High-dose vitamin D supplementation in pregnancy and 25(OH)D sufficiency in childhood reduce the risk of fractures and improve bone mineralization in childhood: Follow-up of a randomized clinical trial.
High-dose vitamin D supplementation in pregnancy and 25(OH)D sufficiency in childhood reduce the risk of fractures and improve bone mineralization in childhood: Follow-up of a randomized clinical trial.
复制标题
DOI：
10.1016/j.eclinm.2021.101254
复制
发表时间：
2022-01
影响因子：
15.1
通讯作者：
Bisgaard H
中科院分区：
文献类型：
--
作者：
Brustad N;Chawes BL;Thorsen J;Krakauer M;Lasky-Su J;Weiss ST;Stokholm J;Bønnelykke K;Bisgaard H
在生命早期接触维生素D与改善骨矿化有关，但没有研究调查妊娠补充剂和儿童25（OH）D浓度对骨骼健康的综合影响。我们分析了6个月和6岁时血清25（OH）D浓度的影响，以及产前高剂量维生素D（2800 vs. 400 IU/天）对3岁和6岁时通过双能X线吸收测定法（DXA）扫描评估的骨矿物质密度（BMD）和含量（BMC）以及骨折纵向风险的影响，该研究是在哥本哈根儿童哮喘前瞻性研究2010中进行的一项双盲、随机临床试验（COPSAC 2010）2009年3月4日至2010年11月17日入组的母婴队列，临床随访至2019年1月31日（NCT 00856947）。所有随机分配到干预组并具有完整数据的参与者均纳入分析。在6个月大时，在584名儿童中，93%（n = 541）测定了血清25（OH）D浓度。浓度充足（≥ 75 nmol/l）与浓度不足（< 75 nmol/l）的儿童并没有降低骨折风险：发生率比（95%CI）; 0.64（0.37;1.11），p = 0.11。然而，与接受标准剂量维生素D不足的儿童相比，母亲在怀孕期间接受高剂量补充剂的维生素D充足儿童的骨折发生率降低了60%：0.40（0.19;0.84），p = 0.02。在年龄6岁，血清25（OH）D浓度测定83%（n = 318）的383名儿童可用DXA数据。6岁时维生素D充足儿童的全身骨矿化较高; BMD，校正均值差（aMD）（95% CI）：0.011 g/cm 2（0.001;0.021），p = 0.03，BMC，aMD：12.3 g（-0.8 25. 4），p = 0.07，对母亲接受高剂量维生素D补充的维生素D充足儿童的影响最大; BMD，aMD：0.016 g/cm 2（0.002;0.030），p = 0.03，BMC，aMD：23.5 g（5.5;41.5），p = 0.01。儿童期维生素D充足可改善骨矿化，并与产前高剂量维生素D补充剂结合可降低骨折风险。该研究得到了Lundbeck基金会R16-A1694、丹麦卫生部903，516、丹麦战略研究理事会0603- 00280 B和欧洲研究理事会946，228的支持。
Exposure to vitamin D in early life has been associated with improved bone mineralization, but no studies have investigated the combined effect of pregnancy supplementation and childhood 25(OH)D concentrations on bone health. We analyzed the effect of serum 25(OH)D concentrations at age 6 months and 6 years and the combined effect with prenatal high-dose vitamin D (2800 vs. 400 IU/day) on bone mineral density (BMD) and content (BMC) assessed by dual-energy X-ray absorptiometry (DXA) scans at age 3 and 6 years and longitudinal risk of fractures in a double-blinded, randomized clinical trial in the Copenhagen Prospective Studies on Asthma in Childhood 2010 (COPSAC2010) mother-child cohort with enrollment from March 4, 2009, to November 17, 2010, and clinical follow-up until January 31, 2019 (NCT00856947). All participants randomized to intervention and with complete data were included in the analyses. At age 6 months, serum 25(OH)D concentration was measured in 93% (n = 541) of 584 children. Children with sufficient (≥ 75 nmol/l) vs. insufficient (< 75 nmol/l) concentrations did not have lower risk of fractures: incidence rate ratio (95% CI); 0.64 (0.37;1.11), p = 0.11. However, vitamin D sufficient children from mothers receiving high-dose supplementation during pregnancy had a 60% reduced incidence of fractures compared with vitamin D insufficient children from mothers receiving standard-dose: 0.40 (0.19;0.84), p = 0.02. At age 6 years, serum 25(OH)D concentration was measured in 83% (n = 318) of 383 children with available DXA data. Whole-body bone mineralization was higher in vitamin D sufficient children at age 6 years; BMD, adjusted mean difference (aMD) (95% CI): 0.011 g/cm2 (0.001;0.021), p = 0.03, and BMC, aMD: 12.3 g (-0.8;25.4), p = 0.07, with the largest effect in vitamin D sufficient children from mothers receiving high-dose vitamin D supplementation; BMD, aMD: 0.016 g/cm2 (0.002;0.030), p = 0.03, and BMC, aMD: 23.5 g (5.5;41.5), p = 0.01. Childhood vitamin D sufficiency improved bone mineralization and in combination with prenatal high-dose vitamin D supplementation reduced the risk of fractures. The study was supported by The Lundbeck Foundation R16-A1694, The Danish Ministry of Health 903,516, The Danish Council for Strategic Research 0603–00280B and The European Research Council 946,228.
登录
查看更多内容
影响因子：
168.9
作者：
Javaid, MK;Crozier, SR;Cooper, C
通讯作者：
Cooper, C
影响因子：
3.7
作者：
Pekkinen, Minna;Viljakainen, Heli;Makitie, Outi
通讯作者：
Makitie, Outi
影响因子：
5.9
作者：
Bisgaard, H
通讯作者：
Bisgaard, H
影响因子：
4
作者：
Hernandez, CJ;Beaupré, GS;Carter, DR
通讯作者：
Carter, DR
DOI：
10.1111/cea.12213
发表时间：
2013-12
期刊：
Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology
影响因子：
--
作者：
Bisgaard H;Vissing NH;Carson CG;Bischoff AL;Følsgaard NV;Kreiner-Møller E;Chawes BL;Stokholm J;Pedersen L;Bjarnadóttir E;Thysen AH;Nilsson E;Mortensen LJ;Olsen SF;Schjørring S;Krogfelt KA;Lauritzen L;Brix S;Bønnelykke K
通讯作者：
Bønnelykke K