Influence of vitamin D on non-communicable disease outcomes in South African schoolchildren: the ViDiKids-NCD sub-study

维生素 D 对南非学童非传染性疾病结局的影响：ViDiKids-NCD 子研究

• 批准号: MR/R023050/1
• 负责人: Adrian Martineau
• 金额: $ 42.54万
• 依托单位: Queen Mary University of London
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2018
• 资助国家: 英国
• 起止时间: 2018 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FR023050%2F1
• 关键词: Influence; vitamin; non; communicable; disease

'Non-communicable disease' (NCD) is a term used to describe any illness that is not caused by infections. NCDs are becoming more common worldwide, particularly among less wealthy city-dwellers living in lower- and middle-income countries such as South Africa. Most research on NCDs focuses on illnesses that primarily affect adults, such as heart disease and cancer. However, children are also affected by NCDs including thinning of the bones leading to fractures (broken bones), and reduced muscle mass. 20% of urban South African schoolchildren suffer a bone fracture by the age of 15, compared with 13% in England. There is an urgent need to identify a way to improve bone health and muscle mass in children.Low levels of vitamin D ('the sunshine vitamin') are common among children living in disadvantaged urban environments such as the townships around Cape Town, due to decreased time outdoors, poor diets and obesity (which leads to vitamin D being stored in fat so that it is not available to the organs that need it). A growing body of research suggests that low levels of vitamin D may be a risk factor for developing thinning of the bones and reduced muscle mass. However, there is a lack of large, well-conducted research studies designed to find out whether vitamin D supplementation could strengthen children's bones and boost their muscle mass.We are already conducting a large MRC-funded clinical trial (the ViDiKids study) in 5,400 Cape Town schoolchildren to see if vitamin D supplementation can prevent TB. In this application, we propose to conduct a sub-study in which we will measure additional outcomes including bone density, muscle mass and physical fitness in a sub-set of 400 children who are also taking part in the main VidiKids trial.2) Aims and objectivesThe aim of this research is to determine whether a weekly vitamin D supplement, taken by mouth for 3 years, can improve bone density, muscle mass and physical fitness in children living in townships around Cape Town. We will achieve this by conducting a sub-study in 400 children. At the start of the sub-study we will measure participants' bone density, muscle mass and physical fitness. Participants will then be allocated to receive weekly doses of vitamin D or placebo (dummy medication) at random, supervised by study staff. At the end of the study we will repeat assessments of bone density, muscle mass and physical fitness, and compare these outcomes between children who received vitamin D vs placebo over the previous 3 years.3) Potential applications and benefitsWe already know that improvements in bone density in children translate into reduced risk of bone fractures: if we show that bone density is boosted by vitamin D, then supplements could be routinely given to children to prevent bone fractures. 1 billion people worldwide have inadequate vitamin D levels: results of our study could therefore have global importance.Several groups could benefit from the study. Children could benefit from the discovery of a cheap, safe method of reducing their risk of fractures; public health doctors could benefit from the discovery of a new tool for control of non-communicable diseases; and medical researchers could benefit from new scientific insights into the effects of vitamin D on children's health.

