Download PDF
Horm Metab Res 2023; 55(03): 191-195
DOI: 10.1055/a-2003-0124
Original Article: Endocrine Care

Optimal 25-OH-Vitamin D Level in Children Derived From Biochemical Parameters

David Gillis   *
1   Pediatrics, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
2   Faculty of Medicine, Hebrew University, Jerusalem, Israel
,
Ari Hefter   *
2   Faculty of Medicine, Hebrew University, Jerusalem, Israel
,
Shalom Edri
3   Department of Data Management, Clalit Health Services, Jerusalem, Israel
,
David Strich
2   Faculty of Medicine, Hebrew University, Jerusalem, Israel
4   Department of Pediatrics, Shaare Zedek Medical Center, Jerusalem, Israel
5   Pediatric Specialties Clinics, Clalit Health Services, Jerusalem, Israel
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Abstract

The aim of the study was to evaluate the bone-optimal pediatric levels of 25-hydroxy-vitamin D (25OHD) by testing the level at which 25OHD optimally effects calcium, phosphorus, and parathyroid hormone levels in a large population-based dataset. This was an observational retrospective “big-data” study. We analyzed 49 935 25OHD tests from children sampled in Clalit Health Services, Jerusalem district between 2009 and 2019. Associated data were available in the following number of samples: corrected calcium; 18 869, phosphorus: 1241, and PTH: 449. We tested correlations between each parameter and 25OHD, adjusting phosphorus levels by age using a “phosphorus index”. Pearson’s and Spearman’s correlation coefficients were calculated to determine the strength of the correlation between 25OHD and each parameter. There was a significant correlation between 25OHD levels and both PTH and calcium but not for the phosphorus index. The level at which increase in 25OHD continued to cause significant alteration was: for PTH up to 100 nmol/l (40 ng/ml), for corrected calcium it increased beyond 100 nmol/l. Increasing levels of 25OHD levels up to at least 100 nmol/l are associated with improvement in parameters known to be associated with increased bone mineralization. Therefore, one should aim for a 25OHD level of 100 nmo/l.

Key words

vitamin D - calcium - parathyroid hormone

* These authors have contributed equally to this work.




Publication History

Received: 14 September 2022

Accepted after revision: 21 December 2022

Accepted Manuscript online:
21 December 2022

Article published online:
16 February 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Pludowski P, Holick MF, Grant WB. et al. Vitamin D supplementation guidelines. J Steroid Biochem Mol Biol 2018; 175: 125-135
    CrossrefPubMedGoogle Scholar
  • 2 Rao YK, Midha T, Singh S. et al. Increment in vitamin D level and bone mineral accrual in children with vitamin D deficiency. Korean J Pediatr 2016; 59: 292-297
    CrossrefPubMedGoogle Scholar
  • 3 Sahota O, Mundey MK, San P. et al. The relationship between vitamin D and parathyroid hormone: calcium homeostasis, bone turnover, and bone mineral density in postmenopausal women with established osteoporosis. Bone 2004; 35: 312-319
    CrossrefPubMedGoogle Scholar
  • 4 Rajakumar K, Moore CG, Yabes J. et al. Effect of vitamin D3 supplementation in black and in white children: a randomized, placebo-controlled trial. J Clin Endocrinol Metab 2015; 100: 3183-3192
    CrossrefPubMedGoogle Scholar
  • 5 Hwang S, Choi HS, Kim KM. et al. Associations between serum 25-hydroxyvitamin D and bone mineral density and proximal femur geometry in Koreans: the Korean National Health and Nutrition Examination Survey (KNHANES) 2008–2009. Osteoporos Int 2015; 26: 163-171
    CrossrefPubMedGoogle Scholar
  • 6 Bischoff-Ferrari HA, Dietrich T, Orav EJ, Dawson-Hughes B. Vitamin D levels and bone mineral density: a population-based study of younger and older adults. Am J Med 2004; 116: 634-639
    CrossrefPubMedGoogle Scholar
  • 7 Priemel M, Von Domarus C, Klatte TO. et al. Bone mineralization defects and vitamin D deficiency: histomorphometric analysis of iliac crest bone biopsies and circulating 25-Hydroxyvitamin D in 675 patients. J Bone Miner Res 2010; 25: 305-312
    CrossrefPubMedGoogle Scholar
  • 8 Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357: 266-281
    CrossrefPubMedGoogle Scholar
  • 9 Adeli K, Higgins V, Trajcevski K. et al. The Canadian laboratory initiative on pediatric reference intervals: A CALIPER white paper. Crit Rev Clin Lab Sci 2017; 54: 358-413
    CrossrefPubMedGoogle Scholar
  • 10 Kang JI, Lee YS, Han YJ. et al. The serum level of 25-hydroxyvitamin D for maximal suppression of parathyroid hormone in children: the relationship between 25- hydroxyvitamin D and parathyroid hormone. Korean J Pediatr 2017; 60: 45-49
    CrossrefPubMedGoogle Scholar
  • 11 Shaikh AMA, Abaalkhail B, Soliman A. et al. Prevalence of vitamin D deficiency and calcium homeostasis in saudi children. J Clin Res Pediatr Endocrinol 2016; 8: 461-467
    CrossrefPubMedGoogle Scholar
  • 12 Lewis RD, Laing EM, Hill Gallant KM. et al. A randomized trial of vitamin D3 supplementation in children: dose-response effects on vitamin D metabolites and calcium absorption. J Clin Endocrinol Metab 2013; 98: 4816-4825
    CrossrefPubMedGoogle Scholar
  • 13 Selby PL, Davles M, Marks JS. et al. Vitamin D intoxication causes hypercalcaemia by increased bone resorption which responds to pamidronate. Clin Endocrinol (Oxf) 1995; 531-536
    CrossrefPubMedGoogle Scholar
  • 14 Sahin ON, Serdar M, Serteser M. et al. Vitamin D levels and parathyroid hormone variations of children living in a subtropical climate: a data mining study. Ital J Pediatr 2018; 44: 1-7
    CrossrefPubMedGoogle Scholar
  • 15 Sulimani RA, Mohammed AG, Alfadda AA. et al. Vitamin D deficiency and biochemical variations among urban Saudi adolescent girls according to season. Saudi Med J 2016; 37: 1002-1008
    CrossrefPubMedGoogle Scholar
  • 16 Patel P, Zulf Mughal M, Patel P. et al. Dietary calcium intake influences the relationship between serum 25-hydroxyvitamin D3 (25OHD) concentration and parathyroid hormone (PTH) concentration. Arch Dis Child 2016; 101: 316-319
    CrossrefPubMedGoogle Scholar
  • 17 Abrams SA, Griffin IJ, Hawthorne KM. et al. Relationships among vitamin D levels, parathyroid hormone, and calcium absorption in young adolescents. J Clin Endocrinol Metab 2005; 90: 5576-5581
    CrossrefPubMedGoogle Scholar
  • 18 Chen RA, Goodman WG. Role of the calcium-sensing receptor in parathyroid gland physiology. Am J Physiol. Ren Physiol 2004; 286: 1005-1011
    CrossrefPubMedGoogle Scholar
  • 19 Abate EG, Clarke BL. Review of hypoparathyroidism. Front Endocrinol (Lausanne) 2017; 7: 1-7
    CrossrefPubMedGoogle Scholar
  • 20 Atapattu N, Shaw N, Högler W. Relationship between serum 25-hydroxyvitamin D and parathyroid hormone in the search for a biochemical definition of vitamin D deficiency in children. Pediatr Res 2013; 74: 552-556
    CrossrefPubMedGoogle Scholar