Bone. 2012 Jul 6.
Czech-Kowalska J, Pludowski P, Dobrzanska A, Kryskiewicz E, Karczmarewicz E, Gruszfeld D, Pleskaczynska A, Golkowska M.
Department of Neonatology and Neonatal Intensive Care, The Children's Memorial Health Institute, 04-730 Warsaw, Al. Dzieci Polskich 20, Poland.
25-hydroxyvitamin D (25OHD) may influence bone turnover. We compared the dynamics of bone markers in 30 infants on vitamin D supplementation (?550IU/d) with different degrees of hypovitaminosis D (25OHD <11ng/ml - deficiency vs. ?11<20ng/ml - insufficiency). Baseline and follow-up (after 10 weeks), 25OHD, 1,25-dihydroxyvitamin D (1,25(OH)(2)D), alkaline phosphatase (ALP), PTH, osteocalcin (OC), N-terminal propeptide of type I procollagen (PINP), C-terminal telopeptide of type I collagen (CTX), amino-terminal propeptide of C-type natriuretic peptide (NT-proCNP) were measured. None of the newborns had craniotabes, hypocalcaemia or hyperparathyroidism.
The median (Q1;Q3) 25OHD increased from a baseline of 8.45 (7;11.9) ng/ml to 54.6 (34.7;67.3) ng/ml (p<0.001).
The baseline 25OHD negatively correlated with total increment of 25OHD (r=-0.54; p=0.002). There were changes in ALP (241 vs. 331IU; p<0.001), 1,25(OH)(2)D (48 vs. 95.5pg/ml, p<0.001), OC (88.8 vs. 159.1ng/ml, p<0.001), PINP (3886 vs. 2409ng/ml; p<0.001), CTX (1.6 vs. 1.1ng/ml; p<0.001), NT-proCNP (75.1 vs. 35.1pmol/l; p<0.001).
Vitamin D deficient infants at baseline, compared to the insufficient group, revealed significantly higher percentage changes for 25OHD (745% vs. 167%, p<0.0001), OC (113% vs. 40%, p<0.05) and 1,25(OH)(2)D (95% vs. 58%, p<0.05).
Conclusions: Vitamin D supplements had little to no impact on markers of bone turnover in term infants in the first few months of life, with the exception of osteocalcin.
Ten weeks of cholecalciferol supplementation at a dose of 550 IU/d led to a marked increase of 25OHD concentration. The magnitude of 25OHD increment was inversely related to vitamin D status at baseline. Irrespective of the severity of vitamin D deficiency, a secondary hyperparathyroidism with elevated iPTH, ALP, phosphaturia or hypophosphatemia was not observed in the studied neonates.
Copyright © 2012. Published by Elsevier Inc.
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- Average 8.5 ng ==> 55 ng (6.9 x)
- Deficient: 7 ng ==> 35 ng ( 5 x)
- Insufficient: 12 ng ==>67 ng (5.6 X)
- Calcium, Magnesium, Vitamin K2, etc.
The Deficient infants probably were still increasing vitamin D levels at 10 weeks (had not stabilized)