The effect of vitamin D supplementation and nutritional intake on skeletal maturity and bone health in socio-economically deprived children.
Bone health
Growth
Malnutrition
Radiographs
Short stature
Vitamin D
Journal
European journal of nutrition
ISSN: 1436-6215
Titre abrégé: Eur J Nutr
Pays: Germany
ID NLM: 100888704
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
08
06
2020
accepted:
05
02
2021
pubmed:
22
2
2021
medline:
13
8
2021
entrez:
21
2
2021
Statut:
ppublish
Résumé
1. To determine the effect of vitamin D supplementation on bone age (BA), a marker of skeletal maturity, and Bone Health Index (BHI), a surrogate marker of bone density. 2. To characterise the differences in nutritional intake and anthropometry between children with advanced vs. delayed BA. The current study is a post hoc analysis of radiographs obtained as part of a randomised controlled trial. In this double-blind, placebo-controlled trial, deprived Afghan children (n = 3046) aged 1-11 months were randomised to receive six doses of oral placebo or vitamin D3 (100,000 IU) every 3 months for 18 months. Dietary intake was assessed through semi-quantitative food frequency questionnaires at two time points. Anthropometric measurements were undertaken at baseline and 18 months. Serum 25OHD was measured at five time points on a random subset of 632 children. Knee and wrist radiographs were obtained from a random subset (n = 641), of which 565 wrist radiographs were digitised for post-hoc analysis of BA and BHI using BoneXpert version 3.1. Nearly 93% (522, male = 291) of the images were analysable. The placebo (n = 258) and vitamin D (n = 264) groups were comparable at baseline. The mean (± SD) age of the cohort was 2 (± 0.3) years. At study completion, there was no difference in mean 25-hydroxy vitamin D concentrations [47 (95% CI 41, 56) vs. 55 (95% CI 45, 57) nmol/L, p = 0.2], mean (± SD) BA SDS [- 1.04 (1.36) vs. - 1.14 (1.26) years, p = 0.3] or mean (± SD) BHI SDS [- 0.30 (0.86) vs. - 0.31 (0.80), p = 0.8] between the placebo and vitamin D groups, respectively. Children with advanced skeletal maturity (BA SDS ≥ 0) when compared to children with delayed skeletal maturity (BA SDS < 0), had consumed more calories [mean (± SD) calories 805 (± 346) vs 723 (± 327) kcal/day, respectively, p < 0.05], were significantly less stunted (height SDS - 1.43 vs. - 2.32, p < 0.001) and underweight (weight SDS - 0.82 vs. - 1.45, p < 0.001), with greater growth velocity (11.57 vs 10.47 cm/ year, p < 0.05). Deprived children have significant delay in skeletal maturation but no substantial impairment in bone health as assessed by BHI. BA delay was influenced by total calorie intake, but not bolus vitamin D supplementation.
Identifiants
pubmed: 33611615
doi: 10.1007/s00394-021-02511-5
pii: 10.1007/s00394-021-02511-5
pmc: PMC8354903
doi:
Substances chimiques
Vitamin D
1406-16-2
Cholecalciferol
1C6V77QF41
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
3343-3353Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Development Partnership in higher education
ID : 53
Organisme : Wellcome Trust
ID : 082476/Z/07/Z
Pays : United Kingdom
Informations de copyright
© 2021. Crown.
