Vitamin D Clinical Trial
Official title:
Are Bone, Nutritional and Cardiovascular Status of French Children and Adolescents, Correlated With Their Vitamin D Status?
Vitamin D is not seen anymore only as a phosphocalcic hormone, but also as having an effect
on global health (anti-infective, anti-inflammatory, anti-tumour roles and cardiovascular
protection).
The link between vitamin D deficiency and osteomalacia lesions is well-known. In paediatrics,
systematic vitamin D supplementation of infants and toddlers, associated with milk
enrichment, has allowed an almost total disappearance of rickets. Vitamin D repletion was
defined as the minimal concentration that enables the prevention of rickets in children and
osteomalacia in adults, that is approximately 8 ng/mL (20 nmol/L). However, in 2010, most of
the international experts agreed to set minimal threshold of 25 OH vitamin D serum
concentration, higher than the one previously admitted, with a limit of 20 ng/mL (50 nmol/L)
to define a vitamin D deficiency and a limit of 30 ng/mL (75 nmol/L) to define vitamin D
insufficiency in adults. In the paediatric population, the consensus is less obvious and we
consider that a serum concentration of minimum 20 ng/mL is necessary.
A study on more than 200 children from Lyon, followed in the paediatric nephrology unit and
having a renal function normal or sub-normal, demonstrated an important prevalence of vitamin
D deficiency (75%) in adolescents and pre-adolescents.
Concurrently, the appearance of new bone imaging techniques (especially high-resolution
peripheral quantitative computed tomography HR-pQCT) improved bone status evaluation in a
non-invasive manner.
Given the new pathophysiological data on pleiotropic role of vitamin D (bone, cardiovascular
system, adipose tissue) and given the proportion of French children possibly suffering from
vitamin D deficiency, it seems urgent to actualize current recommendations regarding
systematic supplementation in vitamin D. This transversal study on 200 healthy children and
adolescents will allow to have an overview of vitamin D status in French healthy children and
adolescents, studying with non-invasive, safe, reliable and innovative tools, the theoretical
targets of vitamin D (bones, cardiovascular system and nutritional status); and then to lay
the foundations of therapeutic trials aiming to evaluate the mode of vitamin D
supplementation for healthy children and adolescents; while having a cohort for HR-pQCT
measurements, that will allow us to have French reference range in a 10-17 year-old
population, for this innovative, non-invasive and low radiation exposure technique.
To study the correlation between bone assessment by high-resolution peripheral quantitative computed tomography (HR-pQCT) and vitamin D serum concentration. ;
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