An inflection point of serum 25-hydroxyvitamin D for maximal suppression of parathyroid hormone is not evident from multi-site pooled data in children and adolescents

Kathleen M. Hill, George P. McCabe, Linda D. McCabe, Catherine M. Gordon, Steven A. Abrams, Connie M. Weaver

Research output: Contribution to journalArticlepeer-review

49 Scopus citations

Abstract

In adults, maximal suppression of serum parathyroid hormone (PTH) has commonly been used to determine the sufficiency of serum 25-hydroxyvitamin D [25(OH)D]. In children and adolescents, the relationship between serum 25(OH)D and PTH is less clear and most studies reporting a relationship are derived from relatively small samples and homogeneous cohorts. Our objective was to determine the relationship between serum 25(OH)D and PTH in children and adolescents from a large and diverse U.S. cohort and to identify a point of inflection of serum 25(OH)D for maximal suppression of serum PTH. Data from 735 participants, ages 7-18 y, were pooled from 3 study sites located in Indiana, Texas, and Massachusetts. A two-phase linear spline was used to model the relationship between serum 25(OH)D and PTH. The value of serum 25(OH)D for maximal suppression of serum PTH was identified as the inflection point of the spline. Before adjustment for site, the inflection point of serum 25(OH)D for maximal suppression of serum PTH was 92.4 nmol/L (95% CI: 62.2, 130.7). After adjusting for site, the point of inflection was poorly defined and the relationship between serum 25(OH)D and PTH appeared to be linear. The lack of an inflection point of serum 25(OH)D for maximal suppression of PTH brings into question the value of using maximal suppression of serum PTH as a basis for determining optimal serum 25(OH)D for healthy children and adolescents.

Original languageEnglish (US)
Pages (from-to)1983-1988
Number of pages6
JournalThe Journal of nutrition
Volume140
Issue number11
DOIs
StatePublished - Nov 2010

Keywords

  • 25-Hydroxyvitamin D 2/blood
  • Adolescent
  • Calcifediol/blood
  • Child
  • Cohort Studies
  • Down-Regulation
  • Humans
  • Models, Biological
  • Nutritional Requirements
  • Nutritional Status
  • Parathyroid Hormone/blood
  • Reproducibility of Results
  • Statistics as Topic
  • United States
  • Vitamin D
  • Vitamin D Deficiency/blood

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

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