“非传染性疾病”（NCD）是一个术语，用于描述任何不是由感染引起的疾病。非传染性疾病在世界范围内越来越普遍，特别是在南非等中低收入国家不太富裕的城市居民中。大多数关于非传染性疾病的研究都集中在主要影响成年人的疾病上，例如心脏病和癌症。然而，儿童也受到非传染性疾病的影响，包括骨骼变薄导致骨折（骨折）和肌肉质量减少。20%的南非城市学龄儿童在15岁时发生骨折，而英格兰为13%。目前迫切需要找到一种改善儿童骨骼健康和肌肉质量的方法。生活在贫困城市环境中的儿童，如开普敦周围的乡镇，由于户外时间减少，饮食不良和肥胖（导致维生素D储存在脂肪中，无法提供给需要它的器官），维生素D水平低（“阳光维生素”）很常见。越来越多的研究表明，维生素D水平低可能是骨骼变薄和肌肉质量减少的风险因素。然而，目前还缺乏大型、精心进行的研究来确定维生素D补充剂是否可以增强儿童的骨骼并增加他们的肌肉质量。我们已经在5，400名儿童中进行了一项由MRC资助的大型临床试验（ViDiKids研究）开普敦学童，看看维生素D补充剂是否可以预防结核病。在本申请中，我们建议进行一项子研究，其中我们将测量400名儿童的额外结果，包括骨密度，肌肉质量和身体健康，这些儿童也参加了主要的VidiKids试验。2）目的和目标本研究的目的是确定每周口服维生素D补充剂3年是否可以改善骨密度，生活在开普敦附近乡镇的儿童的肌肉质量和身体健康。我们将通过在400名儿童中进行子研究来实现这一目标。在子研究开始时，我们将测量参与者的骨密度，肌肉质量和身体素质。然后，受试者将被随机分配接受每周剂量的维生素D或安慰剂（模拟药物），由研究人员监督。在研究结束时，我们将重复评估骨密度，肌肉质量和身体健康，并比较在过去3年中接受维生素D与安慰剂的儿童之间的这些结果。3）潜在的应用和益处我们已经知道，儿童骨密度的改善转化为骨折风险的降低：如果我们证明维生素D可以提高骨密度，那么就可以给儿童常规服用维生素D补充剂来预防骨折。全世界有10亿人维生素D水平不足：因此，我们的研究结果可能具有全球重要性。儿童可以受益于发现一种廉价、安全的降低骨折风险的方法;公共卫生医生可以受益于发现一种控制非传染性疾病的新工具;医学研究人员可以受益于关于维生素D对儿童健康影响的新科学见解。

项目成果

Influence of vitamin D supplementation on growth, body composition, pubertal development and spirometry in South African schoolchildren: a randomised controlled trial (ViDiKids)

补充维生素 D 对南非学童生长、身体成分、青春期发育和肺活量测定的影响：一项随机对照试验 (ViDiKids)

• DOI: 10.1101/2023.11.29.23299226
• 发表时间: 2023
• 作者: Middelkoop K

Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low- and middle-income countries.

• DOI: 10.1111/nyas.13968
• 发表时间: 2018-10
• 期刊: Annals of the New York Academy of Sciences
• 影响因子: 5.2
• 作者: Roth DE;Abrams SA;Aloia J;Bergeron G;Bourassa MW;Brown KH;Calvo MS;Cashman KD;Combs G;De-Regil LM;Jefferds ME;Jones KS;Kapner H;Martineau AR;Neufeld LM;Schleicher RL;Thacher TD;Whiting SJ
• 通讯作者: Whiting SJ

Vitamin D supplementation to prevent tuberculosis infection in South African schoolchildren: multicenter phase 3 double-blind randomized placebo-controlled trial (ViDiKids)

补充维生素 D 以预防南非学童的结核感染：多中心 3 期双盲随机安慰剂对照试验 (ViDiKids)

• DOI: 10.1016/j.ijid.2023.05.010
• 发表时间: 2023
• 期刊: International Journal of Infectious Diseases
• 影响因子: 8.4
• 作者: Middelkoop K

Prevalence and Determinants of Vitamin D Deficiency in 1825 Cape Town Primary Schoolchildren: A Cross-Sectional Study.

• DOI: 10.3390/nu14061263
• 发表时间: 2022-03-16
• 期刊: Nutrients
• 影响因子: 5.9
• 作者: Middelkoop K;Walker N;Stewart J;Delport C;Jolliffe DA;Nuttall J;Coussens AK;Naude CE;Tang JCY;Fraser WD;Wilkinson RJ;Bekker LG;Martineau AR
• 通讯作者: Martineau AR