Vitamin D Deficiency and Seasonal and Inter-day Variation in Circulating 25-hydroxyvitamin D and Parathyroid Hormone Levels in Indoor Daytime Workers: A Longitudinal Study

AbstractBackgroundLimited data exist on the vitamin D status in Fontan patients. We determined the prevalence and potential risk factors of vitamin D deficiency in this patient subset.Methods and resultsData were collected from 27 Fontan patients (55.6% male, mean age 8.1±5.3 years). Protein-losing enteropathy was diagnosed in six patients (22.2%). Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D level of <20 ng/ml. The neutrophil-to-lymphocyte ratio, a marker of systemic inflammation, was calculated. Associations between laboratory measurements and patient characteristics were explored. Mean serum 25-hydroxyvitamin D level was 14.1±10.4 ng/ml. Vitamin D deficiency was found in 19/27 patients (70.3%). Only skin type was associated with vitamin D deficiency (p=0.04). Hyperparathyroidism was present in 5/21 (23.8%) patients, and was more prevalent in patients with protein-losing enteropathy (p<0.001). Parathyroid hormone levels correlated with parameters of systemic inflammation (neutrophil-to-lymphocyte ratio: r=0.484, p=0.026; relative lymphocyte count: r=−0.635, p=0.002). Vitamin D supplementation significantly increased serum 25-hydroxyvitamin D levels (p<0.0001), and was accompanied by a reduction in parathyroid hormone concentrations (p=0.032).ConclusionsA high prevalence of vitamin D deficiency was found among Fontan patients, independent of age, time after Fontan procedure, ventricular morphology, and presence of protein-losing enteropathy. A potentially important link between parathyroid hormone levels and systemic inflammation is suggested.

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Relationship between serum 25-hydroxyvitamin D and parathyroid hormone in the search for a biochemical definition of vitamin D deficiency in children

Pediatric Research ◽

10.1038/pr.2013.139 ◽

2013 ◽

Vol 74 (5) ◽

pp. 552-556 ◽

Cited By ~ 37

Author(s):

Navoda Atapattu ◽

Nick Shaw ◽

Wolfgang Högler

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Definition Of

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Associations of Vitamin D Deficiency, Parathyroid hormone, Calcium, and Phosphorus with Perinatal Adverse Outcomes. A Prospective Cohort Study

Nutrients ◽

10.3390/nu12113279 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3279

Author(s):

Íñigo María Pérez-Castillo ◽

Tania Rivero-Blanco ◽

Ximena Alejandra León-Ríos ◽

Manuela Expósito-Ruiz ◽

María Setefilla López-Criado ◽

...

Keyword(s):

Vitamin D ◽

Cohort Study ◽

Parathyroid Hormone ◽

Preterm Birth ◽

Vitamin D Deficiency ◽

Prospective Cohort ◽

Adverse Outcomes ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Calcium And Phosphorus

Vitamin D deficiency during pregnancy has been linked to perinatal adverse outcomes. Studies conducted to date have recommended assessing interactions with other vitamin D-related metabolites to clarify this subject. We aimed to evaluate the association of vitamin D deficiency during early pregnancy with preterm birth. Secondary outcomes included low birth weight and small for gestational age. Additionally, we explored the role that parathyroid hormone, calcium and phosphorus could play in the associations. We conducted a prospective cohort study comprising 289 pregnant women in a hospital in Granada, Spain. Participants were followed-up from weeks 10–12 of gestation to postpartum. Serum 25-hydroxyvitamin D, parathyroid hormone, calcium, and phosphorus were measured within the first week after recruitment. Pearson’s χ2 test, Mann–Whitney U test, binary and multivariable logistic regression models were used to explore associations between variables and outcomes. 36.3% of the participants were vitamin D deficient (<20 ng/mL). 25-hydroxyvitamin D concentration was inversely correlated with parathyroid hormone (ρ = −0.146, p = 0.013). Preterm birth was associated with vitamin D deficiency in the multivariable model, being this association stronger amongst women with parathyroid hormone serum levels above the 80th percentile (adjusted odds ratio (aOR) = 6.587, 95% CI (2.049, 21.176), p = 0.002). Calcium and phosphorus were not associated with any studied outcome. Combined measurement of 25-hydroxyvitamin D and parathyroid hormone could be a better estimator of preterm birth than vitamin D in isolation.

