[Vitamin D and pubertal maturation. Value and tolerance of vitamin D supplementation during the winter season].
BACKGROUND
In France, several cases of vitamin D-deficiency rickets among adolescents have been reported, but no prophylaxis measure has been systematically recommended at this age. The aim of this study was to measure 25-hydroxyvitamin D (25-(OH)D) levels and to search for biological signs of vitamin D deficiency during adolescence. Moreover, the effects of a unique oral dose of 100,000 IU of vitamin D3, given during the winter, were analysed.


METHODS
Circulating levels of 25-(OH)D, 1,25-dihydroxyvitamin D, intact parathyroid hormone (iPTH), alkaline phosphatase activities, calcium and phosphate were measured in 53 adolescents aged 10-17 years (81% of metropolitan origin), seen during the winter. The effect of a single oral dose of 100,000 IU of vitamin D3 or of placebo was studied in 15 of these subjects.


RESULTS
24.5% of the adolescents had low 25-(OH)D concentrations (< 6 ng/ml), this frequency being even more elevated (38%) at the end of pubertal maturation (stages 4 and 5). An increase in iPTH concentrations was found in subjects with lowest 25-(OH)D levels (< 3 ng/ml). An oral dose of 100,000 IU of vitamin D3 resulted in a significant increase in the 25-(OH)D levels; yet, these levels remained within the normal range during the 1-2 month follow-up of the nine treated subjects. This dosage made it possible to correct the low calcium concentrations (2.20-2.24 mmol/l) found before treatment in three adolescents.


CONCLUSIONS
The high frequency of low vitamin D status observed during puberty and its normalization after a 100,000 IU vitamin D3 supplementation show the interest and safety of this intermittent 100,000 IU vitamin D3 supplementation to adolescents during the winter season.
Zeghoud
F
F
CNRS URA 583, université Paris-V, hôpital Saint-Vincent-de-Paul, France.
Delaveyne
R
R
Rehel
P
P
Chalas
J
J
Garabédian
M
M
Odièvre
M
M
D000293:Adolescent; D000469:Alkaline Phosphatase / Q000378:metabolism; D002117:Calcitriol / Q000097:blood; D002118:Calcium / Q000097:blood; D002648:Child; D005260:Female; D005527:Food, Fortified; D006801:Humans; D006887:Hydroxycholecalciferols / Q000097:blood*; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D011627:Puberty / Q000097:blood*; D012621:Seasons; D012741:Sexual Maturation; D014807:Vitamin D / Q000494:pharmacology / Q000627:therapeutic use*
D006887:Hydroxycholecalciferols; D010281:Parathyroid Hormone; D010710:Phosphates; D014807:Vitamin D; D000469:Alkaline Phosphatase; D002117:Calcitriol; D002118:Calcium
Vitamine D et maturation pubertaire. Intérêt et tolérance d'une supplémentation vitaminique D en période hivernale.