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Year : 2019  |  Volume : 23  |  Issue : 1  |  Page : 27-34

Effect of vitamin D supplementation on bone turnover markers in children and adolescents from North India

1 International Life Science-India, Lajpat Nagar, New Delhi, India
2 Department of Medicine and Endocrinology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
3 Department of Endocriology, Medanta Hospital, Gurgram, Haryana, India
4 Department of Endocriology, Sanjay Gandhi Postgraduate Institute, Lucknow, Uttar Pradesh, India
5 Department of Dermatology, All India Institute of Medical Sciences, New Delhi, India
6 Department of Medicine, Dr. B R Sur Homeopathic Medical College, New Delhi, India

Correspondence Address:
Raman K Marwaha
Flat No. 17, Gautam Apartments, Gautam Nagar, New Delhi - 110 049
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijem.IJEM_149_18

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Objectives: Vitamin D is known to play an important role in bone mineral metabolism. Its deficiency may affect growth and status of bone markers in children. Hence, we undertook to study the status of bone markers in children with vitamin D deficiency (VDD) and impact of vitamin D3 supplementation on them. Materials and Methods: Total 468 out of 615 children and adolescents with VDD, who were given either of the three doses (600, 1000, and 2000) of vitamin D supplementation, were included in the study. These 468 children with pre- and postsupplementation preserved samples with available anthropometry, serum biochemistry, 25-hydroxy-vitamin D, and parathormone were evaluated for bone formation (procollagen type 1 amino-terminal propeptide [P1NP]) and resorption (β-cross laps [CTx]) markers. Results: The mean age and body mass index of these children were 11.3 ± 2.3 years (boys: 11.5 ± 2.4; girls: 12.2 ± 1.2 years; P = 0.03) and 18.1 ± 3.8 kg/m2 (boys: 18.2 ± 3.9; girls: 17.6 ± 3.2 kg/m2; P = 0.208), respectively. There were 8.8% subjects with severe, 42.7% with moderate, and 48.5% with mild VDD. There was a significant decline in serum P1NP (from 691 ± 233 ng/ml to 640 ± 259 ng/ml, P < 0.001) and CTx (from 1.67 ± 0.53 ng/ml to 1.39 ± 0.51 ng/ml, P < 0.001) following supplementation. Though decline in serum P1NP and CTx levels was observed in both boys and girls, among all three supplementation groups and VDD categories, the effect was more marked in serum CTx than P1NP levels. Conclusions: Vitamin D supplementation in VDD children resulted in decrease in both bone formation (P1NP) and resorption (CTx). The impact, however, was more marked on bone resorption than bone formation.

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