Optimal vitamin D status for Chinese infants in Hong Kong: insights from the relationship between serum 25-hydroxyvitamin D and parathyroid hormone levels

Joanna Yuet-Ling Tung; Hung-Kwan So; Ka-Man Yip; Sarah Wing-Yiu Poon; Gloria Shir-Wey Pang; Keith Tsz-Suen Tung; Hing-Wai Tsang; Wilfred Hing-Sang Wong; Patrick Ip

doi:10.1515/jpem-2024-0507

Article

Optimal vitamin D status for Chinese infants in Hong Kong: insights from the relationship between serum 25-hydroxyvitamin D and parathyroid hormone levels

Joanna Yuet-Ling Tung , Hung-Kwan So , Ka-Man Yip , Sarah Wing-Yiu Poon , Gloria Shir-Wey Pang , Keith Tsz-Suen Tung , Hing-Wai Tsang , Wilfred Hing-Sang Wong and Patrick Ip

Published/Copyright: March 21, 2025

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 38 Issue 7

Abstract

Objectives

This study aimed to identify the 25-hydroxyvitamin D (25OHD) threshold that maximally suppressed parathyroid hormone (PTH) in a group of healthy Chinese Infants in Hong Kong.

Methods

Healthy infants detected to have low serum 25OHD less than 25 nmol/L in a population study on vitamin D status were referred to Hong Kong Children’s Hospital (HKCH) for further management. Their total 25OHD was repeated with serum calcium, phosphate, alkaline phosphatase and PTH. Three-phase segmented regression was used to identify the optimal breakpoint between 25OHD and PTH.

Results

Two hundred and twelve infants were included (59 % male). They were reassessed at a median age of 156 days (IQR: 111–247 days). Using unadjusted three-phase segmented regression, the estimated breakpoint of 25OHD on PTH suppression, after adjusting for factors including age, gender, history of vitamin D supplement and mode of feeding, was 20.0 nmol/L (95 % CI: 13.1 to 26.9).

Conclusions

The threshold of 25OHD that triggered the inflection point for PTH in our Hong Kong Chinese infants was lower than that reported in the Western literature. This might imply the cutoff for vitamin D deficiency is lower for Chinese infants. This could be explained by younger age and different ethnicity. Further study with larger sample size is needed to validate the observation.

Keywords: 25-hydroxyvitamin D; vitamin D; Chinese; infants; vitamin D deficiency

Corresponding author: Joanna Yuet-Ling Tung, Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Doctors Office, 9/F, Tower B, Kowloon Bay, Kowloon, Hong Kong SAR, China, E-mail: tungylj@hku.hk

Acknowledgments

The authors would like to thank all participants in this study.

Research ethics: This study was performed according to the Helsinki Declaration and was approved by the Research Ethics Committee of Hong Kong Children’s Hospital (HKCH-REC-2024-024) and the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster Research Ethics Committee (UW 13–055).
Informed consent: Written informed consent was obtained from each participant.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Use of Large Language Models, AI and Machine Learning Tools: None declared.
Conflict of interest: The authors state no conflict of interest.
Research funding: This study was an extension study to the original study funded by the Health and Medical Research Fund (Vit D-HKU), Food and Health Bureau, Hong Kong SAR Government.
Data availability: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Received: 2024-10-23

Accepted: 2025-03-03

Published Online: 2025-03-21

Published in Print: 2025-07-28

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Articles in the same Issue

https://doi.org/10.1515/jpem-2024-0507

Keywords for this article

25-hydroxyvitamin D; vitamin D; Chinese; infants; vitamin D deficiency