Background: Idiopathic juvenile osteoporosis (IJO) is a transient, primary, nonhereditary form of osteoporosis of unknown aetiology, characterized by spontaneous remission with progression of puberty. Good levels of vitamin D are essential for bone growth and mineralization since vitamin D insufficiency can lead to bone loss, secondary hyperparathyroidism and increased risk of fractures. In the literature few studies have considered the prevalence of vitamin D insufficiency in osteopaenic-osteoporotic children or adolescents and none in patients affected by IJO. Objective and hypotheses: The purpose of this work is to evaluate the prevalence of vitamin D insufficiency in the patients affected by IJO followed in our Clinic and the relationship between serum 25-hydroxyvitamin D (25OHD) levels and bone parameters. Methods: We selected 12 Caucasian paediatric patients (9 males and 3 females; mean age 12.63 ± 4,3 years and 12.78 ± 3,9 years respectively) affected by IJO. All had a clinically significance fracture history and a lumbar BMD Z-score adjusted for age, gender and body size, lower than -2.0 (mean Z-score -2.45 ± 0.9 SD). Pubertal stage, serum 25OHD, parathyroid hormone and other bone markers, as well as bone mineral density, were obtained. Results: Vitamin D insufficiency was observed in the majority of patients (autumn: mean 27.68 ng/ml ± 11.8 SD; spring: mean 29.73 ng/ml ± 16,7 SD; summer mean 37,7 ng/ml ± 0 SD). CTX levels are increased (mean: 1.43 ng/ml ± 0,5 SD) compared to normal values (0.15-0.45 ng/ml). Total lumbar BMDs are significantly correlated with 25OHD levels (p<0.02) as well as Lumbar BMD Z scores correlate with 25OHD levels. Conclusions: We reckon that it is important to dose serum 25OHD, especially in patients with JIO; in fact, since lumbar BMDs seem to be directly correlated with vitamin D levels, and that there is evidence of vitamin D insufficiency, we believe that calcium and vitamin D supplementations are potential preventive measures that must be use before any further treatment in case of osteopaenia or osteoporosis.
Idiopathic juvenile osteoporosis and vitamin D insufficiency
MAINES, Evelina;Morandi, Grazia;MONTI, Elena;Doro, Francesco;CAVARZERE, Paolo;GAUDINO, Rossella;LAURIOLA, Silvana;ANTONIAZZI, Franco
2011-01-01
Abstract
Background: Idiopathic juvenile osteoporosis (IJO) is a transient, primary, nonhereditary form of osteoporosis of unknown aetiology, characterized by spontaneous remission with progression of puberty. Good levels of vitamin D are essential for bone growth and mineralization since vitamin D insufficiency can lead to bone loss, secondary hyperparathyroidism and increased risk of fractures. In the literature few studies have considered the prevalence of vitamin D insufficiency in osteopaenic-osteoporotic children or adolescents and none in patients affected by IJO. Objective and hypotheses: The purpose of this work is to evaluate the prevalence of vitamin D insufficiency in the patients affected by IJO followed in our Clinic and the relationship between serum 25-hydroxyvitamin D (25OHD) levels and bone parameters. Methods: We selected 12 Caucasian paediatric patients (9 males and 3 females; mean age 12.63 ± 4,3 years and 12.78 ± 3,9 years respectively) affected by IJO. All had a clinically significance fracture history and a lumbar BMD Z-score adjusted for age, gender and body size, lower than -2.0 (mean Z-score -2.45 ± 0.9 SD). Pubertal stage, serum 25OHD, parathyroid hormone and other bone markers, as well as bone mineral density, were obtained. Results: Vitamin D insufficiency was observed in the majority of patients (autumn: mean 27.68 ng/ml ± 11.8 SD; spring: mean 29.73 ng/ml ± 16,7 SD; summer mean 37,7 ng/ml ± 0 SD). CTX levels are increased (mean: 1.43 ng/ml ± 0,5 SD) compared to normal values (0.15-0.45 ng/ml). Total lumbar BMDs are significantly correlated with 25OHD levels (p<0.02) as well as Lumbar BMD Z scores correlate with 25OHD levels. Conclusions: We reckon that it is important to dose serum 25OHD, especially in patients with JIO; in fact, since lumbar BMDs seem to be directly correlated with vitamin D levels, and that there is evidence of vitamin D insufficiency, we believe that calcium and vitamin D supplementations are potential preventive measures that must be use before any further treatment in case of osteopaenia or osteoporosis.
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