Left-Shifted Relation between Calcium and Parathyroid Hormone in Obesity

Hultin, Hella; Edfeldt, Katarina; Sundbom, Magnus; Hellman, Per

doi:10.1210/jc.2009-2822

Cited by 46 publications

(30 citation statements)

References 43 publications

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“…50,51 However, in contrast to previous studies in adults, 52,53 as well as in contrast to the findings in our studied women, our analyses did not show an inverse correlation between plasma 25OHD and PTH levels in infants. We do not believe that this necessary suggest an altered relationship between plasma 25OHD and PTH levels in newborns.…”

Section: Maternal and Infant Vitamin D Status S Vij Streym Et Alcontrasting

confidence: 99%

Maternal and infant vitamin D status during the first 9 months of infant life—a cohort study

et al. 2013

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BACKGROUND/OBJECTIVES: The objective of this study was to assess vitamin D status and possible consequences of low plasma 25-hydroxyvitamin D (25OHD) levels in a population of healthy mothers and their infants. SUBJECTS/METHODS: A total of 107 women aged 24-41 years gave birth to 108 infants. They were followed up three times during 9 months. RESULTS: Cord blood 25OHD level (43.3 ± 20.4 nmol/l) on average was 62 ± 16% of maternal levels (73.3 ± 30.7 nmol/l), measured 1-2 weeks postpartum. Cord blood 25OHD correlated positively with maternal 25OHD levels (r ¼ 0.83, Po0.001). At birth, 23% of mothers and 61% of infants had 25OHD o50 nmol/l. Vitamin D deficiency (25OHDo25 nmol/l) was present in 66% of the children born by mothers with 25OHD levels below 50 nmol/l (Po0.01), whereas only one child was born with deficiency among mothers with 25OHD 450 nmol/l. During follow-up, most of the children (485%) had 25OHD levels 450 nmol/l, which most likely was attributable to the use of supplements, as more than 95% of the children were given daily vitamin D supplements of 10 mg of vitamin D. Cord blood parathyroid hormone levels were very low (median 0.21; interquartile range 0.11-0.33 pmol/l), with increasing levels (Po0.01) reaching 3.08 (2.67-3.92 pmol/l) at the last visit. Vitamin D levels were not associated with anthropometric indices of the newborn infant or their growth during follow-up. CONCLUSIONS: Vitamin D deficiency is widespread in newborn. Maternal 25OHD levels above 50 nmol/l are needed to prevent vitamin D deficiency among newborn.

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Section: Maternal and Infant Vitamin D Status S Vij Streym Et Alcontrasting

confidence: 99%

Maternal and infant vitamin D status during the first 9 months of infant life—a cohort study

et al. 2013

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“…25,26 A mechanism of impaired calcium homeostasis in obesity has been raised to explain the high levels of PTH. 27 These authors have highlighted a shift to the left of the calcium PTH curve in patients with morbid obesity resulting in a lowered threshold of the ''set point'' calcium for PTH response given. 27 …”

Section: Nutritional Deficiency Of Vitamin D In the Obesementioning

confidence: 99%

“…27 These authors have highlighted a shift to the left of the calcium PTH curve in patients with morbid obesity resulting in a lowered threshold of the ''set point'' calcium for PTH response given. 27 …”

Section: Nutritional Deficiency Of Vitamin D In the Obesementioning

confidence: 99%

Vitamin D alteration associated with obesity and bariatric surgery

Lespessailles

Toumi

2017

Exp Biol Med (Maywood)

