Moderators of the Association Between Serum Parathyroid Hormone and Metabolic Syndrome in Participants with Elevated Parathyroid Hormone: NHANES 2003–2006

2020 ◽  
Vol 52 (07) ◽  
pp. 509-516
Author(s):  
Liang Chen ◽  
Jian-Hao Pei ◽  
Jian Kuang
Keyword(s):  
Physical Activity ◽  
Metabolic Syndrome ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Protein Intake ◽  
Elevated Serum ◽  
Vitamin D Supplementation ◽  
Serum Parathyroid Hormone ◽  
Severity Scores ◽  
Serum Pth

AbstractThis cross-sectional study extracted data of 392 NHANES participants with elevated serum parathyroid hormone (PTH) concentrations from 2 cycles of the US National Health and Nutrition Examination Survey (NHANES) 2003–2006 and evaluated the association between serum (PTH) concentration and metabolic syndrome (MetS) to identify dietary and lifestyle factors that may modify that association. The primary outcome was MetS severity scores. Results of univariate linear regression analyses revealed that serum PTH concentrations correlated positively and significantly with MetS severity scores (β=0.399, p=0.030). After adjusting for gender, age, race, and alcohol consumption, results of multivariate analysis revealed that increased serum PTH concentration correlated significantly with higher MetS severity scores (β=0.413, p=0.045) in participants with moderate physical activity over the past 30 days. Serum PTH concentration also correlated significantly with higher MetS severity scores in participants with serum 25-hydroxyvitamin D deficiency (β=0.456 and p=0.014), those without vitamin D supplementation (β=0.524, p=0.028) and with higher protein intake (β=0.586 and p=0.030). In conclusion, increased serum PTH concentration is associated with higher MetS severity scores in participants with elevated serum PTH at baseline. The association between PTH concentration and MetS severity is moderated by participants’ physical activity levels, status of serum vitamin D, vitamin D supplementation, and daily protein intake.

scholarly journals Serum parathyroid hormone level is associated with body mass index. The 5th Tromso study

2004 ◽  
pp. 167-172 ◽  
Author(s):  
E Kamycheva ◽  
J Sundsfjord ◽  
R Jorde
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Relative Risk ◽  
Body Mass ◽  
Serum Calcium ◽  
Population Based ◽  
Serum Parathyroid Hormone ◽  
Serum Pth

OBJECTIVE: To study whether serum parathyroid hormone (PTH) and serum calcium are associated with body mass index (BMI), and their predicting role in obesity. DESIGN: Population based, cross-sectional study. METHODS: In 2001 a population-based health survey was held in Tromso, North Norway. Questionnaires on medical history and life-style factors were completed and anthropometric data were collected. Calcium and vitamin D intakes and a physical activity score were calculated. Serum calcium and PTH were measured in a subset of 3447 men and 4507 women. Pearson correlation and linear regression were used to evaluate associations between BMI, PTH and serum calcium, and logistic regression was used to test PTH and serum calcium as predictors of obesity and to calculate odds ratio. Relative risk was calculated using frequency tables. RESULTS: For serum calcium and PTH there was a significant positive relation to BMI in both genders (P<0.001), which to our knowledge has not previously been reported on the basis of a large epidemiological study. Age, low calcium and vitamin D intakes were explanatory variables for serum PTH. The highest quartile of serum PTH (>4.20 pmol/l) was a significant predictor for obesity (P<0.001) in both genders, adjusted for age, physical activity and serum calcium. Obesity rates were higher in those with PTH levels in the highest quartile compared with those in the lower quartiles, which resulted in a relative risk of 1.40 (95% confidence interval (C.I.) 1.20-1.60) for men and 1.48 (95% C.I. 1.31-1.67) for women. CONCLUSIONS: Serum PTH, adjusted for age, physical activity and serum calcium, is positively associated with BMI in both sexes, and serum PTH is an independent predictor of obesity in our statistical model.

scholarly journals Serum PTH is not a good marker for defining a threshold for vitamin D deficiency

