Vitamin D levels and parathyroid hormone variations of children living in a subtropical climate: a data mining study

Sahin, Ozlem Naciye; Serdar, Muhittin; Serteser, Mustafa; Ünsal, İbrahim; Özpınar, Aysel

doi:10.1186/s13052-018-0479-8

Cited by 37 publications

(46 citation statements)

References 35 publications

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“…As the main source of Vitamin D is skin synthesis under direct sunlight, seasons may cause significant changes in serum levels of 25 (OH) D [14]. Between February and May, the level is lower than other times of the year according to the data mining study of Şahin et al [1]. In this study, the period of serum vitamin D level assessment had no significance, but season of birth proved important.…”

Section: Discussionmentioning

confidence: 64%

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Vitamin D status in infancy: What is the solution?

Celep¹,

Durmaz²,

Demir³

et al. 2019

Journal of Surgery and Medicine

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Aim: Vitamin D deficiency and insufficiency are common public health problems throughout the world. Besides important multisystemic metabolic effects, vitamin D is necessary for a healthy skeletal system. Various reasons cause vitamin D deficiency in infancy, and supplementation is one of the treatment options. A nationwide supplementation program has been implemented in Turkey since 2005. In this study, we aimed to evaluate the efficacy of this program in our city. Methods: All infants aged between one and twelve months who were referred to the pediatric outpatient clinics of the hospital and tested for serum 25-(OH)-D levels between January 1, 2015 and December 31, 2016 were enrolled in the study. Patients with chronic illnesses were excluded. Data was obtained retrospectively from the hospital registry. In accordance with the criteria of American Academy of Pediatrics, patients were divided into three groups based on serum 25-(OH)-D levels as follows: 25-(OH)-D<15 ng/ml were considered deficient, 15.1<25-(OH)-D<20 ng/ml were considered insufficient and sufficiency was defined as 25-(OH)-D>20 ng/ml. Results: The study group consisted of 265 infants. The mean age of the group was 7.53 (2.75) months. Approximately 15% (n=39) of the study group had vitamin D deficiency, 10.5% (n=28) had insufficiency and Vitamin D levels of 74.4% (n=198) of the group were sufficient. Serum 25 (OH) D levels did not differ with gender, age or season (P=0.12, P=0.65 and P=0.09, respectively). Vitamin D levels were sufficient in 78.5% (n=150) of the urban area residents and 69.6% (n=32) of the rural area residents, between which there was no significant difference (P=0.32). Conclusion: Our results established that supplementation is one of the ways to avoid limitations affecting serum vitamin D levels. Supplementation with 400 IU/day Cholecalciferol is provided during the first year of life by the Turkish Ministry of Health, which we believe rendered gender, age, time of measurement and residential area insignificant in terms of 25(OH) D levels. This supplementation program may solve the problem of vitamin D insufficiency or deficiency among disadvantaged groups.

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Section: Discussionmentioning

confidence: 64%

“…Many studies find that gender is key factor with increasing age, i.e. the increased deficiency rate among adolescent girls' [1,21].…”

Section: Discussionmentioning

confidence: 99%

Vitamin D status in infancy: What is the solution?

Celep¹,

Durmaz²,

Demir³

et al. 2019

Journal of Surgery and Medicine

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“…Güneş ışığı etkinliğinin azaldığı mevsimlerde, ilerleyen yaşlarda ve kız çocuklarında eksiklik oranı daha fazladır. D vitamini eksikliği Kuzey Yarımküre'de ılıman iklim kuşağında yer alan ilimiz ve ülkemiz için önemli bir halk sağlığı sorunudur [5,17]. İstanbul'da yapılan ve yeterlilik eşik değerinin 30 ng/ml alındığı çalışmada erken çocuklukta %40-45 civarında olan D vitamini eksikliği 10 yaşından itibaren %80-90'lara çıkmaktadır [5].…”

