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Percent true calcium absorption, mineral metabolism, and bone mineralization in children with cystic fibrosis: effect of supplementation with vitamin D and calcium.
Pediatr Pulmonol 2008; 43(8):772-80PP

Abstract

OBJECTIVE

To assess whether percent true calcium absorption (alpha) is normal in children with cystic fibrosis (CF) and to assess whether supplementation with 2,000 IU vitamin D(3), 1 g calcium, or both will alter alpha, mineral metabolism, and/or bone mass in children with CF.

STUDY DESIGN

Fifteen children ages 7-13 were randomly assigned to one of four different orders to receive all four 6-month treatments including placebos. Change in 25-hydroxyvitamin D (25-OHD), 1,25-dihydroxyvitamin D (1,25(OH)(2)D), PTH, bone turnover markers, and minerals after 6 months, and bone mineral content (Hologic 1000W) after 9 months was measured. alpha was measured by a dual stable isotope method using (48)Ca intravenously and (46)Ca orally and measuring (48)Ca, (46)Ca, and (42)Ca in a 24-hr urine using High Resolution Inductively Coupled Mass Spectroscopy (HR-ICP-MS). Analysis used Wilcoxon Sign Ranks.

RESULTS

alpha was in the normal range and did not differ by treatment (P 35 +/- 10%, Ca 38 +/- 23%, D 36 +/- 11%, D + Ca 46 +/- 21%). One gram calcium did not increase serum or urine calcium. Two thousand IU D(3) did not increase 25-OHD or change 1,25(OH)(2)D. Serum and urine minerals, markers of bone turnover and bone mineral gains did not differ by treatment.

CONCLUSIONS

alpha is normal in children with CF. One gram calcium and/or 2,000 IU D(3) does not change alpha or increase 25-OHD, serum calcium, or mineralization. Longer trials of a significantly higher dose of vitamin D(3) shown to increase serum 25-OHD are needed to assess effects on mineral metabolism and bone mass accrual. However, study of therapeutic options other than calcium and vitamin D should be encouraged.

Authors+Show Affiliations

Department of Child Health, University of Missouri, Columbia, Missouri 65212, USA. hillmanl@health.missouri.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18615666

Citation

Hillman, Laura S., et al. "Percent True Calcium Absorption, Mineral Metabolism, and Bone Mineralization in Children With Cystic Fibrosis: Effect of Supplementation With Vitamin D and Calcium." Pediatric Pulmonology, vol. 43, no. 8, 2008, pp. 772-80.
Hillman LS, Cassidy JT, Popescu MF, et al. Percent true calcium absorption, mineral metabolism, and bone mineralization in children with cystic fibrosis: effect of supplementation with vitamin D and calcium. Pediatr Pulmonol. 2008;43(8):772-80.
Hillman, L. S., Cassidy, J. T., Popescu, M. F., Hewett, J. E., Kyger, J., & Robertson, J. D. (2008). Percent true calcium absorption, mineral metabolism, and bone mineralization in children with cystic fibrosis: effect of supplementation with vitamin D and calcium. Pediatric Pulmonology, 43(8), pp. 772-80. doi:10.1002/ppul.20863.
Hillman LS, et al. Percent True Calcium Absorption, Mineral Metabolism, and Bone Mineralization in Children With Cystic Fibrosis: Effect of Supplementation With Vitamin D and Calcium. Pediatr Pulmonol. 2008;43(8):772-80. PubMed PMID: 18615666.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Percent true calcium absorption, mineral metabolism, and bone mineralization in children with cystic fibrosis: effect of supplementation with vitamin D and calcium. AU - Hillman,Laura S, AU - Cassidy,James T, AU - Popescu,Mihaela F, AU - Hewett,John E, AU - Kyger,Joseph, AU - Robertson,J David, PY - 2008/7/11/pubmed PY - 2008/10/22/medline PY - 2008/7/11/entrez SP - 772 EP - 80 JF - Pediatric pulmonology JO - Pediatr. Pulmonol. VL - 43 IS - 8 N2 - OBJECTIVE: To assess whether percent true calcium absorption (alpha) is normal in children with cystic fibrosis (CF) and to assess whether supplementation with 2,000 IU vitamin D(3), 1 g calcium, or both will alter alpha, mineral metabolism, and/or bone mass in children with CF. STUDY DESIGN: Fifteen children ages 7-13 were randomly assigned to one of four different orders to receive all four 6-month treatments including placebos. Change in 25-hydroxyvitamin D (25-OHD), 1,25-dihydroxyvitamin D (1,25(OH)(2)D), PTH, bone turnover markers, and minerals after 6 months, and bone mineral content (Hologic 1000W) after 9 months was measured. alpha was measured by a dual stable isotope method using (48)Ca intravenously and (46)Ca orally and measuring (48)Ca, (46)Ca, and (42)Ca in a 24-hr urine using High Resolution Inductively Coupled Mass Spectroscopy (HR-ICP-MS). Analysis used Wilcoxon Sign Ranks. RESULTS: alpha was in the normal range and did not differ by treatment (P 35 +/- 10%, Ca 38 +/- 23%, D 36 +/- 11%, D + Ca 46 +/- 21%). One gram calcium did not increase serum or urine calcium. Two thousand IU D(3) did not increase 25-OHD or change 1,25(OH)(2)D. Serum and urine minerals, markers of bone turnover and bone mineral gains did not differ by treatment. CONCLUSIONS: alpha is normal in children with CF. One gram calcium and/or 2,000 IU D(3) does not change alpha or increase 25-OHD, serum calcium, or mineralization. Longer trials of a significantly higher dose of vitamin D(3) shown to increase serum 25-OHD are needed to assess effects on mineral metabolism and bone mass accrual. However, study of therapeutic options other than calcium and vitamin D should be encouraged. SN - 1099-0496 UR - https://www.unboundmedicine.com/medline/citation/18615666/Percent_true_calcium_absorption_mineral_metabolism_and_bone_mineralization_in_children_with_cystic_fibrosis:_effect_of_supplementation_with_vitamin_D_and_calcium_ L2 - https://doi.org/10.1002/ppul.20863 DB - PRIME DP - Unbound Medicine ER -