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Vitamin D-Dependent Rickets Type 1: A Rare, but Treatable, Cause of Severe Hypotonia in Infancy

Journal of Child Neurology ◽

10.1177/0883073811411190 ◽

2011 ◽

Vol 26 (12) ◽

pp. 1571-1575 ◽

Cited By ~ 7

Author(s):

Yun Yan ◽

Ali S. Calikoglu ◽

Nina Jain

Keyword(s):

Vitamin D ◽

Alkaline Phosphatase ◽

Parathyroid Hormone ◽

Tubular Dysfunction ◽

Exon 2 ◽

Hormone Levels ◽

Hydroxyvitamin D ◽

Severe Hypotonia ◽

25 Hydroxyvitamin D

Vitamin D-dependent rickets type 1 is an autosomal recessive disorder caused by an inactivating mutation of the 25-hydroxyvitamin-D-1α-hydroxylase (CYP27B1) gene. Clinical presentation is characterized by early onset of severe rickets and can include severe hypotonia. Here, we report a 16-month-old white male who presented with severe muscle weakness, failure to thrive, renal tubular dysfunction, and skeletal deformities, including osteopenia and multiple fractures. At presentation, he had severe hypocalcemia, hypophosphatemia, hypomagnesemia, and elevated alkaline phosphatase and parathyroid hormone levels, although normal 25-hydroxyvitamin D levels. DNA sequencing of the CYP27B1 gene revealed a novel mutation in exon 2 (c286_300de115) and a previously reported mutation in exon 7 (c.1166G>A). Once calcitriol therapy was initiated, the patient showed significant improvement in muscle strength and linear growth. Serum calcium, phosphorous, and alkaline phosphatase returned to normal range. Organic aciduria resolved and aminoaciduria significantly improved 2 months after parathyroid hormone levels normalized.

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Predictors of Serum 25-Hydroxyvitamin D Concentrations among a Sample of Egyptian Schoolchildren

The Scientific World JOURNAL ◽

10.1155/2016/8175768 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 11

Author(s):

Mones M. Abu Shady ◽

Mai M. Youssef ◽

Ebtissam M. Salah El-Din ◽

Ola M. Abdel Samie ◽

Hala S. Megahed ◽

...

Keyword(s):

Physical Activity ◽

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Maternal Education ◽

Sun Exposure ◽

Education Level ◽

Milk Intake ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

Objective. To assess the level of 25-hydroxyvitamin D status among a sample of Egyptian schoolchildren and to evaluate predictors of deficiency and insufficiency.Subjects and Methods. A cross-sectional study comprising 200 prepubescent schoolchildren aged from 9 to 11 years was performed. A questionnaire including frequency of midday sun exposure, milk intake, physical activity, and level of maternal education was taken. Body mass index (BMI) was calculated; serum 25-hydroxyvitamin D [25(OH)D], serum calcium, phosphorus, and parathyroid hormone were measured.Results. Vitamin D deficiency [serum 25(OH)D < 20 ng/mL] was detected in 11.5% of subjects while its insufficiency (serum 25(OH)D is between 20 and 29.9 ng/mL) was detected in 15%. Results revealed that obesity, low physical activity, low sun exposure, and low maternal education level are significant predictors of insufficiency, though female gender, low maternal education level, and low milk intake are significant predictors of deficiency. Lower serum phosphorus and higher serum parathyroid hormone were significantly associated with both deficiency and insufficiency (p<0.05).Conclusion. Vitamin D deficiency and insufficiency are common among schoolchildren in Egypt. Food fortification, vitamin D supplementation, and increasing maternal awareness about the importance of physical activity and exposure of their children to ultraviolet light may help to overcome this problem.

