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Based on PTH response, obese adolescents may not need and much vitamin D as non-obese (12 ng vs 16.5 ng) – June 2021

Different threshold levels of circulating total and free 25-hydroxyvitamin D for the diagnosis of vitamin D deficiency in obese adolescents

Eur J Pediatr. 2021 Jun 11. doi: 10.1007/s00431-021-04137-5
Nurullah Çelik 1, Halef Okan Doğan 2, Gökmen Zararsiz 3 4


The response of the parathyroid hormone (PTH) is about the only way to determin that vitamin D is actually getting to cells

Vitamin D titles containing PTH OR Parathyroid

Items found: 40
Title Modified
Parathyroid response to Vitamin D among obese 27 Jun, 2021
Based on PTH response, obese adolescents may not need and much vitamin D as non-obese (12 ng vs 16.5 ng) – June 2021 12 Jun, 2021
Parathyroid Hormone levels increase 63 percent with age (33,000 people) – Sept 2017 17 May, 2021
Parathyroid hormone level is inversely associated with both Vitamin D and age – April 2021 17 May, 2021
High PTH plus low Vitamin D is not good (5X more likely for COPD to need hospital) – April 2021 25 Apr, 2021
Increased Colorectal cancer risk if Vitamin D does not lower PTH (Vit D not getting to cells) – Nov 2020 06 Nov, 2020
ICU death rate reduced 3X when a vitamin D injection changed the PTH – Nov 2015 06 Jun, 2020
Parathyroid increase with age associated with worsening Vitamin D genes – April 2020 01 May, 2020
Worse diabetic vision is associated with low vitamin D or high PTH - Nov 2012 07 Jan, 2020
PTH failed to decrease with Vitamin D if overweight and had low Magnesium – Aug 2019 08 Nov, 2019
Parathyroid – Vitamin D inflection points might be at both 16 and 32 ng – Oct 2019 04 Oct, 2019
Hip fractures worse if both high PTH and low Vitamin D – Jan 2019 01 Feb, 2019
Interview of Dr. Coimbra: MS, Autoimmune, Vitamin D, B2, Ca, Mg, PTH etc. – perhaps 2018 02 Dec, 2018
Heart Failure is predicted by PTH (but vitamin D both prevents and treats HF) – Jan 2018 31 Mar, 2018
Coronary Heart Disease 57 percent more likely if poor Vitamin D Binding Protein with high PTH – Nov 2017 08 Nov, 2017
Thyroid and parathyroid 12 Sep, 2017
Ischemic Stroke risk best predicted by Vitamin D, including PTH improves the prediction – Feb 2017 02 Mar, 2017
Critically ill injected with 300,000 IU of vitamin D, 3X more likely to die if PTH did not respond - RCT July 2015 22 Jan, 2017
3000 IU of vitamin D minimum to reduce parathyroid hormone (PTH) – meta-analysis Sept 2015 10 Dec, 2016
Need 40 ng of vitamin D to have proper PTH levels – May 2011 29 Mar, 2016
PTH boosts immune response when vitamin D levels are low – May 2012 29 Mar, 2016
PTH does not plateau with increasing vitamin D, but does decrease with patient age – Aug 2012 29 Mar, 2016
Hypothesis Vitamin D receptor controls PTH without needing Vitamin D – Aug 2015 01 Sep, 2015
Knee Osteoarthritis 3.2X more likely to get worse if low Vitamin D and high PTH – Dec 2014 23 Feb, 2015
PTH reduced 3.5 pmol by vitamin D intervention which added 22 ng – meta-analysis June 2014 01 Jan, 2015
Diabetes after giving birth was associated with low vitamin D combined with high PTH – May 2014 31 May, 2014
2800 IU of vitamin D before and after parathyroid surgery helped a lot – RCT Jan 2014 16 Jan, 2014
ICU reduces Vitamin D levels, deregulates PTH - Sept 2013 28 Sep, 2013
Almost 3X more likely to get preeclampsia if low vitamin D and high PTH– July 2013 15 Sep, 2013
Vitamin D deficiency for children’s bones is 14ng, based on PTH analysis – Sept 2013 09 Sep, 2013
Japanese decided that 28 ng mimimum for proper parathyroid hormone – June 2010 09 Sep, 2013
PTH needs vitamin D level higher than 13 ng – Cohort June 2010 09 Sep, 2013
Children have PTH problems when vitamin D is less than 15 ng – Nov 2011 09 Sep, 2013
Variations in Parathyroid Hormone Concentrations in Patients with Low Vitamin D – June 2012 09 Sep, 2013
Hypothesis: Not vitamin D deficient if have normal PTH and BMD – May 2013 01 Jun, 2013
1000 IU of vitamin D reduced child PTH, but did not increase Calcium – RCT Jan 2013 03 Jan, 2013
Chronic kidney disease and PTH – Calcium – Phosphate – Vitamin D – April 2011 23 May, 2012
20 ng of vitamin D is enough for African American PTH – Dec 2011 09 Mar, 2012
Africans in Europe might only need 19 ng of vitamin D – estimated from PTH July 2011 09 Mar, 2012
Blacks may need less vitamin D than whites – PTH Aug 2010 23 Dec, 2011

