TY - JOUR
T1 - Effect of vitamin D replacement on hip structural geometry in adolescents
T2 - A randomized controlled trial
AU - Al-Shaar, Laila
AU - Nabulsi, Mona
AU - Maalouf, Joyce
AU - El-Rassi, Rola
AU - Vieth, Reinhold
AU - Beck, Thomas J.
AU - El-Hajj Fuleihan, Ghada
N1 - Funding Information:
The study was supported in large part by an educational grant from Nestle Foundation and by a grant from Merck KGaA . The authors thank the administrators, school nurses, parents and students from the American Community School, the International College, Amlieh School and Ashbal Al Sahel School for their support in making the study possible. The authors thank Mrs. U. Usta, for her assistance in preparing the vitamin D solutions and implementing the randomization protocol, Mrs. S. Mroueh for her expert technical assistance in the acquisition and analyses of the bone mineral density scans and Mrs. C. Hajj Shahine for her tireless efforts in running the hormonal assays.
PY - 2013/10
Y1 - 2013/10
N2 - Background: We have shown in a randomized controlled trial that vitamin D increases bone mass, lean mass and bone area in adolescent girls, but not boys. These increments may translate into improvements in bone geometry and therefore bone strength. This study investigated the impact of vitamin D on hip geometric dimensions from DXA-derived hip structural analyses in adolescents who participated in the trial. Methods: 167 girls (mean age 13.1years) and 171 boys (mean age 12.7years) were randomly assigned to receive weekly placebo oil or vitamin D3, at doses of 1400IU or 14,000IU, in a double blind placebo-controlled 1-year trial. DXA images were obtained at baseline and one year, and hip images were analyzed using the hip structural analysis (HSA) software to derive parameters of bone geometry. These include outer diameter (OD), cross sectional area (CSA), section modulus (Z), and buckling ratio (BR) at the narrow neck (NN), intertrochanteric (IT), and shaft (S) regions. Analysis of Covariance (ANCOVA) was used to examine group differences for changes of bone structural parameters. Results: In the overall group of girls, vitamin D supplementation increased aBMD (7.9% and 6.8% in low and high doses, versus 4.2% in placebo) and reduced the BR of NN (6.1% and 2.4% in low and high doses, versus 1.9% in placebo). It also improved aBMD (7.9% and 5.2% versus 3.6%) and CSA (7.5% and 5.1% versus 4.1%) of the IT and OD of the S (2.4% and 2.5% versus 0.8% respectively). Significant changes in the OD and BR of the NN, in the overall group of girls remained, after adjusting for lean mass, and were unaffected with further adjustments for lifestyle, pubertal status, and height measures. Conversely, boys did not exhibit any significant changes in any parameters of interest. A dose effect was not detected and subgroup analyses revealed no beneficial effect of vitamin D by pubertal stage. Conclusions: Vitamin D supplementation improved bone mass and several DXA-derived structural bone parameters, in adolescent girls, but not boys. This occurred at a critical site, the femoral neck, and if maintained through adulthood could improve bone strength and lower the risk of hip fractures.
AB - Background: We have shown in a randomized controlled trial that vitamin D increases bone mass, lean mass and bone area in adolescent girls, but not boys. These increments may translate into improvements in bone geometry and therefore bone strength. This study investigated the impact of vitamin D on hip geometric dimensions from DXA-derived hip structural analyses in adolescents who participated in the trial. Methods: 167 girls (mean age 13.1years) and 171 boys (mean age 12.7years) were randomly assigned to receive weekly placebo oil or vitamin D3, at doses of 1400IU or 14,000IU, in a double blind placebo-controlled 1-year trial. DXA images were obtained at baseline and one year, and hip images were analyzed using the hip structural analysis (HSA) software to derive parameters of bone geometry. These include outer diameter (OD), cross sectional area (CSA), section modulus (Z), and buckling ratio (BR) at the narrow neck (NN), intertrochanteric (IT), and shaft (S) regions. Analysis of Covariance (ANCOVA) was used to examine group differences for changes of bone structural parameters. Results: In the overall group of girls, vitamin D supplementation increased aBMD (7.9% and 6.8% in low and high doses, versus 4.2% in placebo) and reduced the BR of NN (6.1% and 2.4% in low and high doses, versus 1.9% in placebo). It also improved aBMD (7.9% and 5.2% versus 3.6%) and CSA (7.5% and 5.1% versus 4.1%) of the IT and OD of the S (2.4% and 2.5% versus 0.8% respectively). Significant changes in the OD and BR of the NN, in the overall group of girls remained, after adjusting for lean mass, and were unaffected with further adjustments for lifestyle, pubertal status, and height measures. Conversely, boys did not exhibit any significant changes in any parameters of interest. A dose effect was not detected and subgroup analyses revealed no beneficial effect of vitamin D by pubertal stage. Conclusions: Vitamin D supplementation improved bone mass and several DXA-derived structural bone parameters, in adolescent girls, but not boys. This occurred at a critical site, the femoral neck, and if maintained through adulthood could improve bone strength and lower the risk of hip fractures.
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U2 - 10.1016/j.bone.2013.06.020
DO - 10.1016/j.bone.2013.06.020
M3 - Article
C2 - 23810841
AN - SCOPUS:84880391809
SN - 8756-3282
VL - 56
SP - 296
EP - 303
JO - Bone
JF - Bone
IS - 2
ER -
