Serum levels of 25-hydroxyvitamin D (25-OHD) and 1,25-dihydroxyvitamin D (1,25-(OH)2D) were measured on 19 occasions in seven children receiving total parenteral nutrition (TPN). The daily intakes of vitamin D3 ranged from 44 to 540 IU/day, and all serum samples were obtained after the same daily intake of vitamin D3 for more than 1 month. There was a significant positive correlation between serum 25-OHD levels and parenteral vitamin D3 intakes (r = 0.90, p < 0.01). In this study, serum 25-OHD levels in all cases taking 200 to 360 IU/day of vitamin D3 were within the normal range. On the other hand, no significant correlation was found between serum 1,25-(OH)2D levels and vitamin D3 intakes, and serum 1,25-(OH)2D levels were normal or elevated in all cases. (Journal of Parenteral and Enteral Nutrition 10:191-194, 1986)
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References
1.
Dudrick SJ, Wilmore DW, Vars HM, et al: Long-term total parenteral nutrition with growth, development, and positive nitrogen balance. Surgery64:134-142, 1968
2.
Leape LL, Valaes T.: Rickets in low birth weight infants receiving total parenteral nutrition . J Pediatr Surg11:665-674, 1976
3.
Geggel RL, Pereira GR, Spackman TJFractured ribs: Unusual presentation of rickets in premature infants . J Pediatr93:680-682, 1978
4.
Gutcher GR, Chesney RW: Iatrogenic rickets as a complication of a total parenteral nutrition program . Clin Pediatr17:817-819, 1978
5.
Toomey F., Hoag R., Batton D., et al: Rickets associated with cholestasis and parenteral nutrition in premature infants. Radiology142:85-88, 1982
6.
Gefter WB, Epstein DM, Anday EK, et al: Rickets presenting as multiple fractures in premature infants on hyperalimentation. Radiology142:371-374, 1982
7.
Kien CL, Browning C., Jona J., et al: Rickets in premature infants receiving parenteral nutrition . JPEN6:152-156, 1982
8.
The TS, Kollee LAA, Boon JM, et al: Rickets in a preterm infant during intravenous alimentation . Acta Pediatr Scand72:769-771, 1983
9.
Shike M., Harrison JE, Sturtridge WC, et al: Metabolic bone disease in patients receiving long-term total parenteral nutrition. Ann Intern Med92:343-350, 1980
10.
Klein GL, Targoff CM, Ament ME, et al: Bone disease associated with total parenteral nutrition. Lancet2:1041-1044, 1980
11.
Dudrick SJ: Historical consideration of intravenous hyperalimentation. IN Intravenous Nutrition in the High Risk Infant. John Wiley & Sons , New York. 1975
12.
Wretlind A.: General aspects of parenteral nutrition. IN Therapeutic Aspects of Nutrition. H.E. Stenfert. Kroese B.V., Leiden, Holland. 1973
13.
American Medical Association: Multivitamin preparations for parenteral use: A statement by the nutrition advisory group. JPEN3:258-262, 1979
14.
Okada A.: Total parenteral nutrition in gastroenterological surgery. Asian Med J25:199-226, 1982
15.
Shimotsuji T. , Seino Y.: Competitive protein binding assay for 25-Hydroxycholecalciferol . Methods Enzymol67:466-472, 1980
16.
Seino Y., Shimotsuji T., Yamaoka K., et al: Plasma 1,25-dihydroxyvitamin D concentrations in cords, newborns, infants and children. Calcif Tissue Int30:1-3, 1980
17.
Seino Y., Shimotsuji T., Ishida M., et al: Vitamin D metabolism in hypophosphatemic vitamin D-resistant rickets. Contr Nephrol22:101-106, 1980
18.
Seino Y., Ishida M., Yamaoka K., et al: Serum calcium regulating hormones in the perinatal period. Calcif Tissue Int34:131-135, 1982
19.
Yamaoka K., Seino Y., Ishida M., et al: Effect of dibutyryl adenosine 3',5'-monophosphate administration on plasma concentrations of 1,25-dihydroxyvitamin D in pseudohypoparathyroidism type 1. J Clin Endocrinol Metab53:1096-1100, 1981
20.
Markestad T. , Halvorsen S., Halvorsen KS, et al: Plasma concentrations of vitamin D metabolites before and during treatment of vitamin D deficiency rickets in children. Acta Pediatr Scand73:225-231, 1984
21.
Chesney RW, Zimmerman J., Hamstra A., et al: Vitamin D metabolite concentrations in vitamin D deficiency . Am J Dis Child135:1025-1028, 1981
22.
Rasmussen H. , Baron R., Broadus A., et al: 1,25-(OH)2D3 is not the only D metabolite involved in the pathogenesis of osteomalasia . Am J Med69:360-368, 1980
23.
Eastwood JB , Wardener HE, Gary RW, et al: Normal plasma-1,25-(OH)2-vitamin-D concentrations in nutritional osteomalacia. Lancet1:1377-1378, 1979
24.
Shike M., Sturtridge WC, Tam CS, et al: A possible role of vitamin D in the genesis of parenteral-nutrition-induced metabolic bone disease. Ann Intern Med95:560-568, 1981
25.
Kendrick NC , Kabakoff D., DeLuca HF: Oxygen-dependent 1,25-dihydroxycholecalciferol-induced calcium ion transport in rat intestine. Biochem J194:179-186, 1981
26.
Tajiri H., Nose O., Kimura S., et al: Rickets presenting as pathological fractures in two infants receiving long-term total parenteral nutrition. Nihon Shonika Gakkai Zasshi (JJPS)89:5-10, 1985
27.
DeLuca HF: The vitamin D system in the regulation of calcium and phosphorus metabolism. Nutr Rev37:161-193, 1979
28.
Klein GL, Horst RL, Norman AW, et al: Reduced serum levels of 1α,25-dihydrogyvitamin D during long-term total parenteral nutrition. Ann Intern Med94:638-643, 1981
29.
Klein GL, Cannon RA, Diament M., et al: Infantile vitamin D-resistant rickets associated with total parenteral nutrition. Am J Dis Child136:74-76, 1982
30.
Klein GL, Alfrey AC, Miller NL, et al: Aluminum loading during total parenteral nutrition. Am J Clin Nutr35:1425-1429, 1982
31.
Klein GL, Vaccaro M., Jongen M., et al: Aluminum blocks the PTHstimulated rise in serum 1,25-(OH)2-vitamin D levels in D-replete rats. The 6th Annual Scientific Meeting of the American Society For Bone And Mineral Research (Abstr) A69:1984
32.
Tam CS, Jeejeebhoy KN: Bone changes in patients on total parenteral nutrition: Follow-up by sequential bone biopsies. IN Metabolic Bone Disease in Total Parenteral Nutrition. Urban & Schwarzenberg, Baltimore- Munich, 1985
