OBJECTIVES. The purpose of this work was to determine the prevalence of vitamin D deficiency and insufficiency in children with osteopenia or osteoporosis and to evaluate the relationship between serum 25-hydroxyvitamin D levels and bone parameters, including bone mineral density.MATERIALS AND METHODS. Serum 25-hydroxyvitamin D, 1,25 dihydroxyvitamin D, parathyroid hormone, and other bone markers, as well as bone mineral density, were obtained for 85 pediatric patients with primary osteoporosis (caused by osteogenesis imperfecta or juvenile idiopathic osteoporosis) and secondary osteopenia or osteoporosis caused by various underlying chronic illnesses. Pearson's correlation was used to assess the relationship between vitamin D levels and different bone parameters.RESULTS. Vitamin D insufficiency (defined as serum 25-hydroxyvitamin D 30 ng/mL) was observed in 80.0% of patients. Overt vitamin D deficiency (defined as serum 25-hydroxyvitamin D 10 ng/mL) was present in 3.5% of patients. Using a more recent definition for vitamin D deficiency in adults (defined as serum 25-hydroxyvitamin D 20 ng/mL), 21.1% of the patients had vitamin D deficiency. There was a significant inverse correlation between 25-hydroxyvitamin D and parathyroid hormone levels. There was a positive correlation between 1,25 dihydroxyvitamin D and parathyroid hormone, alkaline phosphatase, and urine markers for bone turnover.CONCLUSIONS. Vitamin D insufficiency was remarkably common in pediatric patients with primary and secondary osteopenia or osteoporosis. The inverse relationship between 25-hydroxyvitamin D and parathyroid hormone levels suggests a physiologic impact of insufficient vitamin D levels that may contribute to low bone mass or worsen the primary bone disease. We suggest that monitoring and supplementation of vitamin D should be a priority in the management of pediatric patients with osteopenia or osteoporosis.
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机译：目标这项工作的目的是确定骨质疏松或骨质疏松患儿中维生素D缺乏和不足的患病率，并评估血清25-羟基维生素D水平与骨参数（包括骨矿物质密度）之间的关系。材料与方法。为85名患有原发性骨质疏松症（由成骨不全症或青少年特发性骨质疏松症引起）和继发性骨质疏松症的儿科患者获得了血清25-羟基维生素D，1,25二羟基维生素D，甲状旁腺激素和其他骨标记物以及骨矿物质密度由各种潜在的慢性疾病引起的骨质疏松症。皮尔逊相关性用于评估维生素D水平与不同骨骼参数之间的关系。在80.0％的患者中观察到维生素D功能不足（定义为血清25-羟基维生素D <30 ng / mL）。 3.5％的患者存在明显的维生素D缺乏症（定义为血清25-羟基维生素D <10 ng / mL）。使用针对成人维生素D缺乏症的最新定义（定义为血清25-羟基维生素D <20 ng / mL），有21.1％的患者患有维生素D缺乏症。 25-羟基维生素D与甲状旁腺激素水平呈显着负相关。 1,25二羟基维生素D与甲状旁腺激素，碱性磷酸酶和尿液骨代谢指标呈正相关。维生素D功能不足在患有原发性和继发性骨质减少或骨质疏松症的小儿患者中非常常见。 25-羟基维生素D与甲状旁腺激素水平之间呈反比关系，提示维生素D水平不足会对生理产生影响，这可能导致骨量降低或使原发性骨病恶化。我们建议，监测和补充维生素D应该是骨质疏松症或骨质疏松症患儿治疗的优先事项。
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