Effect of Vitamin D3 Supplementation in Black and in White Children: A Randomized, Placebo-Controlled Trial

Abstract

Context: Dosages of vitamin D necessary to prevent or treat vitamin D deficiency in children remain to be clarified.

Objective: To determine the effects of vitamin D3 1000 IU/d on serum 25-hydroxyvitamin D [25(OH)D], PTH, and markers of bone turnover (osteocalcin and collagen type 1 cross-linked C-telopeptide) in black children and white children, and to explore whether there is a threshold level of 25(OH)D associated with maximal suppression of serum PTH concentration.

Design: Healthy 8- to 14-year-old Pittsburgh-area black (n = 84) and white (n = 73) children not receiving vitamin supplements, enrolled from October through March from 2008 through 2011, were randomized to vitamin D3 1000 IU or placebo daily for 6 months.

Results: The mean baseline concentration of 25(OH)D was <20 ng/mL in both the vitamin D-supplemented group and the placebo group (19.8 ± 7.6 and 18.8 ± 6.9 ng/mL, respectively). The mean concentration was higher in the supplemented group than in the placebo group at 2 months (26.4 ± 8.1 vs 18.9 ± 8.1 ng/mL; P < .0001) and also at 6 months (26.7 ± 7.6 vs 22.4 ± 7.3; P = .003), after adjusting for baseline 25(OH)D, race, gender, pubertal status, dietary vitamin D intake, body mass index, and sunlight exposure. Increases were only significant in black children, when examined by race. The association between 25(OH)D and PTH concentrations was inverse and linear, without evidence of a plateau. Overall, vitamin D supplementation had no effect on PTH and bone turnover.

Conclusions: Vitamin D3 supplementation with 1000 IU/d in children with mean baseline 25(OH)D concentration <20 ng/mL effectively raised their mean 25(OH)D concentration to ≥20 ng/mL but failed to reach 30 ng/mL. Vitamin D supplementation had no effect on PTH concentrations.

Figure 1.

Enrollment, randomization, and follow-up of study participants

Figure 2.

25(OH)D-PTH associations. A, Scatter plot shows combined cross-sectional, between-children data concerning the association between 25(OH)D and PTH concentrations across all time points in all subjects. The solid line constitutes the linear regression line, and the dotted lines indicate its 95% confidence interval (CI). The bold solid line depicts the Lowess (locally weighted scatterplot smoothing) curve. B, Scatter plot of the between-children association between 25(OH)D and PTH in black children with the liner regression line and the fitted Lowess smoother line. C, Scatter plot of the between-children association between 25(OH)D and PTH in white children with the liner regression line and the fitted Lowess smoother line.