Références
Bhutta ZA, Berkley JA, Bandsma RHJ, Kerac M, Trehan I, Briend A (2017) Severe childhood malnutrition. Nat Rev Dis Prim 3:17067. https://doi.org/10.1038/nrdp.2017.67
doi: 10.1038/nrdp.2017.67
pubmed: 28933421
WHO (2020) World Health Organisation Global Database on Child Growth and Malnutrition Child growth indicators and their interpretation. https://www.who.int/nutgrowthdb/about/introduction/en/index2.html . Accessed 12 Sep 2020
Varkey S, Higgins-Steele A, Mashal T, Hamid BA, Bhutta ZA (2015) Afghanistan in transition: Call for investment in nutrition. Lancet Glob Heal 3:e13–e14. https://doi.org/10.1016/S2214-109X(14)70362-6
doi: 10.1016/S2214-109X(14)70362-6
UNICEF (2013) National nutrition survey Afghanistan (2013). UNICEF, New York
Walli NZ, Munubhi EK, Aboud S, Manji KP (2017) Vitamin D levels in malnourished children under 5 years in a tertiary care center at Muhimbili National Hospital, Dar es Salaam, Tanzania - a cross sectional study. J Trop Pediatr 63:203–209. https://doi.org/10.1093/tropej/fmw081
doi: 10.1093/tropej/fmw081
pubmed: 27794532
Mokhtar RR, Holick MF, Sempértegui F, Griffiths JK, Estrella B, Moore LL, Fox MP, Hamer DH (2018) Vitamin D status is associated with underweight and stunting in children aged 6–36 months residing in the Ecuadorian Andes. Public Health Nutr 21:1974–1985. https://doi.org/10.1017/S1368980017002816
doi: 10.1017/S1368980017002816
pubmed: 29162164
Dreizen S, Snodgrasse RM, Webbpeploe H, Spies TD (1957) The effect of prolonged nutritive failure on epiphyseal fusion in the human hand skeleton. Am J Roentgenol 78:461–470
Greulich W, Pyle S (1959) Radiographic atlas of skeletal development of the hand and wrist, 2nd edn. Stanford University Press, California
Tanner JM, Whitehouse RH, Cameron N, Marshall WA, Healy MJGH (1983) Assessment of Skeletal Maturity and Prediction of Adult Height (TW2 Method). Academic Press, London
Thodberg HH, Kreiborg S, Juul A, Pedersen KD (2009) The BoneXpert method for automated determination of skeletal maturity. IEEE Trans Med Imaging 28:52–66. https://doi.org/10.1109/TMI.2008.926067
doi: 10.1109/TMI.2008.926067
pubmed: 19116188
Schündeln MM, Marschke L, Bauer JJ, Hauffa PK, Schweiger B, Führer-Sakel D, Lahner H, Poeppel TD, Kiewert C, Hauffa BP, Grasemann C (2016) A piece of the puzzle: the bone health index of the bonexpert software reflects cortical bone mineral density in pediatric and adolescent patients. PLoS ONE 11:e0151936. https://doi.org/10.1371/journal.pone.0151936
doi: 10.1371/journal.pone.0151936
pubmed: 27014874
pmcid: 4807844
Neelis E, Rijnen N, Sluimer J, Olieman J, Rizopoulos D, Wijnen R, Rings E, de Koning B, Hulst J (2018) Bone health of children with intestinal failure measured by dual energy X-ray absorptiometry and digital X-ray radiogrammetry. Clin Nutr 37:687–694. https://doi.org/10.1016/j.clnu.2017.02.014
doi: 10.1016/j.clnu.2017.02.014
pubmed: 28274657
Thodberg HH, Van Rijn RR, Tanaka T, Martin DD, Kreiborg S (2010) A paediatric bone index derived by automated radiogrammetry. Osteoporos Int 21:1391–1400. https://doi.org/10.1007/s00198-009-1085-9
doi: 10.1007/s00198-009-1085-9
pubmed: 19937229
Thodberg HH, Thrane P, Martin DD (2019) Reference values of cortical thickness, bone width, and Bone Health Index in metacarpals of children from age 0 y, as determined with an extension of the fully automated BoneXpert bone age method. ICCBH. https://doi.org/10.1530/boneabs.7.P11
doi: 10.1530/boneabs.7.P11
Martorell R, Yarbrough C, Klein RE, Lechtig A (1979) Malnutrition, body size, and skeletal maturation : interrelationships and implications for catch-up growth. Hum Biol 51:371–389
pubmed: 230145
Afghanistan Network on Food Insecurity, Famine Early warning System Network (2005) Understanding malnutrition in Afghanistan. https://reliefweb.int/report/afghanistan/understanding-malnutrition-afghanistan . Accessed 12 Sep 2020
Manaseki-Holland S, Maroof Z, Bruce J, Mughal MZ, Masher MI, Bhutta ZA, Walraven G, Chandramohan D (2012) Effect on the incidence of pneumonia of vitamin D supplementation by quarterly bolus dose to infants in Kabul: A randomised controlled superiority trial. Lancet 379:1419–1427. https://doi.org/10.1016/S0140-6736(11)61650-4
doi: 10.1016/S0140-6736(11)61650-4
pubmed: 22494826
pmcid: 3348565
Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, Michigami T, Tiosano D, Mughal MZ, Mäkitie O, Ramos-Abad L, Ward L, Dimeglio LA, Atapattu N, Cassinelli H, Braegger C, Pettifor JM, Seth A, Idris HW, Bhatia V, Fu J, Goldberg G, Sävendahl L, Khadgawat R, Pludowski P, Maddock J, Hyppönen E, Oduwole A, Frew E, Aguiar M, Tulchinsky T, Butler G, Högler W (2016) Global consensus recommendations on prevention and management of nutritional rickets. Horm Res Paediatr 85:83–106. https://doi.org/10.1159/000443136
doi: 10.1159/000443136
pubmed: 26741135
Roe M, Pinchen H, Church S, Finglas P (2015) McCance and Widdowson’s the composition of foods seventh summary edition and updated composition of foods integrated dataset. Nutr Bull. https://doi.org/10.1111/nbu.12124
doi: 10.1111/nbu.12124
Prentics A (1995) Regional Variations in the Composition of Human Milk. In: Jensen RG (ed) Handbook of Milk Composition. Academic Press, London, pp 115–221
doi: 10.1016/B978-012384430-9/50012-3
World Health Organisation (2010) WHO anthro survey analyser. WHO, Geneva
Fischer PR, Pettifor JM, Lawson JO, Manaster BJ, Reading JC, Clinic M, Hani C, Hospital B, Africa S, City SL (2000) Radiographic scoring method for the assessment of the severity of nutritional rickets. J Trop Pediatr 46:132–139
doi: 10.1093/tropej/46.3.132
Ross AC, Manson JAE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA (2011) The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: What clinicians need to know. J Clin Endocrinol Metab 9:53–58. https://doi.org/10.1210/jc.2010-2704
doi: 10.1210/jc.2010-2704
Uday S, Högler W (2017) Nutritional rickets and osteomalacia in the twenty-first century: revised concepts, public health, and prevention strategies. Curr Osteoporos Rep 15:293–302. https://doi.org/10.1007/s11914-017-0383-y
doi: 10.1007/s11914-017-0383-y
pubmed: 28612338
pmcid: 5532418
Creo AL, Thacher TD, Pettifor JM, Strand MA, Fischer PR (2017) Nutritional rickets around the world: an update. Paediatr Int Child Health 37:84–98. https://doi.org/10.1080/20469047.2016.1248170
doi: 10.1080/20469047.2016.1248170
pubmed: 27922335
Uday S, Högler W (2018) Rickets and osteomalacia. In: Huhtaniem I, Martini L (eds) Reference module in biomedical sciences, 2nd edn. Elsevier Inc., Amsterdam
Kumar GT, Sachdev HS, Chellani H, Rehman AM, Singh V, Arora H, Filteau S (2011) Effect of weekly vitamin D supplements on mortality, morbidity, and growth of low birthweight term infants in India up to age 6 months: Randomised controlled trial. Br Med J 342:d2975. https://doi.org/10.1136/bmj.d2975
doi: 10.1136/bmj.d2975
Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P, Dubnov-Raz G, Esposito S, Ganmaa D, Ginde AA, Goodall EC, Grant CC, Griffiths CJ, Janssens W, Laaksi I, Manaseki-Holland S, Mauger D, Murdoch DR, Neale R, Rees JR, Simpson S, Stelmach I, Kumar GT, Urashima M, Camargo CA (2017) Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. Br Med J 356:i6583. https://doi.org/10.1136/bmj.i6583
doi: 10.1136/bmj.i6583
Kim R, Mejía-Guevara I, Corsi DJ, Aguayo VM, Subramanian SV (2017) Relative importance of 13 correlates of child stunting in South Asia: Insights from nationally representative data from Afghanistan, Bangladesh, India, Nepal, and Pakistan. Soc Sci Med 187:144–154. https://doi.org/10.1016/j.socscimed.2017.06.017
doi: 10.1016/j.socscimed.2017.06.017
pubmed: 28686964
Higgins-Steele A, Mustaphi P, Varkey S, Ludin H, Safi N, Bhutta ZA (2016) Stop stunting: Situation and way forward to improve maternal, child and adolescent nutrition in Afghanistan. Matern Child Nutr 12:237–241. https://doi.org/10.1111/mcn.12288
doi: 10.1111/mcn.12288
pubmed: 27187919
pmcid: 5084750
Lifshitz F (2009) Nutrition and growth. J Clin Res Pediatr Endocrinol 1:157–163. https://doi.org/10.4008/jcrpe.v1i4.39
doi: 10.4008/jcrpe.v1i4.39
pubmed: 21274290
Alvear J, Artaza C, Vial M, Guerrero S, Muzzo S (1986) Physical growth and bone age of survivors of protein energy malnutrition. Arch Dis Child 61:257–262. https://doi.org/10.1136/adc.61.3.257
doi: 10.1136/adc.61.3.257
pubmed: 3083790
pmcid: 1777696
Galasso E, Wagstaff A (2019) The aggregate income losses from childhood stunting and the returns to a nutrition intervention aimed at reducing stunting. Econ Hum Biol 34:225–238. https://doi.org/10.1016/j.ehb.2019.01.010
doi: 10.1016/j.ehb.2019.01.010
pubmed: 31003858
Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S, Webb P, Lartey A, Black RE (2013) Evidence-based interventions for improvement of maternal and child nutrition: What can be done and at what cost? Lancet 382:452–477. https://doi.org/10.1016/S0140-6736(13)60996-4
doi: 10.1016/S0140-6736(13)60996-4
pubmed: 23746776