The total serum 25-hydroxyvitamin D [25(OH)DT] level is lower in obese individuals than in their nonobese peers, despite similar bone turnover markers and bone mineral density. This study aimed to investigate whether the threshold level of 25(OH)D for the diagnosis of vitamin D deficiency (VDD) in obese adolescents was lower than that in controls and to compare 25(OH)DT, free [25(OH)DF] and bioavailable [25(OH)DB] vitamin D with VDBP levels in obese individuals and their controls.

A total of 173 adolescents (90 obese individuals and 83 controls) aged 12-18 years were included in the study. The metabolic and anthropometric parameters of the participants were recorded, the 25(OH)DT, 25(OH)DF, and VDBP levels were measured, and the 25(OH)DB levels were calculated. The cutoff values for VDD were estimated according to the level of 25(OH)D below which parathyroid hormone begins to rise.
The obese subjects had lower

  • 25(OH)DT (12.1 ± 5.8 vs. 16.4 ± 9.3 ng/mL, p < 0.001),
  • 25(OH)DF (12.6 ± 4.2 vs. 16.7 ± 7.6 pg/mL, p < 0.001),
  • 25(OH)DB [4.8 (2.3) vs. 6.1 (5.2) ng/mL, p = 0.012], and
  • VDBP [112.2 (51.3) vs. 121.9 (95.5) μg/mL, p < 0.001] levels than the controls.

The cutoff values for 25(OH)DT and 25(OH)DF levels for VDD were lower in the obese group than in the control group (9.4 vs. 14.1 ng/mL; 12.2 vs. 16.8 pg/mL, respectively).

Conclusion: The vitamin D cutoff values for the diagnosis of VDD were different in the obese and control groups. Using the same cutoff value for VDD may cause overtreatment in obese adolescents.

What is Known:

  • Vitamin D deficiency is more prevalent in obese children than nonobese controls,
    • despite the same bone turnover markers and bone mineral density
  • The cutoff value of vitamin D level for the diagnosis of VDD is based on the PTH elevation

What is New

  • In obese adolescents, total and free vitamin D cutoff value for the diagnosis of VDD was lower than nonobese peers


