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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

Serum parathyroid hormone (PTH) levels according to 25(OH)D levels in different age groups. Mean iTPH in individuals older than 75 yr were consistently higher than that of those aged 65 yr or younger, except in the lowest (25(OH)D < 10 ng/mL) vitamin D group (ANOVA, Dunnett's multiple comparison test).
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Figure 2: Serum parathyroid hormone (PTH) levels according to 25(OH)D levels in different age groups. Mean iTPH in individuals older than 75 yr were consistently higher than that of those aged 65 yr or younger, except in the lowest (25(OH)D < 10 ng/mL) vitamin D group (ANOVA, Dunnett's multiple comparison test).

Mentions: To compare iPTH levels between old and young individuals with similar 25(OH)D levels, patients were grouped according to 25(OH)D levels by the increment of 5 ng/mL and were further grouped into 3 age categories in each 25(OH)D group. Mean iPTH levels were compared across the age groups in each 25(OH) D group (ANOVA, Dunnett's multiple comparison test). Though the results did not reach statistical significance, mean iTPH in individuals older than 75 yr were consistently higher than that of those aged 65 yr or younger when 25(OH)D levels were within the inadequacy range (Fig. 2).


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)

Serum parathyroid hormone (PTH) levels according to 25(OH)D levels in different age groups. Mean iTPH in individuals older than 75 yr were consistently higher than that of those aged 65 yr or younger, except in the lowest (25(OH)D < 10 ng/mL) vitamin D group (ANOVA, Dunnett's multiple comparison test).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Serum parathyroid hormone (PTH) levels according to 25(OH)D levels in different age groups. Mean iTPH in individuals older than 75 yr were consistently higher than that of those aged 65 yr or younger, except in the lowest (25(OH)D < 10 ng/mL) vitamin D group (ANOVA, Dunnett's multiple comparison test).
Mentions: To compare iPTH levels between old and young individuals with similar 25(OH)D levels, patients were grouped according to 25(OH)D levels by the increment of 5 ng/mL and were further grouped into 3 age categories in each 25(OH)D group. Mean iPTH levels were compared across the age groups in each 25(OH) D group (ANOVA, Dunnett's multiple comparison test). Though the results did not reach statistical significance, mean iTPH in individuals older than 75 yr were consistently higher than that of those aged 65 yr or younger when 25(OH)D levels were within the inadequacy range (Fig. 2).

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