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Relationship between vitamin D, parathyroid hormone, and bone mineral density in elderly Koreans.

Kim G, Oh KW, Jang EH, Kim MK, Lim DJ, Kwon HS, Baek KH, Yoon KH, Lee WC, Cha BY, Lee KW, Son HY, Kang MI - J. Korean Med. Sci. (2012)

Bottom Line: Anthropometric parameters, serum 25(OH)D and iPTH, lumbar spine and femur BMD by dual-energy radiography absorptiometry (DXA) were measured in 441 men and 598 postmenopausal women. iPTH increased below serum 25(OH) of 36.7 ng/mL in men, but failed to reach plateau in women.In winter, age-associated iPTH increase in women was steeper than in summer.Elderly vitamin D-inadequate women in the winter are most vulnerable to age-associated hyperparathyroidism.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

ABSTRACT
There is controversy regarding definition of vitamin D inadequacy. We analyzed threshold 25-hydroxyvitamin D (25[OH]D) below which intact parathyroid hormone (iPTH) increases, and examined age- and sex-specific changes of 25(OH)D and iPTH, and association of 25(OH)D and iPTH with bone mineral density (BMD) in elderly Koreans. Anthropometric parameters, serum 25(OH)D and iPTH, lumbar spine and femur BMD by dual-energy radiography absorptiometry (DXA) were measured in 441 men and 598 postmenopausal women. iPTH increased below serum 25(OH) of 36.7 ng/mL in men, but failed to reach plateau in women. Femur neck BMD above and below threshold differed when threshold 25(OH)D concentrations were set at 15-27.5 ng/mL in men, and 12.5-20 ng/mL in postmenopausal women. Vitamin D-inadequate individuals older than 75 yr had higher iPTH than those aged ≤ 65 yr. In winter, age-associated iPTH increase in women was steeper than in summer. In conclusion, vitamin D inadequacy threshold cannot be estimated based on iPTH alone, and but other factors concerning bone health should also be considered. Older people seemingly need higher 25(OH)D levels to offset age-associated hyperparathyroidism. Elderly vitamin D-inadequate women in the winter are most vulnerable to age-associated hyperparathyroidism.

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Related in: MedlinePlus

Relationship between serum (iPTH) and 25-hydroxyvitamin D (25(OH)D) values in men (A) and postmenopausal women (B). For a 25(OH)D concentration higher than 36.7 ng/mL, there is a plateau level at 41.6 pg/mL for iPTH in men. In women, the exponential decay function failed to identify a plateau for serum iPTH.
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Figure 1: Relationship between serum (iPTH) and 25-hydroxyvitamin D (25(OH)D) values in men (A) and postmenopausal women (B). For a 25(OH)D concentration higher than 36.7 ng/mL, there is a plateau level at 41.6 pg/mL for iPTH in men. In women, the exponential decay function failed to identify a plateau for serum iPTH.

Mentions: With this approach, the iPTH concentration reached a theoretical plateau at 41.6 pg/mL and the corresponding 25(OH)D level was 36.7 ng/mL in men. In women, the exponential decay function failed to identify a plateau for serum iPTH (Fig. 1). Twelve of the 441 men (2.7%) had 25(OH)D levels equal to or above 36.7 ng/mL.


Relationship between vitamin D, parathyroid hormone, and bone mineral density in elderly Koreans.

Kim G, Oh KW, Jang EH, Kim MK, Lim DJ, Kwon HS, Baek KH, Yoon KH, Lee WC, Cha BY, Lee KW, Son HY, Kang MI - J. Korean Med. Sci. (2012)

Relationship between serum (iPTH) and 25-hydroxyvitamin D (25(OH)D) values in men (A) and postmenopausal women (B). For a 25(OH)D concentration higher than 36.7 ng/mL, there is a plateau level at 41.6 pg/mL for iPTH in men. In women, the exponential decay function failed to identify a plateau for serum iPTH.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369450&req=5

Figure 1: Relationship between serum (iPTH) and 25-hydroxyvitamin D (25(OH)D) values in men (A) and postmenopausal women (B). For a 25(OH)D concentration higher than 36.7 ng/mL, there is a plateau level at 41.6 pg/mL for iPTH in men. In women, the exponential decay function failed to identify a plateau for serum iPTH.
Mentions: With this approach, the iPTH concentration reached a theoretical plateau at 41.6 pg/mL and the corresponding 25(OH)D level was 36.7 ng/mL in men. In women, the exponential decay function failed to identify a plateau for serum iPTH (Fig. 1). Twelve of the 441 men (2.7%) had 25(OH)D levels equal to or above 36.7 ng/mL.

Bottom Line: Anthropometric parameters, serum 25(OH)D and iPTH, lumbar spine and femur BMD by dual-energy radiography absorptiometry (DXA) were measured in 441 men and 598 postmenopausal women. iPTH increased below serum 25(OH) of 36.7 ng/mL in men, but failed to reach plateau in women.In winter, age-associated iPTH increase in women was steeper than in summer.Elderly vitamin D-inadequate women in the winter are most vulnerable to age-associated hyperparathyroidism.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.

ABSTRACT
There is controversy regarding definition of vitamin D inadequacy. We analyzed threshold 25-hydroxyvitamin D (25[OH]D) below which intact parathyroid hormone (iPTH) increases, and examined age- and sex-specific changes of 25(OH)D and iPTH, and association of 25(OH)D and iPTH with bone mineral density (BMD) in elderly Koreans. Anthropometric parameters, serum 25(OH)D and iPTH, lumbar spine and femur BMD by dual-energy radiography absorptiometry (DXA) were measured in 441 men and 598 postmenopausal women. iPTH increased below serum 25(OH) of 36.7 ng/mL in men, but failed to reach plateau in women. Femur neck BMD above and below threshold differed when threshold 25(OH)D concentrations were set at 15-27.5 ng/mL in men, and 12.5-20 ng/mL in postmenopausal women. Vitamin D-inadequate individuals older than 75 yr had higher iPTH than those aged ≤ 65 yr. In winter, age-associated iPTH increase in women was steeper than in summer. In conclusion, vitamin D inadequacy threshold cannot be estimated based on iPTH alone, and but other factors concerning bone health should also be considered. Older people seemingly need higher 25(OH)D levels to offset age-associated hyperparathyroidism. Elderly vitamin D-inadequate women in the winter are most vulnerable to age-associated hyperparathyroidism.

Show MeSH
Related in: MedlinePlus