Karen M O'Callaghan, Celine Funk, Farzana Fariha, Marium H Nagaria, Alison Dasiewicz, Jennifer Harrington, Abdullah Al Mahmud, Steven A Abrams, Tahmeed Ahmed, Daniel R Moore, Daniel E Roth
{"title":"血清25-羟基维生素D和完整甲状旁腺激素作为早期儿童骨量的功能生物标志物。","authors":"Karen M O'Callaghan, Celine Funk, Farzana Fariha, Marium H Nagaria, Alison Dasiewicz, Jennifer Harrington, Abdullah Al Mahmud, Steven A Abrams, Tahmeed Ahmed, Daniel R Moore, Daniel E Roth","doi":"10.1016/j.tjnut.2025.03.022","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The 25-hydroxyvitamin D concentration (25(OH)D) at which parathyroid hormone (PTH) concentration plateaus has been considered to benchmark vitamin D deficiency. However, in young children, there is limited evidence for a suppression point in the 25(OH)D-PTH relationship or its relevance to bone mass accrual.</p><p><strong>Objective: </strong>To determine whether the threshold of 25(OH)D at PTH suppression in young children is corroborated by associations of 25(OH)D (or PTH) with bone mineral content (BMC) and areal bone mineral density (aBMD).</p><p><strong>Methods: </strong>In a cross-sectional secondary analysis of data from the BONe and mUScle health in Kids (BONUSKids) study of 4-year old children in Bangladesh, serum 25(OH)D and intact PTH (iPTH) were analyzed by liquid chromatography-tandem mass spectrometry and a chemiluminescent immunoassay, respectively. BMC and aBMD were measured by dual-energy X-ray absorptiometry. Associations between 25(OH)D, iPTH and bone outcomes (BMC, BMC z-score, aBMD and aBMD z-score) were modelled using multivariable-adjusted linear regression and spline models. Model fit was compared using AIC.</p><p><strong>Results: </strong>Of 534 participants (51% female), 28% had 25(OH)D concentrations <25nmol/L and 34% had iPTH >6.7pmol/L. Model fit of the inverse relationship between 25(OH)D and iPTH was optimised with an inflection point at 25nmol/L (<25nmol/L: -0.16pmol/L per 1nmol/L increase in 25(OH)D; 95%CI: -0.22, -0.10; P<0.001), above which the slope attenuated (≥25nmol/L: -0.02pmol/L; 95%CI: -0.04, -0.003; P=0.019). However, the positive linear associations between 25(OH)D and bone mass outcomes were monotonic (P<0.05), and iPTH was not associated with any bone outcome in adjusted models (P>0.05 for all). Associations were similar in males and females.</p><p><strong>Conclusions: </strong>Among 4-year old children in Dhaka, Bangladesh, we did not identify a 25(OH)D threshold to define vitamin D deficiency based on its association with bone mass. However, efforts to raise 25(OH)D to ≥25nmol/L may be warranted based on the relatively strong inverse association of 25(OH)D with iPTH below this threshold.</p><p><strong>Clinical trial registry: </strong>Clinicaltrials.gov #NCT03537443.</p>","PeriodicalId":16620,"journal":{"name":"Journal of Nutrition","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Serum 25-hydroxyvitamin D and intact parathyroid hormone as functional biomarkers of bone mass in early childhood.\",\"authors\":\"Karen M O'Callaghan, Celine Funk, Farzana Fariha, Marium H Nagaria, Alison Dasiewicz, Jennifer Harrington, Abdullah Al Mahmud, Steven A Abrams, Tahmeed Ahmed, Daniel R Moore, Daniel E Roth\",\"doi\":\"10.1016/j.tjnut.2025.03.022\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The 25-hydroxyvitamin D concentration (25(OH)D) at which parathyroid hormone (PTH) concentration plateaus has been considered to benchmark vitamin D deficiency. However, in young children, there is limited evidence for a suppression point in the 25(OH)D-PTH relationship or its relevance to bone mass accrual.</p><p><strong>Objective: </strong>To determine whether the threshold of 25(OH)D at PTH suppression in young children is corroborated by associations of 25(OH)D (or PTH) with bone mineral content (BMC) and areal bone mineral density (aBMD).</p><p><strong>Methods: </strong>In a cross-sectional secondary analysis of data from the BONe and mUScle health in Kids (BONUSKids) study of 4-year old children in Bangladesh, serum 25(OH)D and intact PTH (iPTH) were analyzed by liquid chromatography-tandem mass spectrometry and a chemiluminescent immunoassay, respectively. BMC and aBMD were measured by dual-energy X-ray absorptiometry. Associations between 25(OH)D, iPTH and bone outcomes (BMC, BMC z-score, aBMD and aBMD z-score) were modelled using multivariable-adjusted linear regression and spline models. Model fit was compared using AIC.