Vitamin D depletion following burn injury in children

A possible factor in post-burn osteopenia

Gordon L. Klein, Craig B. Langman, David Herndon

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Background: Children burned > 40% total body surface area (TBSA) have chronically low bone mineral density (BMD) and increased risk for fractures and adult-onset osteoporosis. Because they are advised to avoid sunlight to prevent burn scar hyperpigmentation, we hypothesized that they develop vitamin D depletion, which could contribute to postburn osteopenia. Methods: We studied 24 children, ages 5-20 years, burned ≥ 40% TBSA 7.1 ± 3.8 (SD) years, range 1.9-13.3 years, previously (n = 12) and 2.0 ± 0.2, range 1.4-2.1 years, previously (n = 12), of which half received recombinant human growth hormone during the first postburn year. We measured lumbar spine BMD, serum 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)2D), intact PTH (iPTH), and osteocalcin. Results: Serum 25(OH)D was low in 10/11 patients and 1,25(OH)2D was low in 5/11 at 7 years post-burn. Serum 25(OH)D was low in 10/12, while 1,25(OH)2D was low in 0/12 at 2 years; osteocalcin was low in 9/12 in the 7-year group; iPTH levels were in the lowest quartile in 5/12 patients at 7 years and 10/12 patients at 2 years Serum 25(OH)D levels correlated with BMD z-scores, r = 0.53, p < 0.05, and inversely with iPTH levels, r = -0.66, p < 0.05, in the 7-year group. Conclusion: Burned children have low circulating levels of 25(OH)D which correlated with BMD z-scores, suggesting that post-burn vitamin D depletion may play a role in the chronically low bone density observed in these children.

Original languageEnglish (US)
Pages (from-to)346-350
Number of pages5
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume52
Issue number2
StatePublished - 2002

Fingerprint

Metabolic Bone Diseases
Burns
Vitamin D
Bone Density
Wounds and Injuries
Body Surface Area
Osteocalcin
Serum
Hyperpigmentation
Human Growth Hormone
Sunlight
Growth Hormone
Osteoporosis
Cicatrix
Spine

Keywords

  • 25-Hydroxyvitamin D
  • Bone mineral density
  • Burns
  • Children
  • Osteocalcin

ASJC Scopus subject areas

  • Surgery

Cite this

Vitamin D depletion following burn injury in children : A possible factor in post-burn osteopenia. / Klein, Gordon L.; Langman, Craig B.; Herndon, David.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 52, No. 2, 2002, p. 346-350.

Research output: Contribution to journalArticle

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title = "Vitamin D depletion following burn injury in children: A possible factor in post-burn osteopenia",
abstract = "Background: Children burned > 40{\%} total body surface area (TBSA) have chronically low bone mineral density (BMD) and increased risk for fractures and adult-onset osteoporosis. Because they are advised to avoid sunlight to prevent burn scar hyperpigmentation, we hypothesized that they develop vitamin D depletion, which could contribute to postburn osteopenia. Methods: We studied 24 children, ages 5-20 years, burned ≥ 40{\%} TBSA 7.1 ± 3.8 (SD) years, range 1.9-13.3 years, previously (n = 12) and 2.0 ± 0.2, range 1.4-2.1 years, previously (n = 12), of which half received recombinant human growth hormone during the first postburn year. We measured lumbar spine BMD, serum 25-hydroxyvitamin D (25(OH)D), 1,25-dihydroxyvitamin D (1,25(OH)2D), intact PTH (iPTH), and osteocalcin. Results: Serum 25(OH)D was low in 10/11 patients and 1,25(OH)2D was low in 5/11 at 7 years post-burn. Serum 25(OH)D was low in 10/12, while 1,25(OH)2D was low in 0/12 at 2 years; osteocalcin was low in 9/12 in the 7-year group; iPTH levels were in the lowest quartile in 5/12 patients at 7 years and 10/12 patients at 2 years Serum 25(OH)D levels correlated with BMD z-scores, r = 0.53, p < 0.05, and inversely with iPTH levels, r = -0.66, p < 0.05, in the 7-year group. Conclusion: Burned children have low circulating levels of 25(OH)D which correlated with BMD z-scores, suggesting that post-burn vitamin D depletion may play a role in the chronically low bone density observed in these children.",
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