  1. Holick MF (2017) The vitamin D deficiency pandemic: approaches for diagnosis, treatment and prevention. Rev Endocr Metab Disord 18:153–165. https://doi.org/10.1007/s11154-017-9424-1 - DOI - PubMed
  2. Turer CB, Lin H, Flores G (2013) Prevalence of vitamin D deficiency among overweight and obese us children. Pediatrics 131:e152–e161. https://doi.org/10.1542/peds.2012-1711 - DOI - PubMed
  3. Walsh JS, Bowles S, Evans AL (2017) Vitamin D in obesity. Curr Opin Endocrinol Diabetes Obes 24:389–394. https://doi.org/10.1097/MED.0000000000000371 - DOI - PubMed
  4. Heaney RP, Horst RL, Cullen DM, Armas LAG (2009) Vitamin D3 Distribution and status in the body. J Am Coll Nutr 28(3):252–256. https://doi.org/10.1080/07315724.2009.10719779 - DOI - PubMed
  5. Bouillon R, Bikle D (2019) Vitamin D metabolism revised: fall of dogmas. J Bone Miner Res 34:1985–1992. https://doi.org/10.1002/jbmr.3884 - DOI - PubMed
  6. Atapattu N, Shaw N, Högler W (2013) Relationship between serum 25-hydroxyvitamin D and parathyroid hormone in the search for a biochemical definition of vitamin D deficiency in children. Pediatr Res 74(5):552–556. https://doi.org/10.1038/pr.2013.139 - DOI - PubMed
  7. Alonso MA, Mantecón L, Santos F (2019) Vitamin D deficiency in children: a challenging diagnosis! Pediatr Res 85:596–601. https://doi.org/10.1038/s41390-019-0289-8 - DOI - PubMed
  8. Ding F, Nie X, Li X, He Y, Li G (2021) Data mining: Biological and temporal factors associated with blood parathyroid hormone, vitamin D, and calcium concentrations in the Southwestern Chinese population. Clin Biochem 87:19–25. https://doi.org/10.1016/j.clinbiochem.2021.01.014 - DOI
  9. Snellman G, Melhus H, Gedeborg R, Byberg L, Berglund L, Wernroth L, Michaëlsson K (2010) Determining vitamin D status: a comparison between commercially available assays. PLoS One 5(7):e11555. https://doi.org/10.1371/journal.pone.0011555 - DOI - PubMed - PMC
  10. Yousefzadeh P, Shapses SA, Wang X (2014) Vitamin D binding protein impact on 25-hydroxyvitamin D levels under different physiologic and pathologic conditions. Int J Endocrinol 2014:981581–981586. https://doi.org/10.1155/2014/981581 - DOI - PubMed - PMC
  11. Ashraf AP, Huisingh C, Alvarez JA, Wang X, Gower BA (2014) Insulin resistance indices are inversely associated with vitamin D binding protein concentrations. jcemendojournalsorg J Clin Endocrinol Metab 99:178–183. https://doi.org/10.1210/jc.2013-2452 - DOI - PubMed
  12. Powe CE, Evans MK, Wenger J, Zonderman AB, Berg AH, Nalls M, Tamez H, Zhang D, Bhan I, Karumanchi SA, Powe NR, Thadhani R (2013) Vitamin D–binding protein and vitamin D status of Black Americans and White Americans. N Engl J Med 369:1991–2000. https://doi.org/10.1056/NEJMoa1306357 - DOI - PubMed - PMC
  13. Safadi FF, Thornton P, Magiera H, Hollis BW, Gentile M, Haddad JG, Liebhaber SA, Cooke NE (1999) Osteopathy and resistance to vitamin D toxicity in mice null for vitamin D binding protein. J Clin Invest 103:239–251. https://doi.org/10.1172/JCI5244 - DOI - PubMed - PMC
  14. Holmlund-Suila E, Pekkinen M, Ivaska KK, Andersson S, Mäkitie O, Viljakainen H (2016) Obese young adults exhibit lower total and lower free serum 25-hydroxycholecalciferol in a randomized vitamin D intervention. Clin Endocrinol 85:378–385. https://doi.org/10.1111/cen.13093 - DOI
