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This version published online on November 8, 2005
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2005-1436
A more recent version of this article appeared on February 1, 2006
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*CALCIUM COMPOUNDS
*CALCIUM, ELEMENTAL
*PHOSPHORUS

Submitted on June 29, 2005
Accepted on October 28, 2005

EFFECT OF VITAMIN D REPLACEMENT ON MUSCULOSKELETAL PARAMETERS IN SCHOOL CHILDREN: A RANDOMIZED CONTROLLED TRIAL

Ghada El-Hajj Fuleihan MD, MPH*, Mona Nabulsi MD, Hala Tamim PhD, Joyce Maalouf BS, Mariana Salamoun BS, BA, Hassan Khalife MD, Mahmoud Choucair MD, Asma Arabi MD, and Reinhold Vieth PhD

Calcium Metabolism and Osteoporosis Program, Department of Medicine, Department of Pediatrics, School of Health Sciences, American University of Beirut, Lebanon; Mt Sinai Hospital, Toronto University, Ontario, Canada

* To whom correspondence should be addressed. E-mail: gf01{at}aub.edu.lb.

Background: Despite the high prevalence of hypovitaminosis D in children and adolescents worldwide, the impact of vitamin D deficiency on skeletal health is unclear.

Methods: 179 girls, ages 10-17 yr, were randomly assigned to receive weekly oral vitamin D doses of 1400 IU (equivalent of 200 IU/day) or 14000 IU (equivalent of 2000 IU/day) in a double blind placebo-controlled 1-year protocol. Areal bone mineral density (BMD), bone mineral content (BMC) at the lumbar spine (LS), hip, forearm, total body, and body composition were measured at baseline and one year. Serum calcium (S-Ca), phosphorus (S-PO4), alkaline phosphatase (S-ALKP) and vitamin D metabolites were measured during the study.

Results: In the overall group of girls, lean mass increased significantly in both treatment groups (P ≤ 0.05), bone area and total hip BMC increased in the high-dose group (P < 0.02). In pre-menarcheal girls, lean mass increased significantly in both treatment groups, and there were consistent trends for increments in BMD and/or BMC at several skeletal sites, reaching significance at lumbar spine BMD in the low-dose group, and at the trochanter BMC in both treatment groups. There was no significant change in lean mass, BMD or BMC in post-menarcheal girls.

Conclusions: Vitamin D replacement had a positive impact on musculoskeletal parameters in girls, especially during the pre-menarcheal period.
Key words: Hypovitaminosis D • bone mineral density and content • lean mass • puberty • randomized trial




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