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Vitamin D insufficiency in adolescent males in Southern Tasmania: prevalence, determinants, and relationship to bone turnover markers

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Abstract

There are limited data on vitamin D insufficiency in healthy children. The aim of this study was to describe the prevalence and determinants of vitamin D insufficiency and its association with bone turnover in adolescent boys (N=136, mean age 16 years). Sun exposure and physical activity were assessed by questionnaire. Vitamin D stores were assessed by serum 25-hydroxyvitamin D3 (25[OH]D3). Bone turnover was assessed by bone-specific alkaline phosphatase (BAP) and urinary pyridinoline (PYR) to creatinine (Cr) ratio (mmol PYR/µmol Cr). The mean 25(OH)D3 level was low (44 nmol/l; 68% <50 nmol/l; range, 16–87) and was associated with self-reported sun exposure on winter weekends (r=0.23, p=0.01), school holidays (r=0.22, p=0.01), and weekdays (r=0.17, p=0.05). It was also associated with number of sports (r=0.34, p<0.001) and vigorous activity (r=0.22, p=0.01) but not television, computer, and video watching (r=-0.04, p=0.68). In multivariate analysis, number of sports but not total sun exposure remained significantly associated with 25(OH)D3. Furthermore, 25(OH)D3 was significantly associated with BAP in cutpoint analysis (cutpoint 55 nmol/l, p=0.03) but not continuous analysis (r=–0.12, p=0.16) and PYR in both forms (r=−0.23, p=0.01, cutpoint 43 nmol/l, p=0.01). In conclusion, vitamin D insufficiency is common in healthy adolescent boys in winter in our setting, is primarily derived from sports-related sun exposure, and is associated with bone turnover markers. These data suggest that a 25(OH)D3 level of at least 43–55 nmol/l is required for optimal bone health in children.

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References

  1. Cooley H, Jones G (2001) A population based study of fracture incidence in Southern Tasmania: lifetime fracture risk and evidence for geographic variations within the same country. Osteoporos Int 12:124–130

    Article  CAS  PubMed  Google Scholar 

  2. Jones G, Cooley H (2002) Symptomatic fracture incidence in those under 50 years of age in Southern Tasmania. J Paediatr Child Health 33:278–283

    Article  Google Scholar 

  3. Riis BJ, Hansen MA, Jensen AM, Overgaard K, Christiansen C (1996) Low bone mass and fast rate of bone loss at menopause: equal risk factors for future fracture: a 15-year follow-up study. Bone 19:9–12

    Article  CAS  PubMed  Google Scholar 

  4. Goulding A, Cannan R, Williams SM, Gold EJ, Taylor RW, Lewis-Barned NJ (1998) Bone mineral density in girls with forearm fractures. J Bone Miner Res 13:143–148

    CAS  PubMed  Google Scholar 

  5. Ma D, Jones G (2003) The association between bone mineral density, metacarpal morphometry and upper limb fractures in children: a population based case-control study. J Clin Endocrinol Metab 88:1486–1491

    Article  CAS  PubMed  Google Scholar 

  6. Jones G, Dwyer T (1998) Bone mass in prepubertal children: gender differences and the role of physical activity and sunlight exposure. J Clin Endocrinol Metab 83:4274–4279

    Article  CAS  PubMed  Google Scholar 

  7. Jones G, Blizzard L, Riley M, Greenaway T, Parameswaran V, Dwyer T (1999) Determinants of vitamin D levels in prepubertal children in Southern Tasmania. Eur J Clin Nutr 53:824–829

    Article  CAS  PubMed  Google Scholar 

  8. Inderjeeth CA, Nicklason F, Al-Lahham Y et al (2000) Vitamin D deficiency and secondary hyperparathyroidism: clinical and biochemical associations in elderly non-institutionalised Southern Tasmanians. ANZ J Med 30:209–214

    CAS  Google Scholar 

  9. Lehtonen-Veromaa MK, Mottonen TT, Nuotio IO et al (2002) Vitamin D and attainment of peak bone mass among peripubertal Finnish girls: a 3-y prospective study. Am J Clin Nutr 76:1446–1453

    CAS  PubMed  Google Scholar 

  10. Zamora SA, Rizzoli R, Belli DC, Slosman DO, Bonjour JP (1999) Vitamin D supplementation during infancy is associated with higher bone mineral mass in prepubertal girls. J Clin Endocrinol Metab 84:4541–4544

    Article  CAS  PubMed  Google Scholar 

  11. Garnero P, Sornay-Rendu E, Claustrat B, Delmas PD (2000) Biochemical markers of bone turnover, endogenous hormones and the risk of fractures in postmenopausal women: the OFELY study. J Bone Miner Res 15:1526–1536

    CAS  PubMed  Google Scholar 

  12. Szulc P, Seeman E, Delmas PD (2000) Biochemical measurements of bone turnover in children and adolescents. Osteoporos Int 11:281–294

    Article  CAS  PubMed  Google Scholar 

  13. Lieuw-A-Fa M, Sierra RI, Specker BL (1995) Carboxy-terminal propeptide of human type I collagen and pyridinium cross-links as markers of bone growth in infants 1 to 18 months of age. J Bone Miner Res 10:849–853

