{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T06:31:06Z","timestamp":1781505066115,"version":"3.54.1"},"reference-count":42,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2015,8,17]],"date-time":"2015-08-17T00:00:00Z","timestamp":1439769600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951115001444_abs1\" sec-type=\"general\"><jats:title>Background<\/jats:title><jats:p>Limited data exist on the vitamin D status in Fontan patients. We determined the prevalence and potential risk factors of vitamin D deficiency in this patient subset.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951115001444_abs2\" sec-type=\"general\"><jats:title>Methods and results<\/jats:title><jats:p>Data were collected from 27 Fontan patients (55.6% male, mean age 8.1\u00b15.3 years). Protein-losing enteropathy was diagnosed in six patients (22.2%). Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D level of &lt;20 ng\/ml. The neutrophil-to-lymphocyte ratio, a marker of systemic inflammation, was calculated. Associations between laboratory measurements and patient characteristics were explored. Mean serum 25-hydroxyvitamin D level was 14.1\u00b110.4 ng\/ml. Vitamin D deficiency was found in 19\/27 patients (70.3%). Only skin type was associated with vitamin D deficiency (p=0.04). Hyperparathyroidism was present in 5\/21 (23.8%) patients, and was more prevalent in patients with protein-losing enteropathy (p&lt;0.001). Parathyroid hormone levels correlated with parameters of systemic inflammation (neutrophil-to-lymphocyte ratio: r=0.484, p=0.026; relative lymphocyte count: r=\u22120.635, p=0.002). Vitamin D supplementation significantly increased serum 25-hydroxyvitamin D levels (p&lt;0.0001), and was accompanied by a reduction in parathyroid hormone concentrations (p=0.032).<\/jats:p><\/jats:sec><jats:sec id=\"S1047951115001444_abs3\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>A high prevalence of vitamin D deficiency was found among Fontan patients, independent of age, time after Fontan procedure, ventricular morphology, and presence of protein-losing enteropathy. A potentially important link between parathyroid hormone levels and systemic inflammation is suggested.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951115001444","type":"journal-article","created":{"date-parts":[[2015,8,17]],"date-time":"2015-08-17T05:48:46Z","timestamp":1439790526000},"page":"876-884","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":25,"title":["Low serum 25-hydroxyvitamin D levels and secondary hyperparathyroidism in Fontan patients"],"prefix":"10.1017","volume":"26","author":[{"given":"Finn","family":"Holler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Hannes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"Germund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Emmel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike","family":"Hoyer-Kuhn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Khalil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narayanswami","family":"Sreeram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floris E. A.","family":"Udink ten Cate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2015,8,17]]},"reference":[{"key":"S1047951115001444_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2011.05.005"},{"key":"S1047951115001444_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.09.063"},{"key":"S1047951115001444_ref36","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-014-1083-3"},{"key":"S1047951115001444_ref34","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvs092"},{"key":"S1047951115001444_ref14","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0385"},{"key":"S1047951115001444_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2004.10.030"},{"key":"S1047951115001444_ref31","doi-asserted-by":"publisher","DOI":"10.1007\/s10741-012-9336-9"},{"key":"S1047951115001444_ref39","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(03)00536-8"},{"key":"S1047951115001444_ref21","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-3059"},{"key":"S1047951115001444_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.04.025"},{"key":"S1047951115001444_ref42","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-001-0078-z"},{"key":"S1047951115001444_ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-014-0881-y"},{"key":"S1047951115001444_ref38","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0000000000000062"},{"key":"S1047951115001444_ref35","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e31817541a8"},{"key":"S1047951115001444_ref16","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.113.301241"},{"key":"S1047951115001444_ref4","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.201772"},{"key":"S1047951115001444_ref25","first-page":"S115","article-title":"Anthropometric data and obesity","volume":"61","author":"Bergmann","year":"1999","journal-title":"Gesundheitswesen"},{"key":"S1047951115001444_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-008-9292-2"},{"key":"S1047951115001444_ref28","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gft090"},{"key":"S1047951115001444_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(97)70183-1"},{"key":"S1047951115001444_ref15","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2007-1894"},{"key":"S1047951115001444_ref19","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2010.187591"},{"key":"S1047951115001444_ref6","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951113001650"},{"key":"S1047951115001444_ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-012-0290-z"},{"key":"S1047951115001444_ref9","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehn215"},{"key":"S1047951115001444_ref29","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfr032"},{"key":"S1047951115001444_ref23","doi-asserted-by":"publisher","DOI":"10.3109\/03014460.2010.521193"},{"key":"S1047951115001444_ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.08.050"},{"key":"S1047951115001444_ref7","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-305723"},{"key":"S1047951115001444_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.hfc.2013.09.010"},{"key":"S1047951115001444_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2012.12.071"},{"key":"S1047951115001444_ref22","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.22877"},{"key":"S1047951115001444_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(03)00894-4"},{"key":"S1047951115001444_ref41","doi-asserted-by":"publisher","DOI":"10.1172\/JCI32335"},{"key":"S1047951115001444_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.09.039"},{"key":"S1047951115001444_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2014.02.024"},{"key":"S1047951115001444_ref24","doi-asserted-by":"publisher","DOI":"10.1038\/ejcn.2010.8"},{"key":"S1047951115001444_ref40","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.02.048"},{"key":"S1047951115001444_ref37","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31821988a3"},{"key":"S1047951115001444_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(96)00135-0"},{"key":"S1047951115001444_ref33","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.08.030"},{"key":"S1047951115001444_ref18","first-page":"583","article-title":"Vitamin D deficiency among native Dutch and first- and second-generation non-western immigrants","volume":"173","author":"Huibers","year":"2014","journal-title":"Eur J Pediatr"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951115001444","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,19]],"date-time":"2019-04-19T04:19:25Z","timestamp":1555647565000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951115001444\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,8,17]]},"references-count":42,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2016,6]]}},"alternative-id":["S1047951115001444"],"URL":"https:\/\/doi.org\/10.1017\/s1047951115001444","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8,17]]},"assertion":[{"value":"\u00a9 Cambridge University Press 2015\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}