Vitamin D Supplementation during Infancy Is Associated with Higher Bone Mineral Mass in Prepubertal Girls

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Abstract
The objective of this study was to determine whether vitamin D supplementation of breast-fed infants during the first year of life is associated with greater bone mineral content and/or areal bone mineral density (aBMD) in later childhood. The design was a ret- rospective cohort study. One hundred and six healthy prepubertal Caucasian girls (median age, 8 yr; range, 7-9 yr) were classified as vitamin D supplemented or unsupplemented during the first year of life on the basis of a questionnaire sent to participating families and their pediatricians. Bone area (square centimeters) and bone mineral content (grams) were determined by dual energy x-ray absorptiometry at six skeletal sites. Vitamin D receptor (VDR) 39-gene polymorphisms (BsmI) were also determined. The supple- mented (n 5 91) and unsupplemented (n 5 15) groups were similar in terms of season of birth, growth in the first year of life, age, anthropometric parameters, and calcium intake at time of dual energy x-ray absorptiometry. The supplemented group had higher aBMD at the level of radial metaphysis (mean 6 SEM, 0.301 6 0.003 vs. 0.283 6 0.008; P 5 0.03), femoral neck (0.638 6 0.007 vs. 0.584 6 0.021; P 5 0.01), and femoral trochanter (0.508 6 0.006 vs. 0.474 6 0.016; P 5 0.04). At the lumbar spine level aBMD values were similar (0.626 6 0.006 vs. 0.598 6 0.019; P 5 0.1). In a multiple regression model taking into account the effects of vitamin D sup- plementation, height, and VDR genotype on aBMD (dependent variable), femoral neck aBMD remained higher by 0.045 g/cm2 in the supplemented group (P 5 0.02).Vitamin D supplementation in infancy was found to be associated with increased aBMD at specific skeletal sites later in childhood in prepubertal Caucasian girls. (J Clin Endocrinol Metab 84: 4541- 4544, 1999)

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