Korean J Pediatr.  2017 Feb;60(2):45-49. 10.3345/kjp.2017.60.2.45.

The serum level of 25-hydroxyvitamin D for maximal suppression of parathyroid hormone in children: the relationship between 25-hydroxyvitamin D and parathyroid hormone

• Kang JI
• Lee YS
• Han YJ
• Kong KA
• Kim HS

• KMID: 2371377
• DOI: http://doi.org/10.3345/kjp.2017.60.2.45

Abstract

PURPOSE
Serum level of 25-hydroxyvitamin D (25-OHD) is considered as the most appropriate marker of vitamin D status. However, only a few studies have investigated the relationship between 25-OHD and parathyroid hormone (PTH) in children. To this end, this study was aimed at evaluating the lowest 25-OHD level that suppresses the production of parathyroid hormone in children.
METHODS
A retrospective record review was performed for children aged 0.2 to 18 years (n=193; 106 boys and 87 girls) who underwent simultaneous measurements of serum 25-OHD and PTH levels between January 2010 and June 2014.
RESULTS
The inflection point of serum 25-OHD level for maximal suppression of PTH was at 18.0 ng/mL (95% confidence interval, 14.3-21.7 ng/mL). The median PTH level of the children with 25-OHD levels of <18.0 ng/mL was higher than that of children with 25-OHD levels ≥ 18.0 ng/mL (P<0.0001). The median calcium level of children with 25-OHD levels<18.0 ng/mL was lower than that of children with 25-OHD levels≥18.0 ng/mL (P=0.0001). The frequency of hyperparathyroidism was higher in the children with 25-OHD levels<18.0 ng/mL than in the children with 25-OHD levels≥18.0 ng/mL (P<0.0001). Hypocalcemia was more prevalent in the children with 25-OHD levels<18.0 ng/mL than in the children with 25-OHD levels≥18.0 ng/mL (P<0.0001).
CONCLUSION
These data suggest that a vitamin D level of 18.0 ng/mL could be the criterion for 25-OHD deficiency in children at the inflection point of the maximal suppression of PTH.

Keyword

Vitamin D; Vitamin D deficiency; Parathyroid hormone

MeSH Terms

Calcium
Child*
Humans
Hyperparathyroidism
Hypocalcemia
Parathyroid Hormone*
Retrospective Studies
Vitamin D
Vitamin D Deficiency
Calcium
Parathyroid Hormone
Vitamin D