title: Bone Mineral Accrual Is Associated With Parathyroid Hormone and 1,25-Dihydroxyvitamin D Levels in Children and Adolescents.
abstract: BACKGROUND
  Rapid bone accrual and calcium demands during puberty may result in compensatory increases in PTH and 1,25-dihydroxyvitamin D [1,25(OH)2D] levels; however, these relations have not been established in longitudinal studies.
  
  
  OBJECTIVE
  To determine whether greater bone accrual velocity is associated with greater PTH and 1,25(OH)2D levels in healthy children and adolescents.
  
  
  METHODS
  Prospective cohort study with baseline PTH, 25-hydroxyvitamin D [25(OH)D], and 1,25(OH)2D levels and dual-energy x-ray absorptiometry whole-body bone mineral content (BMC) accrual over 12 months. Secondary analyses examined bone biomarkers and tibia quantitative computed tomography midshaft cortical-BMC.
  
  
  METHODS
  A total of 594 healthy participants, ages 5-21 years, with longitudinal measures in a subset of 145 participants.
  
  
  METHODS
  PTH and 1,25(OH)2D levels.
  
  
  RESULTS
  PTH levels were higher during Tanner stages 3 and 4 compared to Tanner 1 (P < .05) in males and females and were inversely and significantly associated with 25(OH)D levels and dietary calcium intake. In multivariable analyses, greater bone accrual [measured directly as change in dual-energy x-ray absorptiometry-BMC (P < .001) or quantitative computed tomography-BMC (P < .05), or indirectly as growth velocity (P < .05) or greater bone-formation biomarker level (P < .01)] was associated with higher PTH levels, independent of 25(OH)D level and dietary calcium intake. Similar associations were observed between these direct and indirect indices of bone accrual and 1,25(OH)2D levels.
  
  
  CONCLUSIONS
  PTH levels rise in midpuberty, in association with multiple measures of bone accrual. This is consistent with compensatory increases in PTH to drive 1,25(OH)2D production and calcium absorption during periods of increased calcium demands. Additional studies are needed to address PTH effects on bone modeling and remodeling during growth and development.
authors.affiliation: Department of Pediatrics (M.D.D.), University of Virginia, Charlottesville, Virginia 22908; Department of Pediatrics (D.R.W.), University of Rochester, Rochester, New York 14642; Department of Pediatrics (B.S.Z., M.R.D., R.H., J.L.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; and Departments of Pediatrics and Medicine (M.B.L.), Stanford University, Stanford, California 94305.
authors.forename: Mark D
authors.initials: MD
authors.lastname: DeBoer
authors.affiliation: Department of Pediatrics (M.D.D.), University of Virginia, Charlottesville, Virginia 22908; Department of Pediatrics (D.R.W.), University of Rochester, Rochester, New York 14642; Department of Pediatrics (B.S.Z., M.R.D., R.H., J.L.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; and Departments of Pediatrics and Medicine (M.B.L.), Stanford University, Stanford, California 94305.
authors.forename: David R
authors.initials: DR
authors.lastname: Weber
authors.affiliation: Department of Pediatrics (M.D.D.), University of Virginia, Charlottesville, Virginia 22908; Department of Pediatrics (D.R.W.), University of Rochester, Rochester, New York 14642; Department of Pediatrics (B.S.Z., M.R.D., R.H., J.L.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; and Departments of Pediatrics and Medicine (M.B.L.), Stanford University, Stanford, California 94305.
authors.forename: Babette S
authors.initials: BS
authors.lastname: Zemel
authors.affiliation: Department of Pediatrics (M.D.D.), University of Virginia, Charlottesville, Virginia 22908; Department of Pediatrics (D.R.W.), University of Rochester, Rochester, New York 14642; Department of Pediatrics (B.S.Z., M.R.D., R.H., J.L.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; and Departments of Pediatrics and Medicine (M.B.L.), Stanford University, Stanford, California 94305.
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Denburg
authors.affiliation: Department of Pediatrics (M.D.D.), University of Virginia, Charlottesville, Virginia 22908; Department of Pediatrics (D.R.W.), University of Rochester, Rochester, New York 14642; Department of Pediatrics (B.S.Z., M.R.D., R.H., J.L.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; and Departments of Pediatrics and Medicine (M.B.L.), Stanford University, Stanford, California 94305.
authors.forename: Rita
authors.initials: R
authors.lastname: Herskovitz
authors.affiliation: Department of Pediatrics (M.D.D.), University of Virginia, Charlottesville, Virginia 22908; Department of Pediatrics (D.R.W.), University of Rochester, Rochester, New York 14642; Department of Pediatrics (B.S.Z., M.R.D., R.H., J.L.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; and Departments of Pediatrics and Medicine (M.B.L.), Stanford University, Stanford, California 94305.
authors.forename: Jin
authors.initials: J
authors.lastname: Long
authors.affiliation: Department of Pediatrics (M.D.D.), University of Virginia, Charlottesville, Virginia 22908; Department of Pediatrics (D.R.W.), University of Rochester, Rochester, New York 14642; Department of Pediatrics (B.S.Z., M.R.D., R.H., J.L.), The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104; and Departments of Pediatrics and Medicine (M.B.L.), Stanford University, Stanford, California 94305.
authors.forename: Mary B
authors.initials: MB
authors.lastname: Leonard
mesh_terms: D000293:Adolescent; D015519:Bone Density / Q000502:physiology*; D001846:Bone Development / Q000502:physiology*; D002113:Calcification, Physiologic / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood*; D011627:Puberty / Q000097:blood / Q000502:physiology*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D055815:Young Adult
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D