TY - JOUR
T1 - Population-based pediatric reference values for serum parathyroid hormone, vitamin D, calcium, and phosphate in Danish/North-European white children and adolescents
AU - Vissing Landgrebe, Ann
AU - Asp Vonsild Lund, Morten
AU - Lausten-Thomsen, Ulrik
AU - Frithioff-Bøjsøe, Christine
AU - Esmann Fonvig, Cilius
AU - Lind Plesner, Johanne
AU - Aas Holm, Louise
AU - Jespersen, Thomas
AU - Hansen, Torben
AU - Christian Holm, Jens
N1 - Copyright © 2021 Elsevier B.V. All rights reserved.
PY - 2021/12
Y1 - 2021/12
N2 - INTRODUCTION: Parathyroid hormone (PTH) and vitamin D are essential hormones in bone metabolism, especially during pediatric growth. Vitamin D insufficiency is often asymptomatic and is prevalent in high-latitude countries.METHODS: In a Danish population-based cohort of 2,211 6-18-year-olds, sex- and age-specific pediatric reference values for fasting concentrations of intact serum PTH, vitamin D (25-hydroxycholecalciferol, 25-OH-D), total calcium, and phosphate were generated in accordance with Clinical and Laboratory Standards Institute (CLSI) EP28-A3c guidelines. The effect of season on these biomarkers of bone metabolism was evaluated.RESULTS: In boys, PTH concentrations increased with age, while the vitamin D and phosphate concentrations decreased (all p<.001). In girls, a peak in PTH concentrations and a nadir in vitamin D concentrations were observed in the 10-14-year-olds (both p<.001). Calcium and phosphate decreased with age for both sexes (girls: both p<.001; boys calcium: p<.05, boys phosphate: p<.001). Vitamin D was 20% lower in winter than summer for both sexes (both p<.001). Individuals with vitamin D sufficiency (25-OH-D >50 nmol/L) exhibited a 5% lower level of PTH compared to the whole sample population (p<.001).CONCLUSION: The concentrations of PTH, vitamin D, calcium, and phosphate vary during childhood and adolescence, and is dependent on sex and season. These factors should be considered when screening for and treating imbalances in bone metabolism.
AB - INTRODUCTION: Parathyroid hormone (PTH) and vitamin D are essential hormones in bone metabolism, especially during pediatric growth. Vitamin D insufficiency is often asymptomatic and is prevalent in high-latitude countries.METHODS: In a Danish population-based cohort of 2,211 6-18-year-olds, sex- and age-specific pediatric reference values for fasting concentrations of intact serum PTH, vitamin D (25-hydroxycholecalciferol, 25-OH-D), total calcium, and phosphate were generated in accordance with Clinical and Laboratory Standards Institute (CLSI) EP28-A3c guidelines. The effect of season on these biomarkers of bone metabolism was evaluated.RESULTS: In boys, PTH concentrations increased with age, while the vitamin D and phosphate concentrations decreased (all p<.001). In girls, a peak in PTH concentrations and a nadir in vitamin D concentrations were observed in the 10-14-year-olds (both p<.001). Calcium and phosphate decreased with age for both sexes (girls: both p<.001; boys calcium: p<.05, boys phosphate: p<.001). Vitamin D was 20% lower in winter than summer for both sexes (both p<.001). Individuals with vitamin D sufficiency (25-OH-D >50 nmol/L) exhibited a 5% lower level of PTH compared to the whole sample population (p<.001).CONCLUSION: The concentrations of PTH, vitamin D, calcium, and phosphate vary during childhood and adolescence, and is dependent on sex and season. These factors should be considered when screening for and treating imbalances in bone metabolism.
KW - Calcium
KW - Child
KW - Parathyroid Hormone
KW - Phosphate
KW - Reference Values
KW - Vitamin D
U2 - 10.1016/j.cca.2021.10.024
DO - 10.1016/j.cca.2021.10.024
M3 - Article
C2 - 34695445
SN - 0009-8981
VL - 523
SP - 483
EP - 490
JO - Clinica Chimica Acta
JF - Clinica Chimica Acta
ER -