</p><p><strong>Results: </strong>Of 534 participants (51% female), 28% had 25(OH)D concentrations <25nmol/L and 34% had iPTH >6.7pmol/L. Model fit of the inverse relationship between 25(OH)D and iPTH was optimised with an inflection point at 25nmol/L (<25nmol/L: -0.16pmol/L per 1nmol/L increase in 25(OH)D; 95%CI: -0.22, -0.10; P<0.001), above which the slope attenuated (≥25nmol/L: -0.02pmol/L; 95%CI: -0.04, -0.003; P=0.019). However, the positive linear associations between 25(OH)D and bone mass outcomes were monotonic (P<0.05), and iPTH was not associated with any bone outcome in adjusted models (P>0.05 for all). Associations were similar in males and females.</p><p><strong>Conclusions: </strong>Among 4-year old children in Dhaka, Bangladesh, we did not identify a 25(OH)D threshold to define vitamin D deficiency based on its association with bone mass. However, efforts to raise 25(OH)D to ≥25nmol/L may be warranted based on the relatively strong inverse association of 25(OH)D with iPTH below this threshold.</p><p><strong>Clinical trial registry: </strong>Clinicaltrials.gov #NCT03537443.</p>\",\"PeriodicalId\":16620,\"journal\":{\"name\":\"Journal of Nutrition\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-03-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.tjnut.2025.03.022\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.tjnut.2025.03.022","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
Serum 25-hydroxyvitamin D and intact parathyroid hormone as functional biomarkers of bone mass in early childhood.
Background: The 25-hydroxyvitamin D concentration (25(OH)D) at which parathyroid hormone (PTH) concentration plateaus has been considered to benchmark vitamin D deficiency. However, in young children, there is limited evidence for a suppression point in the 25(OH)D-PTH relationship or its relevance to bone mass accrual.
Objective: To determine whether the threshold of 25(OH)D at PTH suppression in young children is corroborated by associations of 25(OH)D (or PTH) with bone mineral content (BMC) and areal bone mineral density (aBMD).
Methods: In a cross-sectional secondary analysis of data from the BONe and mUScle health in Kids (BONUSKids) study of 4-year old children in Bangladesh, serum 25(OH)D and intact PTH (iPTH) were analyzed by liquid chromatography-tandem mass spectrometry and a chemiluminescent immunoassay, respectively. BMC and aBMD were measured by dual-energy X-ray absorptiometry. Associations between 25(OH)D, iPTH and bone outcomes (BMC, BMC z-score, aBMD and aBMD z-score) were modelled using multivariable-adjusted linear regression and spline models. Model fit was compared using AIC.
Results: Of 534 participants (51% female), 28% had 25(OH)D concentrations <25nmol/L and 34% had iPTH >6.7pmol/L. Model fit of the inverse relationship between 25(OH)D and iPTH was optimised with an inflection point at 25nmol/L (<25nmol/L: -0.16pmol/L per 1nmol/L increase in 25(OH)D; 95%CI: -0.22, -0.10; P<0.001), above which the slope attenuated (≥25nmol/L: -0.02pmol/L; 95%CI: -0.04, -0.003; P=0.019). However, the positive linear associations between 25(OH)D and bone mass outcomes were monotonic (P<0.05), and iPTH was not associated with any bone outcome in adjusted models (P>0.05 for all). Associations were similar in males and females.
Conclusions: Among 4-year old children in Dhaka, Bangladesh, we did not identify a 25(OH)D threshold to define vitamin D deficiency based on its association with bone mass. However, efforts to raise 25(OH)D to ≥25nmol/L may be warranted based on the relatively strong inverse association of 25(OH)D with iPTH below this threshold.
期刊介绍：
The Journal of Nutrition (JN/J Nutr) publishes peer-reviewed original research papers covering all aspects of experimental nutrition in humans and other animal species; special articles such as reviews and biographies of prominent nutrition scientists; and issues, opinions, and commentaries on controversial issues in nutrition. Supplements are frequently published to provide extended discussion of topics of special interest.
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