  15. Corica D, Zusi C, Olivieri F, Marigliano M, Piona C, Fornari E, Morandi A, Corradi M, Miraglia del Giudice E, Gatti D, Rossini M, Bonadonna RC, Maffeis C (2019) Vitamin D affects insulin sensitivity and β-cell function in obese non-diabetic youths. Eur J Endocrinol 181(4):439–450 - DOI
  16. Pekkinen M, Saarnio E, Viljakainen HT, Kokkonen E, Jakobsen J, Cashman K, Mäkitie O, Lamberg-Allardt C (2014) Vitamin D binding protein genotype is associated with serum 25-hydroxyvitamin D and PTH concentrations, as well as bone health in children and adolescents in Finland. PLoS One 30 9(1):e87292. https://doi.org/10.1371/journal.pone.0087292 - DOI
  17. Lopez-Molina M, Santillan C, Murillo M, Valls A, Bosch L, Bel J, Granada ML (2018) Measured free 25-hydroxyvitamin D in healthy children and relationship to total 25-hydroxyvitamin D, calculated free 25-hydroxyvitamin D and vitamin D binding protein. Clin Biochem 61:23–27. https://doi.org/10.1016/j.clinbiochem.2018.08.007 - DOI - PubMed
  18. Mehramiz M, Khayyatzadeh SS, Esmaily H, Ghasemi F, Sadeghi-Ardekani K, Tayefi M, Mirmousavi SJ, Hanachi P, Bahrami-Taghanaki H, Eslami S, Vatanparast H, Ferns GA, Ghayour-Mobarhan M, Avan A (2019) Associations of vitamin D binding protein variants with the vitamin D-induced increase in serum 25-hydroxyvitamin D. Clin Nutr ESPEN 29:59–64. https://doi.org/10.1016/j.clnesp.2018.12.005 - DOI - PubMed
  19. Madden K, Feldman HA, Chun RF, Smith EM, Sullivan RM, Agan AA, Keisling SM, Panoskaltsis-Mortari A, Randolph AG (2015) Critically ill children have low vitamin D-binding protein, influencing bioavailability of vitamin D. Ann Am Thorac Soc 12:1654–1661. https://doi.org/10.1513/AnnalsATS.201503-160OC - DOI - PubMed - PMC
  20. Bacha F, Bartz SK, Tomsa A, Sharma S (2019) Free vitamin D: relationship to insulin sensitivity and vascular health in youth. J Pediatr 212:28–34.e2. https://doi.org/10.1016/j.jpeds.2019.04.057 - DOI - PubMed
  21. Del Giudice EM, Grandone A, Cirillo G et al (2015) Bioavailable vitamin D in obese children: the role of insulin resistance. J Clin Endocrinol Metab 100:3949–3955. https://doi.org/10.1210/jc.2015-2973 - DOI
  22. Drincic AT, Armas LAG, Van Diest EE, Heaney RP (2012) Volumetric dilution, rather than sequestration best explains the low vitamin D status of obesity. Obesity 20:1444–1448. https://doi.org/10.1038/oby.2011.404 - DOI - PubMed
  23. Neyzi O, Bundak R, Gökçay G, Günöz H, Furman A, Darendeliler F, Baş F (2015) Reference values for weight, height, head circumference, and body mass index in Turkish children. JCRPE J Clin Res Pediatr Endocrinol 7:280–293. https://doi.org/10.4274/jcrpe.2183 - DOI - PubMed
  24. Hatipoglu N, Ozturk A, Mazicioglu MM, Kurtoglu S, Seyhan S, Lokoglu F (2008) Waist circumference percentiles for 7- to 17-year-old Turkish children and adolescents. Eur J Pediatr 167(4):383–389. https://doi.org/10.1007/s00431-007-0502-3 - DOI - PubMed
  25. Bundak R, Furman A, Gunoz H, Darendeliler F, Bas F, Neyzi O (2006) Body mass index references for Turkish children. Acta Paediatr 95(2):194–198. https://doi.org/10.1080/08035250500334738 - DOI - PubMed
  26. Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M, on behalf of the Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society (2008) Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics 122:398–417 - DOI
