The relation between circulating levels of vitamin D and parathyroid hormone in children and adolescents with overweight or obesity: Quest for a threshold
Autoři:
Golaleh Asghari aff001; Emad Yuzbashian aff001; Carol L. Wagner aff002; Maryam Mahdavi aff003; Roya Shamsi aff001; Farhad Hosseinpanah aff003; Parvin Mirmiran aff001
Působiště autorů:
Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
aff001; Department of Pediatrics, Division of Neonatology, Shawn Jenkins Children’s Hospital, Charleston, SC, United States of America
aff002; Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
aff003
Vyšlo v časopise:
PLoS ONE 14(11)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0225717
Souhrn
The level of serum 25-hydroxyvitamin D (25(OH)D) at which intact parathyroid hormone (iPTH) is maximally suppressed (suppression point) and below which PTH begins to rise (inflection point) has been used to define optimum 25(OH)D concentration. We aimed to study the association of circulating iPTH with 25(OH)D concentrations and to determine a 25(OH)D threshold associated with a significant iPTH suppression. This cross-sectional study was conducted on 198 boys and 180 girls, aged 6–13 years with BMI ≥ 1SD (WHO criteria) recruited from primary schools. Adjusted iPTH for BMI z-score, pubertal status, and dietary calcium was used. Nonlinear regression was used to model the relationship between 25(OH)D and iPTH and identify a suppression point for 25(OH)D at which iPTH reached a plateau. Piecewise regression analysis with a single knot for all possible values of 25(OH)D were fitted. Furthermore, 95% confidence intervals (95%CI) for those point had been calculated. The mean age (SD) of girls and boys was 9.1 (1.6) and 9.4 (1.7) years, respectively. Median 25(OH)D and iPTH were 13.8 ng/mL and 33.9 pg/mL in boys and 9.9 ng/mL and 47.8 ng/mL in girls, respectively. The equation in girls was: log-iPTH = 3.598+0.868 exp[(-0.190×25(OH)D. The point for near maximal suppression of iPTH by 25(OH)D for girls occurred at a 25(OH)D concentration of 20 ng/mL (95% CI: 7.1 to 32.2). No point of maximal suppression was found for boys. We also found a 25(OH)D threshold of 10 ng/mL (95% CI: 4.6 to 22.5) for girls (f: 9.8) by linear piecewise regression modeling of adjusted iPTH. No significant inflection point for boys was observed. In overweight/obese girls, when the concentration of 25(OH)D was higher than 20 ng/mL, an iPTH mean plateau level is reached, and when its concentrations approach 10 ng/mL, the slope of iPTH concentration has been accelerated.
Klíčová slova:
Adolescents – Body Mass Index – Ears – Childhood obesity – Magnesium – Obesity – Parathyroid hormone
Zdroje
1. Kim SY. The pleiomorphic actions of vitamin D and its importance for children. Annals of pediatric endocrinology & metabolism. 2013;18(2):45.
2. Weydert JA. Vitamin D in Children's Health. Children (Basel, Switzerland). 2014;1(2):208–26. doi: 10.3390/children1020208 27417476.
3. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911–30. Epub 2011/06/08. doi: 10.1210/jc.2011-0385 21646368.
4. Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocrine reviews. 2001;22(4):477–501. doi: 10.1210/edrv.22.4.0437 11493580
5. Chapuy M-C, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, et al. Prevalence of vitamin D insufficiency in an adult normal population. Osteoporosis international. 1997;7(5):439–43. doi: 10.1007/s001980050030 9425501
6. Hill TR, Cotter AA, Mitchell S, Boreham CA, Dubitzky W, Murray L, et al. Vitamin D status and parathyroid hormone relationship in adolescents and its association with bone health parameters: analysis of the Northern Ireland Young Heart's Project. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2010;21(4):695–700. Epub 2009/05/14. doi: 10.1007/s00198-009-0959-1 19436930.
7. Dawson-Hughes B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R. Estimates of optimal vitamin D status. Springer; 2005.
8. Harkness L, Cromer B. Low levels of 25-hydroxy vitamin D are associated with elevated parathyroid hormone in healthy adolescent females. Osteoporosis International. 2005;16(1):109–13. doi: 10.1007/s00198-004-1656-8 15175848
9. 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. The Journal of nutrition. 2010;140(11):1983–8. Epub 2010/09/24. doi: 10.3945/jn.110.124966 20861214; PubMed Central PMCID: PMC2955877.
10. Liel Y, Ulmer E, Shary J, Hollis BW, Bell NH. Low circulating vitamin D in obesity. Calcif Tissue Int. 1988;43(4):199–201. Epub 1988/10/01. doi: 10.1007/bf02555135 3145124.