    CAS  PubMed  Google Scholar 

  14. Rauch F, Schonau E, Woitge H, Remer T, Seibel M (1994) Urinary excretion of hydroxy-pyridinium cross-links of collagen reflects skeletal growth velocity in normal children. Exp Clin Endocrinol 102:94–97

    CAS  PubMed  Google Scholar 

  15. Marowska J, Kobylinska M, Lukaszkiewicz J et al (1996). Pyridinium crosslinks of collagen as a marker of bone resorption rates in children and adolescents: normal values and clinical application. Bone 19:669–677

    Article  CAS  PubMed  Google Scholar 

  16. Cheng S, Tylavsky F, Kroger H et al (2003) Association of low 25-hydroxyvitamin D concentrations with elevated parathyroid hormone concentrations and low cortical bone density in early pubertal and prepubertal Finnish girls. Am J Clin Nutr 78:485–492

    CAS  PubMed  Google Scholar 

  17. El-Hajj Fuleihan G, Nabulsi M, Choucair M et al (2001) Hypovitaminosis D in healthy schoolchildren. Pediatrics 107:E53

    Article  PubMed  Google Scholar 

  18. Looker AC, Dawson-Hughes B, Calvo MS, Gunter EW, Sahyoun NR (2002) Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone 30:771–777

    Article  CAS  PubMed  Google Scholar 

  19. Jones G, Dwyer T, Hynes K, Dalais F, Parameswaran V, Greenaway TM (2003) A randomised controlled trial of phytoestrogen supplementation, growth and bone turnover in adolescent males. Eur J Clin Nutr 57:324–327

    Article  CAS  PubMed  Google Scholar 

  20. Morris NM, Udry JR (1980) Validation of a self-administered instrument to assess stage of adolescent development. J Youth Adoles 9:271–280

    Google Scholar 

  21. Aaron DJ, Kriska AM, Dearwater SR, Cauley JA, Metz KF, LaPorte RE (1995) Reproducibility and validity of an epidemiologic questionnaire to assess past year physical activity in adolescents. Am J Epidemiol 142:191–201

    CAS  PubMed  Google Scholar 

  22. Jones G, Glisson M, Hynes K, Cicuttini F (2000) Sex and site differences in cartilage development: a possible explanation for variations in knee osteoarthritis in later life. Arthritis Rheum 43:2543–2549

    Article  CAS  PubMed  Google Scholar 

  23. Ma D, Jones G (2003) Television, computer and video viewing, physical activity and upper limb fracture risk in children: a population based case-control study. J Bone Min Res 18:1970–1979

    Google Scholar 

  24. Dwyer T, Blizzard CL, Gies PH, Ashbolt R, Roy C (1996) Assessment of habitual sun exposure in adolescents via questionnaire: a comparison with objective measurement using polysulphone badges. Melanoma Res 6:231–239

    CAS  PubMed  Google Scholar 

  25. McKenna MJ, Freaney R (1998) Secondary hyperparathyroidism in the elderly: means to defining hypovitaminosis D. Osteoporos Int 8(S2):3–6

    Google Scholar 

  26. Eisenmann JC, Bartee RT, Wang MQ (2002) Physical activity, TV viewing, and weight in U.S. youth: 1999 Youth Risk Behavior Survey. Obes Res 10:379–385

    PubMed  Google Scholar 

  27. Johnson JG, Cohen P, Smailes EM, Kasen S, Brook JS (2002) Television viewing and aggressive behavior during adolescence and adulthood. Science 295:2468–2471

    Article  CAS  PubMed  Google Scholar 

  28. Ozmert E, Toyran M, Yurdakok K (2002) Behavioral correlates of television viewing in primary school children evaluated by the child behavior checklist. Arch Pediatr Adolesc Med 156:910–914

    PubMed  Google Scholar 

  29. Docio S, Riancho JA, Perez A, Olmos JM, Amado JA, Gonzalez-Macias J (1998) Seasonal deficiency of vitamin D in children: a potential target for osteoporosis-preventing strategies. J Bone Min Res 13:544–548

    CAS  Google Scholar 

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Acknowledgements

This study was supported by the National Health and Medical Research Council of Australia and the Arthritis Foundation of Australia. A special thanks to the students, parents, and staff of the Hellyer College in Burnie who made this study possible.

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Authors and Affiliations

  1. Menzies Research Institute, Private Bag 23, 7000, Hobart, Tasmania, Australia

    Graeme Jones, Terry Dwyer & Kristen L. Hynes

  2. Diabetes and Endocrine Services, Royal Hobart Hospital, Liverpool St, Hobart, Tasmania, Australia

    Venkat Parameswaran & Timothy M. Greenaway

Authors
  1. Graeme Jones
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  2. Terry Dwyer
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  3. Kristen L. Hynes
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  4. Venkat Parameswaran
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  5. Timothy M. Greenaway
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Correspondence to Graeme Jones.

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Jones, G., Dwyer, T., Hynes, K.L. et al. Vitamin D insufficiency in adolescent males in Southern Tasmania: prevalence, determinants, and relationship to bone turnover markers. Osteoporos Int 16, 636–641 (2005). https://doi.org/10.1007/s00198-004-1733-z

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  • DOI: https://doi.org/10.1007/s00198-004-1733-z

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