Section: Discussionunclassified

Bir halk sağlığı sorunu: Çocuk sağlığı izleminde D vitamini

Celep¹,

Durmaz²

2020

Pamukkale Medical Journal

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Bir halk sağlığı sorunu: çocuk sağlığı izleminde D vitaminiA public health problem: vitamin D status in child health follow up Gökce Celep, Zeynep Hülya Durmaz Özet Amaç: D vitamini direk güneş ışığı altında deride sentezlenen bir hormondur. Eksikliği ve yetersizliği çocukları etkileyen evrensel bir sorundur. Sağlıklı büyüme ve gelişme için gereklidir. Birçok sistemi etkileyen düzenleyici rolü vardır. Eksiklik eşik değerinin belirlenmesinde parathormon ile olan ilişkisi önemlidir. Bu yazıda amaç, ülkemiz için yakın geçmişte belirlenen eşik değerler göz önüne alınarak hastanemize başvuran çocuklardaki D vitamini eksikliği sıklığının belirlenmesidir. Gereç ve yöntem: Çalışmaya katılan ve bilinen kronik sağlık sorunu olmayan çocuklara ait kayıtlar hastane bilgi sistemi üzerinden retrospektif olarak tarandı. Yaş, cinsiyet, parathormon (PTH), kalsiyum (Ca+2), fosfor (P), alkalen fosfataz (ALP), 25(OH)D düzeyleri kayıt altına alındı. Yaş grupları, cinsiyet, mevsimler dikkate alınarak istatistik paket programıyla analiz edilip sunuldu. Bulgular: Çalışmaya yaşları 1-17 arasında değişen 229'u (%45,6) erkek, 273'ü (%54,4) kız, 502 sağlıklı çocuk katıldı. Uzman kuruluşlarının önerileri dikkate alındığında D vitamini eksikliği (25 (OH)D <12 ng/ml) oranı %26,7 (n=134) idi. Katılımcıların %47,2'sinde "yeterlilik" söz konusu idi. Eksiklik sıklığının yaşla artması, kızlarda ve kış mevsiminde daha sık olması istatistiksel olarak anlamlı idi (sırasıyla: p<0,0001; p=0,0031; p<0,0001). Sonuç: İlimiz Kuzey Yarımküre'nin ılıman iklim kuşağında yer almasına rağmen çalışma grubunun %50'sinden fazlasında D vitamini eksikliği veya yetersizliği mevcuttur. Güneş maruziyetinin arttırılması, destek tedavilerinin uygulanması ile bu sorunun çözülmesinde gereklidir. Yaşamın ilk bir yılında uygulanan D vitamini destek programı bu yaş grubunda başarılı sonuçlar sağlamıştır. Benzer bir uygulamanın diğer yaş grupları için de yararlı olacağı düşünülmektedir.

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“…In this regard, to define optimal levels of 25(OH)D at which PTH plateaus or rapidly raises, some studies found no optimal threshold value [6, 30], whereas others report a wide range of cut points, 14 to 43 ng/mL [6, 8, 9, 29, 31–39] (Fig 3). This variation in inflection points may be explained by mathematical methods used as well as other factors such as age, sex, race or ethnicity, calcium and phosphorus intake, weight status, extent of vitamin D insufficiency, pubertal status, or even inaccuracy of 25(OH)D assays [6, 40].…”

Section: Discussionmentioning

confidence: 99%

The relation between circulating levels of vitamin D and parathyroid hormone in children and adolescents with overweight or obesity: Quest for a threshold

Asghari

Yuzbashian

Wagner³

et al. 2019

PLoS ONE

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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.

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Vitamin D levels and parathyroid hormone variations of children living in a subtropical climate: a data mining study

Cited by 37 publications

References 35 publications

Vitamin D status in infancy: What is the solution?

Vitamin D status in infancy: What is the solution?

Bir halk sağlığı sorunu: Çocuk sağlığı izleminde D vitamini

The relation between circulating levels of vitamin D and parathyroid hormone in children and adolescents with overweight or obesity: Quest for a threshold

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