Osteoporosis International

, Volume 21, Issue 4, pp 695–700

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

  • T. R. Hill
  • A. A. Cotter
  • S. Mitchell
  • C. A. Boreham
  • W. Dubitzky
  • L. Murray
  • J. J. Strain
  • A. Flynn
  • P. J. Robson
  • J. M. W. Wallace
  • M. Kiely
  • K. D. Cashman
Short Communication

Abstract

Summary

In girls, a plateau in parathyroid hormone (PTH) was observed at a 25-hydroxyvitamin D (25(OH)D) concentration of approximately 60 nmol/l. In boys, there was no plateau in PTH concentrations as 25(OH)D concentration increased. A 25(OH)D threshold of 60 nmol/l appears to have implications for bone health outcomes in both girls and boys.

Introduction

Our objective was to investigate if there is a threshold 25(OH)D concentration where a plateau in PTH concentration is evident and to examine the impact of this relationship on bone mineral density (BMD) and bone turnover in a representative sample of adolescents.

Methods

We conducted a cross-sectional analysis among 1,015 Northern Irish adolescents aged 12 and 15 years. Serum 25(OH)D, PTH, osteocalcin, type 1 collagen cross-linked C-telopeptide (CTx), and BMD of the nondominant forearm and heel were measured. Nonlinear regression analysis was used to model the association between 25(OH)D and PTH.

Results

In girls, a plateau in PTH was observed at a 25(OH)D concentration of approximately 60 nmol/l (PTH = 47.146 + 370.314 × exp(−0.092 × 25(OH)D)) while no plateau in PTH was observed in boys (PTH = 42.144 + 56.366 × exp(−0.022 × 25(OH)D)). Subjects with 25(OH)D levels <60 nmol/l had significantly higher osteocalcin concentrations (P < 0.05) compared with those who had ≥60 nmol/l, while no significant (P > 0.05) differences were noted for CTx concentrations. In girls only, nondominant forearm BMD but not heel BMD was significantly higher (P = 0.046) in those with 25(OH)D concentrations ≥ 60 nmol/l.

Conclusions

Serum 25(OH)D levels above 60 nmol/l in Northern Irish adolescent girls prevent an increase in serum PTH levels and maintaining 25(OH)D >60 nmol/l in both girls and boys may lead to improved bone health outcomes.

Keywords

Adolescents Bone turnover PTH Vitamin D 

References

  1. 1.
    UK Department of Health (1998) Nutrition and bone health: with particular reference to calcium and vitamin D. Report on Health and Social Subjects (49). The Stationary Office, LondonGoogle Scholar
  2. 2.
    Lips P (2004) Which circulating level of 25-hydroxyvitamin D is appropriate? J Steroid Biochem Mol Biol 89–90:611–614CrossRefPubMedGoogle Scholar
  3. 3.
    Holick MF (2006) Resurrection of vitamin D deficiency and rickets. J Clin Invest 116:2062–2072CrossRefPubMedGoogle Scholar
  4. 4.
    McKenna MJ (1992) Differences in vitamin D status between countries in young adults and the elderly. Am J Med 93:69–77CrossRefPubMedGoogle Scholar
  5. 5.
    Lips P (2001) Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 22:477–501CrossRefPubMedGoogle Scholar
  6. 6.
    Chapuy MC, Preziosi P, Maamer M et al (1997) Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int 7:439–443CrossRefPubMedGoogle Scholar
  7. 7.
    McKenna MJ, Freaney R (1998) Secondary hyperparathyroidism in the elderly: means to defining hypovitaminosis D. Osteoporos Int 8:S3–S6PubMedGoogle Scholar
  8. 8.
    Krabbe S, Transbol I, Christiansen C (1982) Bone mineral homeostasis, bone growth, and mineralization during years of pubertal growth spurt: a unifying concept. Arch Dis Child 57:359–363CrossRefPubMedGoogle Scholar
  9. 9.
    Cadogan J, Blumsohn A, Barker ME, Eastell R (1998) A longitudinal study of bone gain in pubertal girls: anthropometric. J Bone Miner Res 13:1602–1612CrossRefPubMedGoogle Scholar
  10. 10.
    Cashman KD (2007) Vitamin D in childhood and adolescence. Postgrad Med J 83:230–235CrossRefPubMedGoogle Scholar
  11. 11.
    Gallagher AM, Savage JM, Murray LJ et al (2002) A longitudinal study through adolescence to adulthood: the Young Hearts Project, Northern Ireland. Pub Health 116:332–340Google Scholar
  12. 12.
    McGartland CP, Robson PJ, Murray LJ et al (2004) Fruit and vegetable consumption and bone mineral density: the Northern Ireland Young Hearts Project. Am J Clin Nutr 80:1019–1023PubMedGoogle Scholar
  13. 13.
    Carter GD, Carter R, Jones J, Berry J (2004) How accurate are assays for 25-hydroxyvitamin D? Data from the international vitamin D external quality assessment scheme. Clin Chem 50:2195–2197CrossRefPubMedGoogle Scholar
  14. 14.
    Guillemant J, Taupin P, Le HT et al (1999) Vitamin D status during puberty in French healthy male adolescents. Osteoporos Int 10:222–225CrossRefPubMedGoogle Scholar
  15. 15.
    Outila TA, Kärkkäinen MU, Lamberg-Allardt CJ (2001) Vitamin D status affects serum parathyroid hormone concentrations during winter in female adolescents: associations with forearm bone mineral density. Am J Clin Nutr 74:206–210PubMedGoogle Scholar
  16. 16.
    Cashman KD, Hill TR, Cotter AA et al (2008) Low vitamin D status adversely affects bone health parameters in adolescents. Am J Clin Nutr 87:1039–1044PubMedGoogle Scholar
  17. 17.
    Webb AR, Kline L, Holick MF (1988) Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab 67:373–378CrossRefPubMedGoogle Scholar
  18. 18.
    Department of Health (1991) Dietary reference values for food energy and nutrients for the UK. Report on Health and Social Subjects No 41. Stationery Office, LondonGoogle Scholar
  19. 19.
    Boot AM, de Ridder MA, Pols HA, Krenning EP, de Muinck Keizer-Schrama SM (1997) Bone mineral density in children and adolescents: relation to puberty, calcium intake and physical activity. J Clin Endocrinol Metab 82:57–62CrossRefPubMedGoogle Scholar
  20. 20.
    Frank GR (2003) Role of estrogen and androgen in pubertal skeletal physiology. Med Pediatr Oncol 41:217–221CrossRefPubMedGoogle Scholar
  21. 21.
    Harkness L, Cromer B (2005) Low levels of 25-hydroxy vitamin D are associated with elevated parathyroid hormone in healthy adolescent females. Osteoporos Int 16:109–113CrossRefPubMedGoogle Scholar
  22. 22.
    Yan L, Prentice A, Zhang H et al (2000) Vitamin D status and parathyroid hormone concentrations in Chinese women and men from north-east of the People’s Republic of China. Am J Clin Nutr 54:68–72CrossRefGoogle Scholar
  23. 23.
    Kärkkäinen MU, Wiersma JW, Lamberg-Allardt CJ (1997) Postprandial parathyroid response to four calcium-rich foodstuffs. Am J Clin Nutr 65:1726–1730PubMedGoogle Scholar
  24. 24.
    Kemi VE, Kärkkäinen MU, Lamberg-Allardt CJ (2006) High phosphorus intakes acutely and negatively affect Ca and bone metabolism in a dose-dependent manner in healthy young females. Br J Nutr 96:545–552PubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2009

Authors and Affiliations

  • T. R. Hill
    • 1
  • A. A. Cotter
    • 1
  • S. Mitchell
    • 1
  • C. A. Boreham
    • 5
  • W. Dubitzky
    • 3
  • L. Murray
    • 6
  • J. J. Strain
    • 3
  • A. Flynn
    • 1
  • P. J. Robson
    • 4
  • J. M. W. Wallace
    • 3
  • M. Kiely
    • 1
  • K. D. Cashman
    • 1
    • 2
  1. 1.Vitamin D Research Group, Department of Food and Nutritional SciencesUniversity CollegeCorkIreland
  2. 2.Department of MedicineUniversity CollegeCorkIreland
  3. 3.Northern Ireland Center for Food and HealthUniversity of UlsterColeraineUK
  4. 4.Department of Population Health Research Alberta Health Services - Cancer Epidemiology, Prevention and Screening Sun Life PlaceEdmontonCanada
  5. 5.UCD Institute for Sport and HealthUniversity CollegeDublinIreland
  6. 6.Department of Epidemiology and Public HealthQueens UniversityBelfastUK

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