2020 ◽  
Vol 9 (5) ◽  
pp. 396-404
Author(s):  
Rolf Jorde ◽  
Guri Grimnes
Keyword(s):  
Vitamin D ◽  
Observational Studies ◽  
Vitamin D Supplementation ◽  
Serum Parathyroid Hormone ◽  
Baseline Serum ◽  
Hydroxyvitamin D ◽  
Randomized Controlled ◽  
25 Hydroxyvitamin D ◽  
Skeletal Effects ◽  
Serum Pth

Objective In addition to its skeletal effects, vitamin D may also be important for health in general. It is uncertain what level of serum 25-hydroxyvitamin D (25(OH)D), marker of vitamin D status, is sufficient for these effects. With decreasing serum 25(OH)D levels there is an increase in serum PTH. The point at which this occurs has been considered as a threshold for vitamin D sufficiency. The thresholds found have varied widely and have mainly been based on observational studies. However, to truly establish a threshold for vitamin D effects, this has to be based on randomized controlled trials (RCTs). Methods The study included 2803 subjects from a general health survey, the Tromsø study, and pooled individual person data from five vitamin D intervention studies (n = 1544). Serum parathyroid hormone (PTH) and change in PTH after vitamin D supplementation were related to serum 25(OH)D levels in steps of 25 nmol/L (<24, 25–49, 50–74, 75–99, and >99 nmol/L). Results In the Tromsø study, in the females there was a gradual decrease in serum PTH with increasing serum 25(OH)D with no apparent plateau, whereas in the males the decrease in PTH in subjects with serum 25(OH)D >74 nmol/l was marginal. In pooled RCTs, there was a significant reduction in serum PTH by vitamin D supplementation regardless of baseline serum 25(OH)D level. Conclusions The use of the serum PTH–25(OH)D relation from observational studies to determine a threshold for vitamin D sufficiency is highly questionable.

scholarly journals Combined Effects of Vitamin D Status, Renal Function and Age on Serum Parathyroid Hormone Levels

2021 ◽  
Vol 12 ◽  
Author(s):  
Dan Alexandru Niculescu ◽  
Laura Georgiana Deacu ◽  
Andra Caragheorgheopol ◽  
Nicoleta Popescu ◽  
Adina Ghemigian ◽  
...  
Keyword(s):  
Vitamin D ◽  
Renal Function ◽  
Parathyroid Hormone ◽  
Normal Renal Function ◽  
Combined Effects ◽  
Vitamin D Status ◽  
Serum Parathyroid Hormone ◽  
25 Hydroxy Vitamin D ◽  
D 12 ◽  
Serum Pth

BackgroundVitamin D status and renal function are well-known independent predictors of serum parathyroid hormone (PTH) levels. We aimed to describe the combined effects of 25-hydroxy vitamin D (25(OH)D), glomerular filtration rate (GFR) and age on serum PTH levels across the whole clinical spectrum.MethodsWe retrieved from our endocrinology center database all PTH measurement between 2012 and 2020 for which a simultaneous measurement of serum 25(OH)D, calcium and creatinine was available. Age, sex and diagnosis were available for all subjects. Intact PTH was measured using the same electrochemiluminescence assay.ResultsThere were 6,444 adults and 701 children without a diagnosis of hyper- or hypoparathyroidism or abnormal serum calcium levels. In adults with 25(OH)D≥12 ng/mL multiple regression models showed that serum PTH was negatively correlated with both 25(OH)D and GFR. Regression (-0.68 and -1.59 vs. -0.45 and -0.22 respectively), partial correlation (-0.16 and -0.35 vs. -0.12 and -0.10 respectively) and determination coefficients (0.14 vs. 0.031) were higher in CKD than in normal renal function. In subjects with 25(OH)D&lt;12 ng/mL, GFR was the only significant predictor in those with CKD (β-coefficient=-2.5, r=-0.55) and 25(OH)D was the only significant predictor in those with normal renal function (β-coefficient=-2.05, r=-0.11). Increasing age was associated with higher PTH levels only in those with normal renal function and 25(OH)D≥12 ng/mL.ConclusionsWe showed that declining vitamin D and renal function have additive effects on serum PTH in subjects without vitamin D deficiency. In vitamin D deficient subjects this dependency is stronger but is not additive anymore.

scholarly journals Elevated serum parathyroid hormone predicts impaired survival prognosis in a general aged population

