title: Effect of high-dose vitamin D supplementation on bone density in youth with osteogenesis imperfecta: A randomized controlled trial.
abstract: Osteogenesis imperfecta (OI) is a heritable condition characterized by fragile bones. Our previous studies indicated that serum 25-hydroxyvitamin D (25OHD) concentrations were positively associated with lumbar spine areal bone mineral density (LS-aBMD) in children and adolescents with OI. Here we assessed whether one year of high-dose vitamin D supplementation results in higher LS-aBMD z-scores in youth with OI. A one-year double-blind randomized controlled trial conducted at a pediatric orthopedic hospital in Montreal, Canada. Sixty patients (age: 6.0 to 18.9years; 35 female) were randomized in equal numbers to receive either 400 or 2000international units (IU) of vitamin D, stratified according to baseline bisphosphonate treatment status and pubertal stage. At baseline, the average serum 25OHD concentration was 65.6nmol/L (SD 20.4) with no difference between treatment groups (p=0.77); 21% of patients had results <50nmol/L. Vitamin D supplementation was associated with higher serum 25OHD concentrations in 90% of participants. The increase in mean 25OHD was significantly higher (p=0.02) in the group receiving 2000IU of vitamin D (mean [95% CI]=30.5nmol/L [21.3; 39.6]) than in the group receiving 400IU (15.2nmol/L [6.4; 24.1]). No significant differences in LS-aBMD z-score changes were detected between treatment groups. Thus, supplementation with vitamin D at 2000IU increased serum 25OHD concentrations in children with OI more than supplementation with 400IU. However, in this study where about 80% of participants had baseline serum 25OHD concentrations ≥50nmol/L, this difference had no detectable effect on LS-aBMD z-scores.
authors.affiliation: Shriners Hospital for Children and McGill University, Montreal, Canada; School of Dietetics and Human Nutrition, McGill University, Montreal, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Plante
authors.affiliation: Shriners Hospital for Children and McGill University, Montreal, Canada.
authors.forename: Louis-Nicolas
authors.initials: LN
authors.lastname: Veilleux
authors.affiliation: Shriners Hospital for Children and McGill University, Montreal, Canada.
authors.forename: Francis H
authors.initials: FH
authors.lastname: Glorieux
authors.affiliation: School of Dietetics and Human Nutrition, McGill University, Montreal, Canada.
authors.forename: Hope
authors.initials: H
authors.lastname: Weiler
authors.affiliation: Shriners Hospital for Children and McGill University, Montreal, Canada. Electronic address: frauch@shriners.mcgill.ca.
authors.forename: Frank
authors.initials: F
authors.lastname: Rauch
mesh_terms: D000293:Adolescent; D000328:Adult; D015519:Bone Density / Q000187:drug effects; D002648:Child; D002762:Cholecalciferol / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D010013:Osteogenesis Imperfecta / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D055815:Young Adult
chemical_list: D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D
keywords: Bone mineral density; Collagen type I; Osteogenesis imperfecta; Vitamin D