Seasonal periodicity of serum parathyroid hormone and its relation with vitamin D in Romania

Niculescu, D; Deacu, Laura Georgiana; Caragheorgheopol, Andra; Duşceac, Roxana; Procopiuc, Camelia; Petriş, Rodica; Poiană, Cătălina

doi:10.1007/s11657-020-00744-1

Cited by 11 publications

(11 citation statements)

References 28 publications

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“…Based on different guidelines, the threshold for serum 25(OH)D has been set at 20-30 ng/ mL for bone health [17][18][19][20]. With respect to vitamin D's non-skeletal effects, including the immune system, it has been suggested that a higher blood level of 25(OH)D of at least 30 ng/ mL is required [21][22][23].…”

Section: Plos Onementioning

confidence: 99%

Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection

et al. 2020

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Background To investigate the association between serum 25-hydroxyvitamin D levels and its effect on adverse clinical outcomes, and parameters of immune function and mortality due to a SARS-CoV-2 infection. Study design The hospital data of 235 patients infected with COVID-19 were analyzed. Results Based on CDC criteria, among our study patients, 74% had severe COVID-19 infection and 32.8% were vitamin D sufficient. After adjusting for confounding factors, there was a significant association between vitamin D sufficiency and reduction in clinical severity, inpatient mortality serum levels of C-reactive protein (CRP) and an increase in lymphocyte percentage. Only 9.7% of patients older than 40 years who were vitamin D sufficient succumbed to the infection compared to 20% who had a circulating level of 25(OH)D< 30 ng/ml. The significant reduction in serum CRP, an inflammatory marker, along with increased lymphocytes percentage suggest that vitamin D sufficiency also may help modulate the immune response possibly by reducing risk for cytokine storm in response to this viral infection.

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Section: Plos Onementioning

confidence: 99%

Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection

et al. 2020

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“…It is interesting to note that in subjects with normal or mildly decreased renal function about 25% of subjects with vitamin D deficiency (25(OH)D<12 ng/mL) had PTH values above the upper limit of normal while in those with serum 25 (OH)D over 30 ng/mL the percent drops to 8%. These figures are equivalent to those found by Valcour (2) and our previous study (14) in subjects under 40 years of age in whom CKD is uncommon. Interestingly, although median PTH was significantly higher in subjects with vitamin D deficiency compared with subjects with 25(OH)D above 12 ng/mL, the correlation between PTH and 25(OH)D was not significant anymore in subjects with vitamin D deficiency and impaired renal function.…”

Section: Discussionsupporting

confidence: 91%

“…The correlation between 25(OH)D or GFR and PTH is not linear so a breakpoint was used for both 25(OH)D and GFR. Based on ours (14) and others (3) previous work a breakpoint of 12 ng/mL was chosen for 25(OH)D. For GFR a breakpoint of 60 mL/min/ 1.73m 2 was chosen (10,11). A stepwise multiple regression model was fitted for each of the 4 resulting subgroups: (1) 25 (OH)D<12 ng/mL and GFR<60 mL/min/1.73m 2 ; (2) 25(OH) D<12 ng/mL and GFR≥60 mL/min/1.73m 2 ; (3) 25(OH)D≥12 ng/mL and GFR<60 mL/min/1.73m 2 ; (4) 25(OH)D≥12 ng/mL and GFR≥60 mL/min/1.73m 2 .…”

Section: Discussionmentioning

confidence: 99%

“…Increasing age was frequently associated with higher PTH levels (2,14,17,20). However, it is unclear whether it is an independent effect or it is due to classical confounding effect of lower GFR and 25(OH)D that associates with increasing age (20).…”

Section: Discussionmentioning

confidence: 99%

“…Also, interventional studies showed a significant PTH decrease with vitamin D supplementation in patients with chronic kidney disease (CKD) and vitamin D deficiency or insufficiency (12,13). Age was also showed to be positively associated with higher PTH levels, independently of vitamin D status (2,14), but this is probably due to declining renal function with age.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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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<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.

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Threshold of 25(OH)D and consequently adjusted parathyroid hormone reference intervals: data mining for relationship between vitamin D and parathyroid hormone

Gong

Sun

Wang

et al. 2023

J Endocrinol Invest

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Purpose By recruiting reference population, we aimed to (1): estimate the 25(OH)D threshold that maximally inhibits the PTH, which can be defined as the cutoff value for vitamin D sufficiency; (2) establish the PTH reference interval (RI) in population with sufficient vitamin D. Methods Study data were retrieved from LIS (Laboratory Information Management System) under literature suggested criteria, and outliers were excluded using Tukey fence method. Locally weighted regression (LOESS) and segmented regression (SR) were conducted to estimate the threshold of 25(OH)D. Multivariate linear regression was performed to evaluate the associations between PTH concentration and variables including 25(OH)D, gender, age, estimated glomerular filtration rate (EGFR), body mass index (BMI), albumin-adjusted serum calcium (aCa), serum phosphate(P), serum magnesium(Mg), and blood collection season. Z test was adopted to evaluate whether the reference interval should be stratified by determinants such as age and gender. Results A total of 64,979 apparently healthy subjects were recruited in this study, with median (Q1, Q3) 25(OH)D of 45.33 (36.15, 57.50) nmol/L and median (Q1, Q3) PTH of 42.19 (34.24, 52.20) ng/L. The segmented regression determined the 25(OH)D threshold of 55 nmol/L above which PTH would somewhat plateau and of 22 nmol/L below which PTH would rise steeply. Multivariate linear regression suggested that gender, EGFR, and BMI were independently associated with PTH concentrations. The PTH RI was calculated as 22.17–72.72 ng/L for subjects with 25(OH)D ≥ 55 nmol/L with no necessity of stratification according to gender, age, menopausal status nor season. Conclusion This study reported 25(OH)D thresholds of vitamin D sufficiency at 55 nmol/L and vitamin D deficiency at 22 nmol/L, and consequently established PTH RIs in subjects with sufficient vitamin D for northern China population for the first time.

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Seasonal periodicity of serum parathyroid hormone and its relation with vitamin D in Romania

Cited by 11 publications

References 28 publications

Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection

Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection

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

Threshold of 25(OH)D and consequently adjusted parathyroid hormone reference intervals: data mining for relationship between vitamin D and parathyroid hormone

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