Bone Abstracts

Objectives: Study the prevalence of hypovitaminosis D in chronically ill children in Greece, as well the efficacy of a proposed replacement therapy.

Methods: A total number of 213 children (121 males and 92 females), with mean age 10.1 years (1–18), suffering various pathological conditions (cerebral palsy, Duchenne myopathy, epilepsy), were sampled to measure serum 25(OH)D and parameters of bone turnover. 101 children were given replacement therapy according to levels of hypovitaminosis (15–20 ng/ml pos ergocalciferol and calcium (4000 IU+500 mg/day), <15 ng/ml intramuscular ergocalciferol (400.000 IU) once per month for 2 months combined with pos ergocalciferol and calcium (4000 IU+500 mg/day)) while 60 children were re-evaluated during the 4 months follow-up.

Results: The mean serum 25(OH)D was 14.20 ng/ml on total (15.5 ng/ml for patients <12 years old and 12.6 ng/ml for patients >12 years old), while the highest rate was measured at 44.53 ng/ml. Respectively median value for PTH was 48.87 pg/ml on total. 34.74% of patients had vitamin D deficiency (10–20 ng/ml) while overt vitamin D deficiency (<10 ng/ml) was measured in 21.59% of patients of whom 21.73% had <4 ng/ml. Of the 22 children receiving antiepileptics, 86.34% had vitamin D deficiency. 9% presented secondary hyperparathyroidism. Higher serum PTH levels were observed in the group of 25(OH)D <10 ng/ml for both age groups, however the inverse relationship between serum 25(OH)D and PTH was statistically nonsignificant at 25(OH)D levels >10 ng/ml. A positive correlation between 25(OH)D and serum phosphorus was also observed (P=0.003) After replacement therapy, children displayed higher levels of 25(OH)D on total (median 25(OH)D=25.8 ng/ml, P<0.0005) and for both age groups (Fig. 1).