11. Turer CB, Lin H, Flores G. Prevalence of vitamin D deficiency among overweight and obese US children. Pediatrics. 2012:peds. 2012–1711.
12. Plesner JL, Dahl M, Fonvig CE, Nielsen TRH, Kloppenborg JT, Pedersen O, et al. Obesity is associated with vitamin D deficiency in Danish children and adolescents. Journal of Pediatric Endocrinology and Metabolism. 2018;31(1):53–61. doi: 10.1515/jpem-2017-0246 29197860
13. Barja-Fernández S, Aguilera CM, Martínez-Silva I, Vazquez R, Gil-Campos M, Olza J, et al. 25-Hydroxyvitamin D levels of children are inversely related to adiposity assessed by body mass index. Journal of physiology and biochemistry. 2018;74(1):111–8. doi: 10.1007/s13105-017-0581-1 28744831
14. Ke L, Mason RS, Baur LA, Cowell CT, Liu X, Garnett SP, et al. Vitamin D levels in childhood and adolescence and cardiovascular risk factors in a cohort of healthy Australian children. The Journal of steroid biochemistry and molecular biology. 2018;177:270–7. doi: 10.1016/j.jsbmb.2017.07.010 28716759
15. de Onis M, Blossner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. Am J Clin Nutr. 2010;92(5):1257–64. Epub 2010/09/24. doi: 10.3945/ajcn.2010.29786 20861173.
16. Momenan AA, Delshad M, Sarbazi N, Rezaei Ghaleh N, Ghanbarian A, Azizi F. Reliability and validity of the Modifiable Activity Questionnaire (MAQ) in an Iranian urban adult population. Archives of Iranian medicine. 2012;15(5):279–82. Epub 2012/04/24. doi: 012155/AIM.007 22519376.
17. Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Archives of disease in childhood. 1969;44(235):291–303. Epub 1969/06/01. doi: 10.1136/adc.44.235.291 5785179; PubMed Central PMCID: PMC2020314.
18. Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Archives of disease in childhood. 1970;45(239):13–23. Epub 1970/02/01. doi: 10.1136/adc.45.239.13 5440182; PubMed Central PMCID: PMC2020414.
19. Alyahya KO. Vitamin D levels in schoolchildren: a cross-sectional study in Kuwait. BMC pediatrics. 2017;17(1):213–. doi: 10.1186/s12887-017-0963-0 29273017.
20. Heaney RP. Functional indices of vitamin D status and ramifications of vitamin D deficiency. Am J Clin Nutr. 2004;80(6 Suppl):1706s–9s. Epub 2004/12/09. doi: 10.1093/ajcn/80.6.1706S 15585791.
21. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266–81. Epub 2007/07/20. doi: 10.1056/NEJMra070553 17634462.
22. Srivastava T, Alon US. Stage I vitamin D-deficiency rickets mimicking pseudohypoparathyroidism type II. Clin Pediatr (Phila). 2002;41(4):263–8. Epub 2002/06/04. doi: 10.1177/000992280204100411 12041724.
23. Asghari G, Dehghan P, Mirmiran P, Yuzbashian E, Mahdavi M, Tohidi M, et al. Insulin metabolism markers are predictors of subclinical atherosclerosis among overweight and obese children and adolescents. BMC pediatrics. 2018;18(1):368. Epub 2018/11/25. doi: 10.1186/s12887-018-1347-9 30470212; PubMed Central PMCID: PMC6260656.
24. Asghari G, Mirmiran P, Yuzbashian E, Dehghan P, Mahdavi M, Tohidi M, et al. Association of circulating 25-hydroxyvitamin D and parathyroid hormone with carotid intima media thickness in children and adolescents with excess weight. The Journal of steroid biochemistry and molecular biology. 2019;188:117–23. Epub 2019/01/04. doi: 10.1016/j.jsbmb.2018.12.015 30605777.
25. Del Valle HB, Yaktine AL, Taylor CL, Ross AC. Dietary reference intakes for calcium and vitamin D: National Academies Press; 2011.
26. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122(2):398–417. doi: 10.1542/peds.2007-1894 18676559
27. Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96(1):53–8. Epub 2010/12/02. doi: 10.1210/jc.2010-2704 21118827; PubMed Central PMCID: PMC3046611.
28. Yuzbashian E, Asghari G, Hedayati M, Zarkesh M, Mirmiran P, Khalaj A. Determinants of vitamin D receptor gene expression in visceral and subcutaneous adipose tissue in non-obese, obese, and morbidly obese subjects. The Journal of steroid biochemistry and molecular biology. 2019;187:82–7. Epub 2018/11/10. doi: 10.1016/j.jsbmb.2018.11.004 30412764.
