Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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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, Jung In (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Lee, Yoon Suk (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Han, Ye Jin (Department of Pediatrics, Ewha Womans University School of Medicine) ;
  • Kong, Kyoung Ae (Clinical Trial Center, Ewha Womans University Medical Center) ;
  • Kim, Hae Soon (Department of Pediatrics, Ewha Womans University School of Medicine)
  • Received : 2016.07.16
  • Accepted : 2016.10.25
  • Published : 2017.02.15
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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 ${\geq}$ 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${\geq}18.0ng/mL$ (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${\geq}18.0ng/mL$ (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${\geq}18.0ng/mL$ (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.

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References

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