2008 ◽  
Vol 158 (5) ◽  
pp. 749-753 ◽  
Author(s):  
Mikko P Björkman ◽  
Antti J Sorva ◽  
Reijo S Tilvis
Keyword(s):  
Parathyroid Hormone ◽  
Elevated Serum ◽  
Mortality Data ◽  
Prognostic Impact ◽  
Serum Parathyroid Hormone ◽  
Survival Prognosis ◽  
Aged Population ◽  
Co Morbidity ◽  
Serum Pth

ObjectiveShort-term studies on selected patients have indicated that elevated serum parathyroid hormone (PTH) is an independent risk factor of death. However, long-term data on unselected populations are lacking, thus far. In order to evaluate the predictive value of elevated serum PTH during the last years of life, random persons of age cohorts of 75, 80 and 85 years were followed for 17 years.DesignA prospective cohort study.MethodsSubjects (n=567) were investigated for calcaemic status including serum intact PTH, serum total calcium (CaT) and ionized calcium (Ca2+). Thorough clinical examinations included an assessment of co-morbidity. Mortality data were collected from National Census Records.ResultsUp to 93% of the subjects died within the follow-up. In contrast to Ca2+ levels, high serum PTH (≥63 ng/l, IV quartile cut point) was associated with significant over-mortality (HR=1.56, 95% CI: 1.29–1.88) and a 2.3-year reduction of median life expectancy. After controlling for age, gender, co-morbidity and creatinine, the prognostic impact of elevated serum PTH was still significant (HR=1.24, 95% CI: 1.01–1.53). The tendency for over-mortality was consistent in both genders, in all age groups as well as in subjects with varying co-morbidity, renal function, body mass index categories and Ca2+ levels.ConclusionsElevated serum PTH level is an independent predictor of impaired long-term survival prognosis in unselected aged population. Serum Ca2+ did not emerge as a significant prognostic indicator. The long-term prognostic impact of vitamin D deficiency, the most common cause of elevated PTH levels in the elderly, remains to be investigated.

Vitamin D supplementation for 12 months in older people prevents bone loss and suppresses parathyroid hormone levels

2016 ◽  
Author(s):  
Terry J Aspray ◽  
Roger M Francis ◽  
Elaine McColl ◽  
Thomas Chadwick ◽  
Elaine Stamp ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Bone Loss ◽  
Older People ◽  
Vitamin D Supplementation ◽  
Hormone Levels

scholarly journals Low serum parathyroid hormone is a risk factor for peritonitis episodes in incident peritoneal dialysis patients: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yuqi Yang ◽  
Jingjing Da ◽  
Yi Jiang ◽  
Jing Yuan ◽  
Yan Zha
Keyword(s):  
Risk Factor ◽  
Peritoneal Dialysis ◽  
Parathyroid Hormone ◽  
Proportional Hazard ◽  
Serum Parathyroid Hormone ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Regression ◽  
Gram Negative Organisms ◽  
Serum Pth

Abstract Background Serum parathyroid hormone (PTH) levels have been reported to be associated with infectious mortality in peritoneal dialysis (PD) patients. Peritonitis is the most common and fatal infectious complication, resulting in technique failure, hospital admission and mortality. Whether PTH is associated with peritonitis episodes remains unclear. Methods We examined the association of PTH levels and peritonitis incidence in a 7-year cohort of 270 incident PD patients who were maintained on dialysis between January 2012 and December 2018 using Cox proportional hazard regression analyses. Patients were categorized into three groups by serum PTH levels as follows: low-PTH group, PTH < 150 pg/mL; middle-PTH group, PTH 150-300 pg/mL; high-PTH group, PTH > 300 pg/mL. Results During a median follow-up of 29.5 (interquartile range 16–49) months, the incidence rate of peritonitis was 0.10 episodes per patient-year. Gram-positive organisms were the most common causative microorganisms (36.2%), and higher percentage of Gram-negative organisms was noted in patients with low PTH levels. Low PTH levels were associated with older age, higher eGFR, higher hemoglobin, calcium levels and lower phosphate, alkaline phosphatase levels. After multivariate adjustment, lower PTH levels were identified as an independent risk factor for peritonitis episodes [hazard ratio 1.643, 95% confidence interval 1.014–2.663, P = 0.044]. Conclusions Low PTH levels are independently associated with peritonitis in incident PD patients.

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