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Low levels of 25-hydroxy vitamin D are associated with elevated parathyroid hormone in healthy adolescent females

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Abstract

This study aimed to investigate the relationship between 25-hydroxyvitamin D [25(OH)D)] and parathyroid hormone (PTH) levels in adolescent females residing in a northern climate. Concern regarding vitamin D status in this population is due to limited sunlight exposure in northern latitudes, decreased outdoor recreational activities, as well as decreased conversion in black girls from increased skin pigmentation. In this cross-sectional analysis, serum samples were assayed for 25(OH)D using competitive protein binding (CPB) assay and PTH with immuno-radiometric (RIA) procedures. Four hundred postmenarcheal females (12–18 years) residing in northeastern Ohio were recruited. Subjects were excluded if they had a history of bone, kidney, or liver disease, or used medications that affect bone. The primary goal was to determine serum 25(OH)D concentrations in relation to circulating PTH levels in a population of adolescent girls. The Spearman correlation test was used to compare PTH and 25(OH)D. Fit multiple split models were run to determine change in slope of the regression line when 25(OH)D and PTH were plotted. Analysis of variance was determined using modeled means with differences by race and season in the final model. Unadjusted mean serum 25(OH)D and PTH levels were 55.0±30.4 nmol/l and 39.4±20.6 ng/l, respectively. Blacks had lower 25(OH)D and higher PTH compared with non-blacks (P<0.0001), especially during the winter months. Decreasing 25(OH)D was inversely correlated with PTH (r=−0.314) (P<0.0001), and at concentrations of 25(OH)D ≤90 nmol/l, an increase in PTH was observed. Adolescents are at risk for decreased serum 25(OH)D concentrations, especially black girls. We found that the widely used cutoff for vitamin D deficiency is associated with increasing PTH levels and is below the inflection point for a change in the slope of the regression line. Our results support the need for further research to establish optimal vitamin D status in adolescent girls.

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Acknowledgements

The research presented in this manuscript was supported by NIH grant #M01 RR00080 (National Center for Research Resources) and NIH grant #HD390099 (Contraceptive and Reproductive Health Branch, Center for Population Research, NICHD). We would like to acknowledge the statistical analysis assistance of Michelle Secic.

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Authors and Affiliations

  1. Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA

    Laura Harkness & Barbara Cromer

  2. Division of Adolescent Medicine, Department of Pediatrics, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109, USA

    Laura Harkness & Barbara Cromer

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  1. Laura Harkness
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  2. Barbara Cromer
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Correspondence to Laura Harkness.

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Harkness, L., Cromer, B. Low levels of 25-hydroxy vitamin D are associated with elevated parathyroid hormone in healthy adolescent females. Osteoporos Int 16, 109–113 (2005). https://doi.org/10.1007/s00198-004-1656-8

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  • DOI: https://doi.org/10.1007/s00198-004-1656-8

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