Serum 25-Hydroxyvitamin D, Osteocalcin, and Parathormone Status in Children with Meningomyelocele

Abstract

Sufficient vitamin D levels are required for normal skeletal development and mineralization. This is particularly important in children with meningomyelocele who are at an increased risk of osteoporosis. The purpose of this study was to assess serum 25-hydroxyvitamin D [25(OH)D] and the biochemical markers of bone metabolism (parathormone, osteocalcin, alkaline phosphatase, and electrolytes) in children with meningomyelocele. The patient group comprised 33 children with meningomyelocele. The mean 25(OH)D was 11.51 ± 7.87 ng/mL. A total of 97% of the subjects had a 25(OH)D level in the insufficient range ( < 30 ng/mL) and 48.5% had a 25(OH)D level less than 10 ng/mL. Almost all patients had serum osteocalcin and phosphorus concentrations above the normal limits. The level of 25(OH)D negatively correlated with age and body weight. There were no correlations between the biochemical markers of bone metabolism and the ambulatory status. A significant correlation between serum 25(OH)D and osteoporosis was found.

Keywords

25-hydroxyvitamin D - osteocalcin - meningomyelocele

• References

• 1 Grant WB. Epidemiology of disease risks in relation to vitamin D insufficiency. Prog Biophys Mol Biol 2006; 92 (1) 65-79
• 2 Grant WB, Garland CF, Gorham ED. An estimate of cancer mortality rate reductions in Europe and the US with 1,000 IU of oral vitamin D per day. Recent Results Cancer Res 2007; 174: 225-234
• 3 Chagas CE, Borges MC, Martini LA, Rogero MM. Focus on vitamin D, inflammation and type 2 diabetes. Nutrients 2012; 4 (1) 52-67
• 4 Handel AE, Ramagopalan SV. Vitamin D and multiple sclerosis: an interaction between genes and environment. Mult Scler 2012; 18 (1) 2-4
• 5 Kilpinen-Loisa P, Nenonen H, Pihko H, Mäkitie O. High-dose vitamin D supplementation in children with cerebral palsy or neuromuscular disorder. Neuropediatrics 2007; 38 (4) 167-172
• 6 Rosenstein BD, Greene WB, Herrington RT, Blum AS. Bone density in myelomeningocele: the effects of ambulatory status and other factors. Dev Med Child Neurol 1987; 29 (4) 486-494
• 7 Quan A, Adams R, Ekmark E, Baum M. Bone mineral density in children with myelomeningocele. Pediatrics 1998; 102 (3) E34
• 8 Khoury JG, Morcuende JA. Dramatic subperiosteal bone formation following physeal injury in patients with myelomeningocele. Iowa Orthop J 2002; 22: 94-98
• 9 Szalay EA, Cheema A. Children with spina bifida are at risk for low bone density. Clin Orthop Relat Res 2011; 469 (5) 1253-1257
• 10 Okurowska-Zawada B, Konstantynowicz J, Kułak W , et al. Assessment of risk factors for osteoporosis and fractures in children with meningomyelocele. Adv Med Sci 2009; 54 (2) 247-252
• 11 Bienaimé F, Prié D, Friedlander G, Souberbielle JC. Vitamin D metabolism and activity in the parathyroid gland. Mol Cell Endocrinol 2011; 347 (1-2) 30-41
• 12 Holick MF. Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol 2009; 19 (2) 73-78
• 13 Saintonge S, Bang H, Gerber LM. Implications of a new definition of vitamin D deficiency in a multiracial us adolescent population: the National Health and Nutrition Examination Survey III. Pediatrics 2009; 123 (3) 797-803
• 14 Heaney RP. Functional indices of vitamin D status and ramifications of vitamin D deficiency. Am J Clin Nutr 2004; 80 (6, Suppl) 1706S-1709S
• 15 Calvo MS, Whiting SJ, Barton CN. Vitamin D intake: a global perspective of current status. J Nutr 2005; 135 (2) 310-316
• 16 Charzewska J, Chlebna-Sokół D, Chybicka A. Current (2009) Polish recommendations for the prevention of vitamin D deficiency. Med Prakt Pediatr 2010; 14 (1) 218-223 (Polish)
