Effect of Vitamin D and Calcium on Bone in Pediatric HIV

维生素 D 和钙对 HIV 儿童骨骼的影响

• 批准号: 6668557
• 负责人: Stephen M Arpadi
• 金额: $ 55.47万
• 依托单位: ST. LUKE'S-ROOSEVELT INST FOR HLTH SCIS
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-09-30 至 2005-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6668557
• 关键词: 1,25 dihydroxycholecalciferol; AIDS therapy; HIV infections; adolescence (12-20); antiAIDS agent; antiviral agents; bone density; child (0-11); clinical research; clinical trials; dietary calcium; dietary supplements; drug adverse effect; human subject; interleukin 1; longitudinal human study; medical complication; normal ossification; nutrition related tag; outcomes research; pediatric AIDS; tumor necrosis factor alpha; vitamin D; vitamin deficiency; vitamin therapy

DESCRIPTION (provided by applicant): We have recently observed that HIV-infected children, living in an urban setting in the northeastern United States, have decreased bone mass compared to healthy children. As childhood and adolescence are the critical periods during life for skeletal development and, as it is widely recognized that optimal bone mass accretion during childhood and adolescence may prevent osteoporosis later in life, this observation has serious implications for future risk of osteoporosis and fractures in HIV-infected children. While Highly Active Antiretroviral Treatment (HAART) has been implicated in the etiology of the skeletal demineralization in adults, it remains possible that other factors important for skeletal health, such as vitamin D deficiency, could contribute to or exacerbate bone loss in HIV-infected children. In this regard, we have found that 50% of a small group of HIV-infected children have deficient or insufficient body stores of vitamin D, as measured by serum 25-hydroxyvitamin D levels below 20 ng/ml. The central hypotheses of this proposal are that the prevalence of vitamin D deficiency and insufficiency is increased in HIV-infected children receiving HAART and is related to the decreased bone mass observed in these children. We also hypothesize that supplementation with vitamin D and the recommended daily allowance of calcium will improve bone mineral accrual in these patients, as it does in healthy individuals. We will test these hypotheses in 1. a crosssectional study comparing HIV-infected and healthy children and adolescents with respect to relationships between HIV-infection, vitamin D status, and bone mass, and in 2. a two-year randomized, controlled clinical trial in which the effects of vitamin D and calcium supplementation on bone mass accrual are compared to placebo in HIV-infected children and adolescents.

描述（由申请人提供）：我们最近观察到，与健康儿童相比，居住在美国东北部城市环境中的HIV感染儿童骨量减少了。由于童年和青春期是骨骼发育生命中的关键时期，而且人们广泛认为，儿童和青春期期间的最佳骨质量积聚可能会阻止生活后期的骨质疏松症，因此这种观察对HIV感染儿童的骨质疏松和分裂的未来风险具有严重的影响。尽管高度活跃的抗逆转录病毒治疗（HAART）与成人骨骼脱矿化的病因有关，但对于骨骼健康的其他因素（例如维生素D缺乏症）仍然有可能导致或加剧HIV感染儿童的骨质损失或加剧。在这方面，我们发现，通过血清25-羟基维生素D水平低于20 ng/mL的血清测量，一小组HIV感染的儿童中有50％的维生素D缺乏或不足。该提案的中心假设是，接受HAART的HIV感染儿童的维生素D缺乏症和不足的患病率与这些儿童观察到的骨骼质量降低有关。我们还假设补充维生素D和建议的每日钙津贴将像健康个体一样改善这些患者的骨矿物质应计。我们将在1中检验这些假设。与HIV感染，维生素D状态和骨骼质量之间的关系进行比较，将HIV感染和健康的儿童和青少年进行比较。在2个。一项为期两年的随机，对照临床试验中，其中维生素D和钙补充对群质量的儿童的影响与bote骨的效果相比。