Impact of Vitamin D and Calcium Supplementation on Bone Mineral Density and Bone Metabolism Among Thai Adolescents With Perinatally Acquired Human Immunodeficiency Virus (HIV) Infection: A Randomized Clinical Trial

作者：Tavitiya Sudjaritruk, Torsak Bunupuradah, Linda Aurpibul, Suparat Kanjanavanit, Tawalchaya Chotecharoentanan, Natthanidnan Sricharoen, Pradthana Ounchanum, Piyarat Suntarattiwong, Krittaporn Pornpaisalsakul, Thanyawee Puthanakit, CAL-D Study Group, Tavitiya Sudjaritruk, Linda Aurpibul, Tawalchaya Chotecharoentanan, Natthanidnan Sricharoen, Thanyawee Puthanakit, Torsak Bunupuradah, Krittaporn Pornpaisalsakul, Suparat Kanjanavanit, Pradthana Ounchanum, Piyarat Suntarattiwong · 发表于：Clinical Infectious Diseases · 年份：2021 · DOI：10.1093/cid/ciab547 · 被引用次数：22 · 研究领域：HIV-related health complications and treatments、Vitamin D Research Studies、Bone health and osteoporosis research

BACKGROUND: To evaluate the impact of vitamin D and calcium supplementation (VitD/Ca) on lumbar spine bone mineral density (LSBMD) and bone metabolism among Thai adolescents with perinatally acquired HIV (PHIVA). METHODS: A multicenter, randomized, active-control, open-labeled trial was conducted. PHIVA (aged 10-20 years) who were on stable cART were enrolled. Baseline LSBMD status was defined as low (z-score ≤ -2) and normal (> -2). Eligible PHIVA were randomly assigned to receive standard-dose (400 IU/1200 mg/day) or high-dose (400 IU/1200 mg/day plus ergocalciferol 20 000 IU/week) VitD/Ca supplementation for 48 weeks (ratio 1:1, stratified by baseline LSBMD). Study outcomes were changes in LSBMD, LSBMD z-scores, and bone metabolism-related biomarkers (25-hydroxyvitamin D [25(OH)D], intact parathyroid hormone [iPTH], C-terminal telopeptide [CTX], procollagen type I amino-terminal propeptide [PINP]) from baseline to week 48. RESULTS: Among 200 enrolled PHIVA, median age was 16 (IQR:14-18) years; 61% were on NNRTI-based cART. Median 25(OH)D level was 25.5 (IQR: 20.8-33.0) ng/mL. After 48-week VitD/Ca supplementation, LSBMD significantly increased in both treatment groups (high-dose: median: +0.07 [IQR: +0.04 to +0.11] g/cm2; P < .001; standard-dose: +0.09 [+0.03 to +0.13] g/cm2; P < .001). Notably, the change in LSBMD z-scores was significantly greater in high-dose versus standard-dose groups (median: +0.4 [IQR: -0.1 to +0.9] vs +0.1 [-0.4 to +0.7]; P = .02). Levels of 25(OH)...