  27. Bikle DD, Gee E, Halloran B et al (1986) Assessment of the free fraction of 25-hydroxyvitamin d in serum and its regulation by albumin and the vitamin d-binding protein. J Clin Endocrinol Metab 63(4):954–959. https://doi.org/10.1210/jcem-63-4-954 - DOI - PubMed
  28. Conwell LS, Trost SG, Brown WJ, Batch JA (2004) Indexes of insulin resistance and secretion in obese children and adolescents: a validation study. Diabetes Care 27:314–319. https://doi.org/10.2337/diacare.27.2.314 - DOI - PubMed
  29. Muggeo VMR (2003) Estimating regression models with unknown break-points. Stat Med 22:3055–3071. https://doi.org/10.1002/sim.1545 - DOI - PubMed - PMC
  30. Peris P, Filella X, Monegal A et al (2017) Comparison of total, free and bioavailable 25-OH vitamin D determinations to evaluate its biological activity in healthy adults: the LabOscat study. Osteoporos Int 28:2457–2464. https://doi.org/10.1007/s00198-017-4062-8 - DOI - PubMed
  31. Dastani Z, Berger C, Langsetmo L, Fu L, Wong BYL, Malik S, Goltzman D, Cole DE, Richards JB (2014) In healthy adults, biological activity of vitamin d, as assessed by serum pth, is largely independent of DBP concentrations. J Bone Miner Res 29:494–499. https://doi.org/10.1002/jbmr.2042 - DOI - PubMed
  32. Ponda MP, Mcgee D, Breslow JL (2014) Vitamin D-binding protein levels do not influence the effect of vitamin D repletion on serum PTH and calcium: data from a randomized, controlled trial. jcemendojournalsorg J Clin Endocrinol Metab 99:2494–2499. https://doi.org/10.1210/jc.2014-1181 - DOI - PubMed
  33. Bikle DD, Malmstroem S, Schwartz J (2017) Current controversies: are free vitamin metabolite levels a more accurate assessment of vitamin D status than total levels? Endocrinol Metab Clin N Am 46:901–918. https://doi.org/10.1016/j.ecl.2017.07.013 - DOI
  34. Aloia J, Dhaliwal R, Mikhail M, Shieh A, Stolberg A, Ragolia L, Fazzari M, Abrams SA (2015) Free 25(OH)D and calcium absorption, PTH, and markers of bone turnover. J Clin Endocrinol Metab 100:4140–4145. https://doi.org/10.1210/jc.2015-2548 - DOI - PubMed - PMC
  35. Bikle D, Bouillon R, Thadhani R, Schoenmakers I (2017) Vitamin D metabolites in captivity? Should we measure free or total 25(OH)D to assess vitamin D status? J Steroid Biochem Mol Biol 173:105–116. https://doi.org/10.1016/j.jsbmb.2017.01.007 - DOI - PubMed
  36. Asghari G, Yuzbashian E, Wagner CL, Mahdavi M, Shamsi R, Hosseinpanah F, Mirmiran P (2019) The relation between circulating levels of Vitamin D and parathyroid hormone in children and adolescents with overweight or obesity: Quest for a threshold. PLoS One 26 14(11):e0225717. https://doi.org/10.1371/journal.pone.0225717 - DOI
  37. Habibesadat S, Ali K, Shabnam JM, Arash A (2014) Prevalence of vitamin D deficiency and its related factors in children and adolescents living in North Khorasan, Iran. J Pediatr Endocrinol Metab 27:431–436. https://doi.org/10.1515/jpem-2013-0198 - DOI - PubMed
  38. Amini Z, Bryant S, Smith C, Singh R, Kumar S (2013) Is the serum vitamin d-parathyroid hormone relationship influenced by obesity in children? Horm Res Paediatr 80:252–256. https://doi.org/10.1159/000354645 - DOI - PubMed
  39. Miraglia E, Giudice D, Grandone A et al (2015) Bioavailable vitamin D in obese children: the role of insulin resistance. J Clin Endocrinol Metab 100:3949–3955. https://doi.org/10.1210/jc.2015-2973 - DOI
