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Relationships among Vitamin D Levels, Parathyroid Hormone, and Calcium Absorption in Young Adolescents

United States Department of Agriculture/Agricultural Research Service, Children’s Nutrition Research Center, Department of Pediatrics, Sections of Nutrition (S.A.A., I.J.G., K.M.H., K.J.E.), Neonatology (S.A.A., I.J.G.), and Endocrinology (S.K.G.), Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas 77030; and Departments of Pediatrics (T.O.C.) and Orthopedics and Rehabilitation (C.M.G.), Yale University School of Medicine, New Haven, Connecticut 06510

Address all correspondence and requests for reprints to: Dr. Steven A. Abrams, United States Department of Agriculture/Agricultural Research Service Children’s Nutrition Research Center, 1100 Bates Street, Houston, Texas 77030. E-mail: sabrams{at}bcm.edu.

Background: Evidence suggests that vitamin D status in adults, as assessed by serum 25-hydroxyvitamin D (25-OHD), is positively associated with calcium absorption fraction and inversely associated with serum PTH. Few comparable pediatric data exist.

Objectives: The objective of this study was to evaluate the relationships among vitamin D status, PTH, and calcium absorption in midpubertal boys and girls.

Methods: Calcium absorption was measured as part of an evaluation of the effects of prebiotics (inulin-type fructans) using a stable isotope method in 93 young adolescents, 12.7 ± 1.0 yr of age, receiving diets averaging approximately 900 mg/d calcium.

Results: A significant positive relation to calcium absorption was found for serum 1,25-dihydroxyvitamin D (P = 0.048) and PTH (P = 0.007), but not for 25-OHD (P = 0.77). PTH was significantly inversely related to 25-OHD and was positively related to serum 1,25-dihydroxyvitamin D and osteocalcin. PTH was marginally significantly inversely related to lumbar spinal, but not whole body, bone mineral density.

Conclusions: These data suggest that in adolescents, especially in the presence of vitamin D insufficiency, PTH secretion increases to adapt to higher rates of bone formation associated with growth. This results in higher serum 1,25(OH)₂D concentrations and increased calcium absorption results. Vitamin D status, as reflected by the serum 25-OHD level, is not closely related to calcium absorption. Whether adaptation to low serum 25-OHD is adequate under physiologically stressful situations, including those leading to very low serum 25-OHD levels, is unknown.

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