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The relationship between serum 25-hydroxyvitamin D and parathyroid hormone concentration in assessing vitamin D deficiency in pet rabbits

BMC Veterinary Research ◽

10.1186/s12917-020-02599-7 ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

J. Mäkitaipale ◽

S. Sankari ◽

H. Sievänen ◽

O. Laitinen-Vapaavuori

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Bone Diseases ◽

Hormone Concentration ◽

Metabolic Bone Diseases ◽

Hydroxyvitamin D ◽

Metabolic Bone ◽

Ionised Calcium ◽

25 Hydroxyvitamin D

Abstract Background Vitamin D deficiency and related metabolic bone diseases in pet rabbits have been intermittently debated. In human research, the parathyroid hormone concentration in relation to the 25-hydroxyvitamin D concentration is used to determine vitamin D deficiency. Thus, this study aimed to identify the breakpoint in the 25-hydroxyvitamin D concentration indicating a significant change in the parathyroid hormone concentration in 139 pet rabbits. An enzyme immunoassay kit was used for 25-hydroxyvitamin D analysis and the intact parathyroid hormone (PTH 1–84) immunoradiometric assay kit for parathyroid hormone analysis. The mid-tibial cortical bone density was measured using peripheral quantitative computed tomography. A segmented linear regression analysis was performed, with the 25-hydroxyvitamin D concentration as the independent variable, and parathyroid hormone, ionised calcium, total calcium, inorganic phosphorus concentrations and the mid-tibial cortical density as the dependent variables. Results The breakpoint for the parathyroid hormone concentration occurred at a 25(OH)D concentration of 17 ng/mL, whereas the cortical bone density breakpoint occurred at a 25-hydroxyvitamin D concentration of 19 ng/mL. No breakpoints were found for ionised calcium, total calcium or phosphorus. Conclusions These results suggest that a serum 25-hydroxyvitamin D concentration of 17 ng/mL serves as the threshold for vitamin D deficiency in rabbits. Nearly one-third of the rabbits had a serum 25-hydroxyvitamin D concentration below this threshold. Concerns persist regarding the high prevalence of vitamin D deficiency in pet rabbits and the possible health consequences caused by a chronic vitamin D deficiency, including the risk for metabolic bone diseases.

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Exploring the concept of functional vitamin D deficiency in pregnancy: impact of the interaction between 25-hydroxyvitamin D and parathyroid hormone on perinatal outcomes

American Journal of Clinical Nutrition ◽

10.1093/ajcn/nqy150 ◽

2018 ◽

Vol 108 (4) ◽

pp. 821-829 ◽

Cited By ~ 5

Author(s):