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Obesity and severe obesity constitute growing serious health problems reaching epidemic proportion in most countries with a prevalence increasing from 6.4 in 1975 to 14.9% in 2014. This present review summarizes currently available data on vitamin D deficiencies in the obese population before and after bariatric surgery. The important evidence emerging from our evaluation confirms that obese patients are at risk of multiple nutritional deficiencies, especially vitamin D deficiency, before bariatric surgery. Our survey confirms that the precise role of the gut microbiome and its associated changes on the vitamin D metabolism after the different bariatric surgery procedures has not yet been studied. Furthermore, whether differences in the microbiota may alter the therapeutic responses to vitamin D is not known. AbstractObesity and severe obesity constitute growing serious health problems reaching epidemic proportion in most countries. Interactions and relationships between obesity and bone tissue and its metabolism are complex but are more and more studied and recognized. Obesity is associated with an altered hormonal profile including particularly bone-regulating hormones like vitamin D. Bariatric surgery procedures, thanks to their effectiveness to achieve therapeutic endpoints for comorbidities associated with obesity, have had an increasing success. However, these surgeries by producing mechanical restriction and or malabsorption syndrome lead to nutritional deficiencies including vitamin D. In this review, we aim to (1) discuss the nutritional deficiency of vitamin D in the obese, (2) to summarize the different surgical options in bariatric surgery and to present the evidence concerning these procedures and their associated profile in vitamin D post-operative insufficiency, (3) to present the different recommendations in clinical practice to prevent or treat vitamin D deficiencies or insufficiencies in patients treated by bariatric surgery and finally to introduce emerging assumptions on the relationship between vitamin D, microbiota composition and circulating bile acids.

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“…It is possible that there may be a different set point for the calcium PTH relationship in the obese, as demonstrated in a calcium-citrate clamp that showed an exaggerated PTH response to hypocalcemia as compared to normal subjects (Hultin et al, 2010;Cipriani et al, 2014). Moreover, while many subjects with hypovitaminosis D could have PTH within the "normal" reference range, they may have "functional hyperparathyroidism" (Souberbielle et al, 2003).…”

Section: )mentioning

confidence: 99%

High Prevalence of Hypovitaminosis D in Postmenopausal Women with Type 2 Diabetes Mellitus

et al. 2016

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Abstract:The link between vitamin D and type 2 diabetes mellitus (T2DM) is intensively studied. This study aims to define the serum concentration of 25-hydroxyvitamin D (25-OH D) and to investigate the relationship between 25-OH D status, glycated hemoglobin (HbA1c) and body composition in postmenopausal women with T2DM and in non-diabetic controls. In this crosssectional study, 75 women with T2DM and 32 control subjects were selected. Serum 25-OH D, intact parathyroid hormone (PTH), calcium, fasting glucose and HbA1c, were measured. The mean 25-OH D level was 21.4 ± 11.4 ng/ml (range 4.1-50.7 ng/ml) in diabetic women and 30.3 ± 9.4 ng/ml (range 10.8-54.2 ng/ml) in control group (p<0.001). The prevalence of hypovitaminosis D (< 30 ng/ml) was higher in vitamin D 3 non-supplemented T2DM women (89% vs. 63% controls); the difference diminished in vitamin D 3 (500-1000 IU per day) supplemented subgroups (45% diabetics vs. 42% controls). In T2DM women, 25-OH D levels were not associated to HbA1c, duration of diabetes, fasting glucose and PTH levels, however, 25-OH D levels negatively associated with body mass index (p=0.011), total body fat mass (p=0.005) and total body lean mass (p=0.004). 6)Prague Medical Report / Vol. 117 (2016) No. 1, p. 5-17 of hypovitaminosis D is higher in non-supplemented postmenopausal women with T2DM than in non-diabetic controls (89% vs. 63%). Obesity is a risk factor for vitamin D insufficiency in T2DM postmenopausal women. Further studies evaluating relationships between fat, muscle, bone and vitamin D metabolism in T2DM patients are warranted.

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Left-Shifted Relation between Calcium and Parathyroid Hormone in Obesity

Cited by 46 publications

References 43 publications

Maternal and infant vitamin D status during the first 9 months of infant life—a cohort study

Maternal and infant vitamin D status during the first 9 months of infant life—a cohort study

Vitamin D alteration associated with obesity and bariatric surgery

High Prevalence of Hypovitaminosis D in Postmenopausal Women with Type 2 Diabetes Mellitus

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