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The impact of vitamin D supplementation on musculoskeletal health outcomes in children, adolescents, and young adults living with HIV: A systematic review
- Source :
- PLoS ONE, PLoS ONE, Vol 13, Iss 11, p e0207022 (2018)
- Publication Year :
- 2018
- Publisher :
- Public Library of Science, 2018.
-
Abstract
- Objective:HIV-positive children, adolescents, and young adults are at increased risk poor musculoskeletal outcomes. Increased incidence of vitamin D deficiency in youth living with HIV may further adversely affect musculoskeletal health. We investigated the impact of vitamin D supplementation on a range of musculoskeletal outcomes among individuals aged 0–25 years living with HIV.Methods:A systematic review was conducted using databases: PubMed/Medline, CINAHL, Web of Knowledge, and EMBASE. Interventional randomised control trials, quasi-experimental trials, and previous systematic reviews/meta-analyses were included. Outcomes included: BMD, BMC, fracture incidence, muscle strength, linear growth (height-for-age Z-score [HAZ]), and biochemical/endocrine biomarkers including bone turnover markers.Results:Of 497 records, 20 studies met inclusion criteria. Thirteen studies were conducted in North America, one in Asia, two in Europe, and four in Sub-Saharan Africa. High-dose vitamin D supplementation regimens (1,000–7,000 IU/day) were successful in achieving serum 25-hydroxyvitamin-D (25OHD) concentrations above study-defined thresholds. No improvements were observed in BMD, BMC, or in muscle power, force and strength; however, improvements in neuromuscular motor skills were demonstrated. HAZ was unaffected by low-dose (200–400 IU/day) supplementation. A single study found positive effects on HAZ with high-dose supplementation (7,000 vs 4,000IU/day).Conclusions:Measured bone outcomes were unaffected by high-dose vitamin D supplementation, even when target 25OHD measurements were achieved. This may be due to: insufficient sample size, follow-up, intermittent dosing, non-standardised definitions of vitamin D deficiency, or heterogeneity of enrolment criteria pertaining to baseline vitamin D concentration. High-dose vitamin D may improve HAZ and neuromuscular motor skills. Adequately powered trials are needed in settings where HIV burden is greatest.
- Subjects :
- RNA viruses
Databases, Factual
lcsh:Medicine
Organic chemistry
HIV Infections
Pathology and Laboratory Medicine
Biochemistry
Database and Informatics Methods
Immunodeficiency Viruses
Bone Density
Medicine and Health Sciences
Public and Occupational Health
Vitamin D
Database Searching
lcsh:Science
Randomized Controlled Trials as Topic
Vitamins
Vaccination and Immunization
Physical sciences
Chemistry
Nutritional deficiencies
Medical Microbiology
Connective Tissue
Viral Pathogens
Viruses
Pathogens
Anatomy
Research Article
Bone and Mineral Metabolism
Immunology
Antiretroviral Therapy
Research and Analysis Methods
Microbiology
Chemical compounds
Antiviral Therapy
Organic compounds
Retroviruses
Humans
Muscle Strength
Bone
Microbial Pathogens
Nutrition
Vitamin D deficiency
lcsh:R
Lentivirus
Organisms
Biology and Life Sciences
HIV
Biological Tissue
Metabolism
Dietary Supplements
lcsh:Q
Preventive Medicine
Biomarkers
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 13
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.pmid.dedup....d02db3fb7bdb664d6702fd7abe8b3a65