  40. Sorensen K, Aksglaede L, Munch-Andersen T, Aachmann-Andersen NJ, Petersen JH, Hilsted L, Helge JW, Juul A (2009) Sex hormone-binding globulin levels predict insulin sensitivity, disposition index, and cardiovascular risk during puberty. Diabetes Care 32(5):909–914. https://doi.org/10.2337/dc08-1618 - DOI - PubMed - PMC
  41. Maddux BA, Chan A, Mandarino LJ, Goldfine ID (2006) IGF-binding protein-1 levels are related to insulin-mediated glucose disposal and are a potential serum marker of insulin resistance. Diabetes Care 29(7):1535–1537. https://doi.org/10.2337/dc05-1367 - DOI - PubMed
  42. Arnaud J, Constans J (1993) Affinity differences for vitamin D metabolites associated with the genetic isoforms of the human serum carrier protein (DBP). Hum Genet 92:183–188. https://doi.org/10.1007/BF00219689 - DOI - PubMed
  43. Moschonis G, Androutsos O, Hulshof T, Dracopoulou M, Chrousos GP, Manios Y (2018) Vitamin D insufficiency is associated with insulin resistance independently of obesity in primary schoolchildren. The healthy growth study. Pediatr Diabetes 19:866–873. https://doi.org/10.1111/pedi.12678 - DOI - PubMed
  44. Ashraf AP, Huisingh C, Alvarez JA, Wang X, Gower BA (2014) Insulin resistance indices are inversely associated with vitamin D binding protein concentrations. J Clin Endocrinol Metab 99:178–183. https://doi.org/10.1210/jc.2013-2452 - DOI - PubMed
  45. Naderpoor N, Shorakae S, Abell SK, Mousa A, Joham AE, Moran LJ, Stepto NK, Spritzer PM, Teede HJ, de Courten B (2018) Bioavailable and free 25-hydroxyvitamin D and vitamin D binding protein in polycystic ovary syndrome: relationships with obesity and insulin resistance. J Steroid Biochem Mol Biol 177:209–215. https://doi.org/10.1016/j.jsbmb.2017.07.012 - DOI - PubMed
  46. Mesinovic J, Teede HJ, Shorakae S, Lambert GW, Lambert EA, Naderpoor N, de Courten B (2020) The Relationship between vitamin D metabolites and androgens in women with polycystic ovary syndrome. Nutrients 12(5):1219. https://doi.org/10.3390/nu12051219 - DOI - PMC
  47. Lopez-Molina M, Santillan C, Murillo M, Valls A, Bosch L, Bel J, Granada ML (2018) Measured free 25-hydroxyvitamin D in healthy children and relationship to total 25-hydroxyvitamin D, calculated free 25-hydroxyvitamin D and vitamin D binding protein. Clin Biochem 61:23–27. https://doi.org/10.1016/j.clinbiochem.2018.08.007 - DOI - PubMed
  48. Evangelos A, Makariou SE, Challa A et al (2020) Adipokines clinical research vitamin D status and cardiometabolic risk factors in Greek adolescents with obesity-the effect of vitamin D supplementation: a pilot study. Arch Med Sci Atheroscler Dis 22 5:e64–e71. https://doi.org/10.5114/amsad.2020.95569 - DOI
  49. Gangloff A, Bergeron J, Lemieux I, Tremblay A, Poirier P, Alméras N, Després JP (2020) Relationships between circulating 25(OH) vitamin D, leptin levels and visceral adipose tissue volume: results from a 1-year lifestyle intervention program in men with visceral obesity. Int J Obes 44:280–288. https://doi.org/10.1038/s41366-019-0347-7 - DOI
  50. Schwartz JB, Lai J, Lizaola B, Kane L, Markova S, Weyland P, Terrault NA, Stotland N, Bikle D (2014) A comparison of measured and calculated free 25(OH) vitamin D levels in clinical populations. J Clin Endocrinol Metab 99:1631–1637. https://doi.org/10.1210/jc.2013-3874 - DOI - PubMed - PMC

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