS Research, an NIH-funded program (P30AI045008). Additional support was from the Jean A. Cortner Endowed Chair, Nutrition Center and the Research Institute at the Children’s Hospital of Philadelphia. Life Extension (Ft. Lauderdale, FL) and J.R. Carlson Laboratories, Inc. (Arlington Heights, IL) donated the vitamin D3 supplements and placebo capsules and drops, respectively.
Compliance with ethical standards
Conflicts of interest
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