Effects of age and serum 25-OH-vitamin D on serum parathyroid hormone levels - PubMed (original) (raw)
. 2012 Nov;97(11):3989-95.
doi: 10.1210/jc.2012-2276. Epub 2012 Aug 29.
Affiliations
- PMID: 22933544
- DOI: 10.1210/jc.2012-2276
Effects of age and serum 25-OH-vitamin D on serum parathyroid hormone levels
A Valcour et al. J Clin Endocrinol Metab. 2012 Nov.
Abstract
Context: Several studies define optimal serum 25-hydroxyvitamin D (25-OHD) levels based on serum PTH level reaching an asymptote. However, results differ widely, ranging from 25-OHD levels of 12-44 ng/ml: many studies are constrained by small sample size.
Objective: The objective of the study was to determine the relationship between serum PTH and 25-OHD levels and age in a very large reference laboratory database.
Design: This was a detailed cross-sectional analysis of 312,962 paired serum PTH and 25-OHD levels measured from July 2010 to June 2011.
Results: Median PTH levels and the proportion of patients (PTH > 65 pg/ml), from 63 successive 25-OHD frequency classes of 5000 patients, provide smooth, exceptionally well-fitted curves (R(2) = 0.994 and R(2) = 0.995, respectively) without discernible inflection points or asymptotes but with striking age dependencies. Serum 25-OHD was below the recent Institute of Medicine sufficiency guidance of 20 ng/ml in 27% (85,000) of the subjects. More importantly, 40 and 51% of subjects (serum 25-OHD <20 and 10 ng/ml, respectively) had biochemical hyperparathyroidism (PTH > 65 pg/ml).
Conclusions: This analysis, despite inevitable inherent limitations, introduces several clinical implications. First, median 25-OHD-dependent PTH levels revealed no threshold above which increasing 25-OHD fails to further suppress PTH. Second, the large number of subjects with 25-OHD deficiency and hyperparathyroidism reinforces the Third International Workshop on Asymptomatic Primary Hyper parathyroidism's recommendations to test for, and replete, vitamin D depletion before considering parathyroidectomy. Third, strong age dependency of the PTH-25-OHD relationship likely reflects the composite effects of age-related decline in calcium absorption and renal function. Finally, this unselected large population database study could guide clinical management of patients based on an age-dependent, PTH-25-OHD continuum.
Comment in
- Cigarette Smoking and Bone Health.
Hamdy RC, Dickerson K, Whalen K. Hamdy RC, et al. J Clin Densitom. 2020 Jul-Sep;23(3):337. doi: 10.1016/j.jocd.2020.06.005. Epub 2020 Jun 24. J Clin Densitom. 2020. PMID: 32665177 No abstract available.
Similar articles
- Parathyroid hormone response to two levels of vitamin D deficiency is associated with high risk of medical problems during hospitalization in patients with hip fracture.
Alarcón T, González-Montalvo JI, Hoyos R, Diez-Sebastián J, Otero A, Mauleon JL. Alarcón T, et al. J Endocrinol Invest. 2015 Oct;38(10):1129-35. doi: 10.1007/s40618-015-0320-9. Epub 2015 Jun 6. J Endocrinol Invest. 2015. PMID: 26048596 - Vitamin D levels and parathyroid hormone variations of children living in a subtropical climate: a data mining study.
Sahin ON, Serdar M, Serteser M, Unsal I, Ozpinar A. Sahin ON, et al. Ital J Pediatr. 2018 Mar 21;44(1):40. doi: 10.1186/s13052-018-0479-8. Ital J Pediatr. 2018. PMID: 29562938 Free PMC article. - Glomerular filtration rate is a major determinant of the relationship between 25-hydroxyvitamin D and parathyroid hormone.
Patel S, Hyer S, Barron J. Patel S, et al. Calcif Tissue Int. 2007 Apr;80(4):221-6. doi: 10.1007/s00223-007-9001-9. Epub 2007 Apr 13. Calcif Tissue Int. 2007. PMID: 17431533 - Responses of parathyroid hormone to vitamin D supplementation: a systematic review of clinical trials.
Björkman M, Sorva A, Tilvis R. Björkman M, et al. Arch Gerontol Geriatr. 2009 Mar-Apr;48(2):160-6. doi: 10.1016/j.archger.2007.12.005. Epub 2008 Feb 19. Arch Gerontol Geriatr. 2009. PMID: 18243368 Review. - [Review of the concept of vitamin D "sufficiency and insufficiency"].
Gómez Alonso C, Naves Díaz M, Rodríguez García M, Fernández Martín JL, Cannata Andía JB. Gómez Alonso C, et al. Nefrologia. 2003;23 Suppl 2:73-7. Nefrologia. 2003. PMID: 12778859 Review. Spanish.
Cited by
- Natural history and complications of normocalcemic hyperparathyroidism: a retrospective cohort study.
Hoong CWS, Broski SM, Sfeir JG, Clarke BL. Hoong CWS, et al. JBMR Plus. 2024 May 31;8(7):ziae074. doi: 10.1093/jbmrpl/ziae074. eCollection 2024 Jul. JBMR Plus. 2024. PMID: 39290342 Free PMC article. - Evaluation of the age-specific relationship between PTH and vitamin D metabolites.
Povaliaeva A, Zhukov A, Bogdanov V, Bondarenko A, Senko O, Kuznetsova A, Kodryan M, Ioutsi V, Pigarova E, Rozhinskaya L, Mokrysheva N. Povaliaeva A, et al. Bone Rep. 2024 Aug 26;22:101800. doi: 10.1016/j.bonr.2024.101800. eCollection 2024 Sep. Bone Rep. 2024. PMID: 39281298 Free PMC article. - Baseline 25(OH)D level is a prognostic indicator for bariatric surgery readmission: a matched retrospective cohort study.
Shang Y, Chen M, Wang T, Xia T. Shang Y, et al. Front Nutr. 2024 May 13;11:1362258. doi: 10.3389/fnut.2024.1362258. eCollection 2024. Front Nutr. 2024. PMID: 38803446 Free PMC article. - Vitamin D Supplementation and Recurrence of Benign Paroxysmal Positional Vertigo.
Rhim G, Kim MJ. Rhim G, et al. Nutrients. 2024 Feb 28;16(5):689. doi: 10.3390/nu16050689. Nutrients. 2024. PMID: 38474817 Free PMC article. Review. - Vitamin D/Bone Mineral Density and Triglyceride Paradoxes Seen in African Americans: A Cross-Sectional Study and Review of the Literature.
Stevens CM, Jain SK. Stevens CM, et al. Int J Mol Sci. 2024 Jan 21;25(2):1305. doi: 10.3390/ijms25021305. Int J Mol Sci. 2024. PMID: 38279305 Free PMC article. Review.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical