title: Effect of high-dose cholecalciferol (vitamin D3) on bone and body composition in children and young adults with HIV infection: a randomized, double-blind, placebo-controlled trial.
abstract: It is unknown whether vitamin D supplementation positively impacts body composition and bone outcomes in children and young adults with HIV. This RCT found that despite increasing 25(OH)D concentrations, high dose vitamin D3supplementation did not impact bone or body composition in children and young adults with HIV infection.
  
  
  
  The objective of this paper was to determine the impact of high-dose daily cholecalciferol (vitamin D3) supplementation on body composition and bone density, structure, and strength in children and young adults with perinatally acquired (PHIV) or behaviorally acquired (BHIV) HIV infection.
  
  
  
  Participants were randomized to receive vitamin D3supplementation (7000 IU/day) or placebo for 12 months. Serum 25-hydroxyvitamin D [25(OH)D] concentrations, dual energy X-ray absorptiometry (DXA) of the whole body and lumbar spine, and peripheral quantitative computed tomography (pQCT) of tibia sites were acquired at 0, 6, and 12 months. DXA and pQCT outcomes were expressed as sex- and population-ancestry specific Z-scores relative to age and adjusted for height or tibia length, as appropriate.
  
  
  
  Fifty-eight participants (5.0 to 24.9 years) received vitamin D3supplements (n = 30) or placebo (n = 28). At enrollment, groups were similar in age, sex, population ancestry, growth status, serum 25(OH)D concentrations, body composition, and size-adjusted bone measures. Median 25(OH)D concentrations were similar (17.3 ng/mL in the vitamin D3supplementation group vs 15.6 ng/mL in the placebo group), and both groups had mild bone deficits. At 12 months, 25(OH)D rose significantly in the vitamin D supplementation group but not in the placebo group (26.4 vs 14.8 ng/mL, respectively, p < 0.008). After adjusting for population ancestry, sex, antiretroviral therapy use, and season, there were no significant treatment group differences in bone or body composition outcomes.
  
  
  
  Despite increasing 25(OH)D concentrations, 12 months of high-dose vitamin D3supplementation did not impact bone or body composition in children and young adults with HIV infection.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, 3535 Market St, Room no. 1560, Philadelphia, PA, 19103, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Rovner
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, 3535 Market St, Room no. 1560, Philadelphia, PA, 19103, USA.
authors.forename: V A
authors.initials: VA
authors.lastname: Stallings
authors.affiliation: General Pediatrics, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Rutstein
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, 3535 Market St, Room no. 1560, Philadelphia, PA, 19103, USA.
authors.forename: J I
authors.initials: JI
authors.lastname: Schall
authors.affiliation: Division of Nephrology, Stanford University, Stanford, CA, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Leonard
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, 3535 Market St, Room no. 1560, Philadelphia, PA, 19103, USA. zemel@email.chop.edu.
authors.forename: B S
authors.initials: BS
authors.lastname: Zemel
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D001823:Body Composition / Q000187:drug effects*; D015519:Bone Density / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D002762:Cholecalciferol / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D019587:Dietary Supplements; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology / Q000821:virology; D055815:Young Adult
chemical_list: D014807:Vitamin D; D002762:Cholecalciferol; C104450:25-hydroxyvitamin D
keywords: Cholecalciferol; Dual energy X-ray absorptiometry; HIV; Peripheral quantitative computed tomography