Dynamics of parathyroid hormone levels and bone metabolism indicators against the background of hypovitaminosis D treatment in children with celiac disease

Abstract

Objective. To analyze the effectiveness of correction of hypovitaminosis D and the dynamics of bone metabolism indicators in children with celiac disease against the background of exogenous dosing with cholecalciferol preparations. Patients and methods. This study included 105 children with celiac disease aged 2–17 years. All patients were divided into two groups: group 1 received vitamin D3 supplements and group 2 did not receive any therapy. The levels of vitamin D, osteocalcin, C-terminal telopeptide (CTX), and parathyroid hormone (PTH) were assessed in all children. Results. An increase in median vitamin D levels up to 32.4 [23.3; 39.7] ng/mL was observed against the background of taking cholecalciferol supplements, which was 2.5 times higher than in the same patients before treatment – 11.1 [5.9; 17.3] ng/mL (p < 0.001); meanwhile, the number of children with optimal calcidiol levels increased to 54.3% (p < 0.001), and the proportion of children with deficiency conditions decreased to 14.3% (p < 0.001). Positive dynamics of serum 25(OH)D levels were observed in 100% of cases. Against the background of vitamin D therapy, there was a decrease in CTX and PTH levels and an increase in osteocalcin levels. In the absence of therapy, a decrease in vitamin D levels from baseline of 25.7 [17.2; 35.1] ng/mL (p < 0.001) was noted. The proportion of patients with normal vitamin D levels decreased to 5.7% (p < 0.001); the number of children with deficiency increased to 85.7% (p < 0.001). There was a decrease in osteocalcin levels and an increase in CTX and PTH levels. Conclusion. Against the background of decreasing vitamin D levels and in the absence of its supplementation in children with celiac disease, osteoresorption processes prevail. Children with celiac disease may receive cholecalciferol supplementation in higher doses, which will avoid the development of osteopenia symptoms and significantly improve the quality of life. Key words: vitamin D, bone tissue, bone mineralization disorders, osteocalcin, osteoporosis, parathyroid hormone, C-terminal telopeptide