• 17 Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics 2008; 122 (2) 398-417
• 18 Taylor CW, Tovey SC. From parathyroid hormone to cytosolic Ca2+ signals. Biochem Soc Trans 2012; 40 (1) 147-152
• 19 Rubin MR, Cosman F, Lindsay R, Bilezikian JP. The anabolic effects of parathyroid hormone. Osteoporos Int 2002; 13 (4) 267-277
• 20 Bevill G, Keaveny TM. Trabecular bone strength predictions using finite element analysis of micro-scale images at limited spatial resolution. Bone 2009; 44 (4) 579-584
• 21 Lee AJ, Hodges S, Eastell R. Measurement of osteocalcin. Ann Clin Biochem 2000; 37 (Pt 4) 432-446
• 22 Hoffer MM, Feiwell E, Perry R, Perry J, Bonnett C. Functional ambulation in patients with myelomeningocele. J Bone Joint Surg Am 1973; 55 (1) 137-148
• 23 Chlebna-Sokół D, Błaszczyk A, Trafalska E, Grzybowski A. [Bone mineralization in children with skeletal system abnormalities in relation to dietary intake of some nutrients]. Przegl Lek 2003; 60 (Suppl. 06) 60-64 (Polish)
• 24 Górska A, Konstantynowicz J, Chlabicz S , et al. M. Bone mineral density in children and adolescents with idiopathic chronic musculoskeletal pain syndromes. Pol Merk Lek 2006; 21 (126) 544-547 (Polish)
• 25 Quan A, Adams R, Ekmark E, Baum M. Bone mineral density in children with myelomeningocele: effect of hydrochlorothiazide. Pediatr Nephrol 2003; 18 (9) 929-933
• 26 Henderson RC. Vitamin D levels in noninstitutionalized children with cerebral palsy. J Child Neurol 1997; 12 (7) 443-447
• 27 Gannagé-Yared MH, Chemali R, Yaacoub N, Halaby G. Hypovitaminosis D in a sunny country: relation to lifestyle and bone markers. J Bone Miner Res 2000; 15 (9) 1856-1862
• 28 Bener A, Al-Ali M, Hoffmann GF. High prevalence of vitamin D deficiency in young children in a highly sunny humid country: a global health problem. Minerva Pediatr 2009; 61 (1) 15-22
• 29 Oren Y, Shapira Y, Agmon-Levin N , et al. Vitamin D insufficiency in a sunny environment: a demographic and seasonal analysis. Isr Med Assoc J 2010; 12 (12) 751-756
• 30 Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ. Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 2004; 158 (6) 531-537
• 31 Kuchuk NO, Pluijm SM, van Schoor NM, Looman CW, Smit JH, Lips P. Relationships of serum 25-hydroxyvitamin D to bone mineral density and serum parathyroid hormone and markers of bone turnover in older persons. J Clin Endocrinol Metab 2009; 94 (4) 1244-1250
• 32 Hill KM, McCabe GP, McCabe LD, Gordon CM, Abrams SA, Weaver CM. An inflection point of serum 25-hydroxyvitamin D for maximal suppression of parathyroid hormone is not evident from multi-site pooled data in children and adolescents. J Nutr 2010; 140 (11) 1983-1988
• 33 Hirani V, Mosdøl A, Mishra G. Predictors of 25-hydroxyvitamin D status among adults in two British national surveys. Br J Nutr 2009; 101 (5) 760-764
• 34 Garanty-Bogacka B, Syrenicz M, Goral J , et al. Serum 25-hydroxyvitamin D (25-OH-D) in obese adolescents. Endokrynol Pol 2011; 62 (6) 506-511
• 35 Zamboni G, Soffiati M, Giavarina D, Tató L. Mineral metabolism in obese children. Acta Paediatr Scand 1988; 77 (5) 741-746
• 36 Parikh SJ, Edelman M, Uwaifo GI , et al. The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab 2004; 89 (3) 1196-1199
• 37 O'Connor E, Mølgaard C, Michaelsen KF, Jakobsen J, Lamberg-Allardt CJ, Cashman KD. Serum percentage undercarboxylated osteocalcin, a sensitive measure of vitamin K status, and its relationship to bone health indices in Danish girls. Br J Nutr 2007; 97 (4) 661-666
• 38 Weber P. Vitamin K and bone health. Nutrition 2001; 17 (10) 880-887