title: Vitamin D supplementation and bone mass accrual in underprivileged adolescent Indian girls.
abstract: Vitamin D deficiency is common among children and adolescents in India, in spite of abundant sunshine. We conducted a pilot; double blind randomised controlled trial to investigate the effect of vitamin D supplementation on bone mineral content in underprivileged adolescent girls, in Pune, India. Fifty post-menarcheal girls aged 14 to 15 years were randomised to receive 300,000 IU (7.5 mg) of ergocalciferol or placebo orally, 4 times/year. All participants received 250 mg elemental calcium (calcium carbonate) daily. Outcome measures included change in serum 25-hydroxyvitamin D, size adjusted bone area and bone mineral content at total body and lumbar spine. Post supplementation, the median serum concentration of 25-hydroxyvitamin D was 75.2 (64.2-85.5) nmol/L in the intervention group and 28.1 (16.7-34.0) nmol/L in the placebo group. Increment in bone outcome measures was not different in the two groups. However, there was a positive effect of intervention in the size adjusted total body bone area (p<0.05), total body bone mineral content (p<0.05) and lumbar spine bone mineral content (p<0.05), and positive trend in lumbar spine bone area (p=0.07) in girls who were within 2 years of menarche. We conclude that vitamin D supplementation did not have a beneficial effect on skeletal mineralization in girls who were more than 2 years post menarcheal. However, there was a significant positive effect of the intervention on size adjusted total body and lumbar spine bone mineral content and a positive trend in lumbar spine bone area, in girls who were <= 2 years of menarche.
authors.affiliation: Hirabai Cowasji Jehangir Medical Research Institute, Jehangire Hosptial, Pune, India.
authors.forename: Anuradha V
authors.initials: AV
authors.lastname: Khadilkar
authors.forename: Mehmood G
authors.initials: MG
authors.lastname: Sayyad
authors.forename: Neha J
authors.initials: NJ
authors.lastname: Sanwalka
authors.forename: Dhanshari R
authors.initials: DR
authors.lastname: Bhandari
authors.forename: Sadanand
authors.initials: S
authors.lastname: Naik
authors.forename: Vaman V
authors.initials: VV
authors.lastname: Khadilkar
authors.forename: M Zulf
authors.initials: MZ
authors.lastname: Mughal
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000097:blood / Q000627:therapeutic use*; D016723:Bone Remodeling / Q000187:drug effects; D001842:Bone and Bones / Q000187:drug effects; D002119:Calcium Carbonate / Q000008:administration & dosage; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007194:India; D008159:Lumbar Vertebrae / Q000187:drug effects; D010865:Pilot Projects; D011203:Poverty; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood / Q000627:therapeutic use*
chemical_list: D015415:Biomarkers; D050071:Bone Density Conservation Agents; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002119:Calcium Carbonate