title: Enhanced effect of zinc and calcium supplementation on bone status in growth hormone-deficient children treated with growth hormone: a pilot randomized controlled trial.
abstract: Reduced bone mineral content in growth hormone-deficient children (GHD) has been reported. Calcium, zinc, and vitamin D play an important role in bone formation. Hence, the aim of this pilot randomized controlled study was to evaluate the effect of calcium, vitamin D, and zinc supplementation in prepubertal GHD children treated with GH on bone health parameters. After 1 year of treatment with GH (20 mg/m(2)/week), 31 GHD (mean age 8.7 ± 2.8 years, 18 boys) prepubertal children were randomised to receive calcium (500 mg/day) and vitamin D (60,000 IU/3 months) [Group A] or a similar supplement of calcium, vitamin D, and zinc (as per Indian Recommended Allowance) [Group B] along with GH therapy for the next 12 months. The two groups were similar in anthropometric and body composition parameters at baseline (p > 0.1). After 1 year of GH therapy, height-adjusted % gain was similar in both groups, 48 % in bone mineral content (BMC) and 45 % in bone area (BA). Height-adjusted % increase in BMC was significantly (p < 0.05) higher in the second year than in the first in both the groups. This % increase in BMC and BA was greater in Group B (51 and 36 % respectively) than in Group A (49 and 34 %), although marginally (p < 0.05). Supplementation of calcium and vitamin D along with GH therapy in GHD Indian children has the potential for enhancing bone mass accrual; this effect was further enhanced through the addition of zinc supplement.
authors.affiliation: Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
authors.forename: Veena
authors.initials: V
authors.lastname: Ekbote
authors.forename: Anuradha
authors.initials: A
authors.lastname: Khadilkar
authors.forename: Shashi
authors.initials: S
authors.lastname: Chiplonkar
authors.forename: Zulf
authors.initials: Z
authors.lastname: Mughal
authors.forename: Vaman
authors.initials: V
authors.lastname: Khadilkar
mesh_terms: D001823:Body Composition / Q000187:drug effects; D001827:Body Height / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects*; D002118:Calcium / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D019587:Dietary Supplements; D005260:Female; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy*; D008297:Male; D010865:Pilot Projects; D016896:Treatment Outcome; D014807:Vitamin D / Q000494:pharmacology* / Q000627:therapeutic use; D015032:Zinc / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D019382:Human Growth Hormone; D014807:Vitamin D; D015032:Zinc; D002118:Calcium