Andrea Hemmingway ◽

Louise C Kenny ◽

Lucio Malvisi ◽

Mairead E Kiely

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Gestational Hypertension ◽

Reference Group ◽

Geometric Mean ◽

Perinatal Outcomes ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

In Pregnancy

AbstractBackgroundAssociations of vitamin D with perinatal outcomes are inconsistent and few studies have considered the wider calcium metabolic system.ObjectivesWe aimed to explore functional vitamin D deficiency in pregnancy by investigating associations between vitamin D status, parathyroid hormone (PTH), and perinatal outcomes.DesignSCOPE (Screening for Pregnancy Endpoints) Ireland is a prospective cohort study of low-risk, nulliparous pregnant women. We measured serum 25-hydroxyvitamin D [25(OH)D] and PTH at 15 wk of gestation in 1754 participants.ResultsMean ± SD 25(OH)D was 56.6 ± 25.8 nmol/L (22.7 ± 10.3 ng/mL) and geometric mean (95% CI) PTH was 7.84 pg/mL (7.7, 8.0 pg/mL) [0.86 pmol/L (0.85, 0.88 pmol/L)]. PTH was elevated in 34.3% of women who had 25(OH)D <30 nmol/L and in 13.9% of those with 25(OH)D ≥75 nmol/L. Whereas 17% had 25(OH)D <30 nmol/L, 5.5% had functional vitamin D deficiency, defined as 25(OH)D <30 nmol/L with elevated PTH. Elevated mean arterial pressure (MAP), gestational hypertension, pre-eclampsia, and small-for-gestational-age (SGA) birth were confirmed in 9.2%, 11.9%, 3.8%, and 10.6% of participants, respectively. In fully adjusted regression models, neither low 25(OH)D nor elevated PTH alone increased the risk of any individual outcome. The prevalence of elevated MAP (19.1% compared with 9.7%) and SGA (16.0% compared with 6.7%) were highest (P < 0.05) in those with functional vitamin D deficiency compared with the reference group [25(OH)D ≥75 nmol/L and normal PTH]. The adjusted prevalence ratio (PR) and RR (95% CIs) for elevated MAP and SGA were 1.83 (1.02, 3.27) and 1.53 (0.80, 2.93), respectively. There was no effect of functional vitamin D deficiency on the risk of gestational hypertension (adjusted RR: 1.00; 95% CI: 0.60, 1.67) or pre-eclampsia (adjusted RR: 1.17; 95% CI: 0.32, 4.20).ConclusionThe concept of functional vitamin D deficiency, reflecting calcium metabolic stress, should be considered in studies of vitamin D in pregnancy.The SCOPE pregnancy cohort is registered at http://www.anzctr.org.au as ACTRN12607000551493.

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An Unusual Case of Hypercalcemia Associated with Graves’ Disease and Vitamin D Deficiency

Clinical Medicine Insights Endocrinology and Diabetes ◽

10.4137/cmed.s7116 ◽

2011 ◽

Vol 4 ◽

pp. CMED.S7116 ◽

Cited By ~ 6

Author(s):

Evgenia Korytnaya ◽

Nagashree Gundu Rao ◽

Jane V. Mayrin

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Serum Calcium ◽

Graves Disease ◽

Hydroxyvitamin D ◽

Vitamin D Levels ◽

Calcium Phosphorus ◽

25 Hydroxyvitamin D ◽

25 Oh Vitamin D

Objective To present a case of hypercalcemia associated with thyrotoxicosis in a patient with vitamin D deficiency and review biochemical changes during the course of treatment. Methods We report a case, describe the changes in serum calcium, phosphorus, parathyroid hormone in Graves’ disease and concomitant Vitamin D deficiency. We compare our findings to those reported in literature. Results Our patient had hypercalcemia secondary to thyrotoxicosis alone, which was confirmed by low parathyroid hormone level and resolution of hypercalcemia with treatment of thyrotoxicosis. The case was complicated by a concomitant vitamin D deficiency. Serum calcium elevation in patients with thyrotoxicosis occurs secondary to hyperthyroidism alone or due to concurrent hyperparathyroidism. Hypercalcemia from thyrotoxicosis is usually asymptomatic and is related to bone resorption. Vitamin D deficiency can be seen in patients with thyrotoxicosis because of accelerated metabolism, poor intestinal absorption and increased demand during bone restoration phase. Coexistence of hypercalcemia and Vitamin D deficiency in patients with thyrotoxicosis is rare, but possible, and 25-hydroxyvitamin D levels should be checked. The definite treatment for hypercalcemia in thyrotoxicosis is correction of thyroid function. Conclusion Hypercalcemia in thyrotoxicosis should be distinguished from concomitant hyperparathyroidism and confirmed by resolution of hypercalcemia with control of thyrotoxicosis. Patients with hypercalcemia and thyrotoxicosis may also have vitamin D deficiency and 25-OH Vitamin D levels should be checked.

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