29. Amini Z, Bryant S, Smith C, Singh R, Kumar S. Is the serum vitamin D-parathyroid hormone relationship influenced by obesity in children? Horm Res Paediatr. 2013;80(4):252–6. Epub 2013/10/02. doi: 10.1159/000354645 24080758.
30. Outila TA, Kärkkäinen MU, Lamberg-Allardt CJ. Vitamin D status affects serum parathyroid hormone concentrations during winter in female adolescents: associations with forearm bone mineral density. The American journal of clinical nutrition. 2001;74(2):206–10. doi: 10.1093/ajcn/74.2.206 11470722
31. Sahin ON, Serdar M, Serteser M, Unsal I, Ozpinar A. Vitamin D levels and parathyroid hormone variations of children living in a subtropical climate: a data mining study. Italian journal of pediatrics. 2018;44(1):40. doi: 10.1186/s13052-018-0479-8 29562938
32. Razzaghy-Azar M, Shakiba M. Assessment of vitamin D status in healthy children and adolescents living in Tehran and its relation to iPTH, gender, weight and height. Annals of human biology. 2010;37(5):692–701. doi: 10.3109/03014460903527348 20166840
33. Habibesadat S, Ali K, Shabnam JM, Arash A. Prevalence of vitamin D deficiency and its related factors in children and adolescents living in North Khorasan, Iran. Journal of Pediatric Endocrinology and Metabolism. 2014;27(5–6):431–6. doi: 10.1515/jpem-2013-0198 24519715
34. Kang JI, Lee YS, Han YJ, Kong KA, Kim HS. 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 journal of pediatrics. 2017;60(2):45. doi: 10.3345/kjp.2017.60.2.45 28289433
35. Maguire JL, Birken C, Thorpe KE, Sochett EB, Parkin PC. Parathyroid hormone as a functional indicator of vitamin D sufficiency in children. JAMA pediatrics. 2014;168(4):383–5. Epub 2014/02/19. doi: 10.1001/jamapediatrics.2013.5379 24535147.
36. Karaguzel G, Dilber B, Can G, Okten A, Deger O, Holick MF. Seasonal vitamin D status of healthy schoolchildren and predictors of low vitamin D status. Journal of pediatric gastroenterology and nutrition. 2014;58(5):654–60. Epub 2014/05/03. doi: 10.1097/MPG.0000000000000274 24787093.
37. Guillemant J, Taupin P, Le H, Taright N, Allemandou A, Peres G, et al. Vitamin D status during puberty in French healthy male adolescents. Osteoporosis International. 1999;10(3):222–5. doi: 10.1007/s001980050219 10525714
38. Lehtonen-Veromaa M, Möttönen T, Irjala K, Kärkkäinen M, Lamberg-Allardt C, Hakola P, et al. Vitamin D intake is low and hypovitaminosis D common in healthy 9− to 15-year-old Finnish girls. European journal of clinical nutrition. 1999;53(9):746. doi: 10.1038/sj.ejcn.1600844 10509773
39. 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. Pediatric research. 2013;74(5):552. doi: 10.1038/pr.2013.139 23999068
40. Newton DA, Baatz JE, Kindy MS, Gattoni-Celli S, Shary JR, Hollis BW, et al. Vitamin D binding protein polymorphisms significantly impact vitamin D status in children. Pediatr Res. 2019. Epub 2019/02/04. doi: 10.1038/s41390-019-0322-y 30712059.
41. Frank GRJM, oncology p. Role of estrogen and androgen in pubertal skeletal physiology. 2003;41(3):217–21.
42. Di Monaco M, Castiglioni C, Vallero F, Di Monaco R, Tappero R. Parathyroid hormone response to severe vitamin D deficiency is sex associated: an observational study of 571 hip fracture inpatients. The journal of nutrition, health & aging. 2013;17(2):180–4.
43. Quaggiotto P, Tran H, Bhanugopan M. Vitamin D deficiency remains prevalent despite increased laboratory testing in New South Wales, Australia. Singapore medical journal. 2014;55(5):271. doi: 10.11622/smedj.2014071 24862752
44. Hekimsoy Z, Dinç G, Kafesçiler S, Onur E, Güvenç Y, Pala T, et al. Vitamin D status among adults in the Aegean region of Turkey. BMC Public Health. 2010;10(1):782.
45. Hirani V, Tull K, Ali A, Mindell J. Urgent action needed to improve vitamin D status among older people in England! Age and ageing. 2009;39(1):62–8. doi: 10.1093/ageing/afp195 19934073
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