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Published in: Archives of Osteoporosis 1/2018

01-12-2018 | Original Article

Vitamin D and parathyroid hormone in relation to bone health in Croatian women

Authors: Irena Keser, Selma Cvijetić, Martina Bituh, Ivana Rumora Samarin, Jasminka Z. Ilich, Irena Colić Barić, Ivana Rumbak

Published in: Archives of Osteoporosis | Issue 1/2018

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Abstract

Summary

In N = 400 women (46.9 ± 15.5 years), the prevalence of severe (< 25 nmol/l) and mild (≥ 25 and < 50 nmol/l) 25(OH)D deficiency was 7 and 32.2%, respectively, while 60.8% women had adequate status. Serum iPTH increased (> 37.0 pg/ml) when 25(OH)D was < 46.9 nmol/l. BMD was not significantly lower in the participants with iPTH > 37.0 pg/ml.

Purpose

Bone mineral density (BMD) is affected by serum 25-hydroxyvitamin D (25(OH)D) and intact parathyroid hormone (iPTH). Our objective was to analyze the association between serum 25(OH)D and iPTH and their mutual regulatory influence on BMD in women with 25(OH)D deficiency. We also attempted to establish a threshold for the serum 25(OH)D below which serum iPTH increases.

Methods

The participants were 400 generally healthy women (46.9 ± 15.5 years) recruited from local communities. BMD was measured by dual-energy X-ray absorptiometry, and serum 25(OH)D, iPTH, calcium, phosphorus, alkaline phosphatase, osteocalcin, and C-telopeptide (CTX) were analyzed from the fasting blood samples. Multivariate regression models were used to investigate the relationships among serum 25(OH)D, iPTH, and BMD.

Results

Serum iPTH increased when 25(OH)D concentrations were below 46.9 nmol/l. Severe 25(OH)D deficiency (< 25 nmol/l) was found in 7% of the participants and was associated with significantly higher iPTH compared to participants with serum 25(OH)D ≥ 25 nmol/l. BMD was negatively associated with iPTH only in the group with severe 25(OH)D deficiency. However, BMD was not significantly lower in the participants with severe 25(OH)D deficiency compared to those with mild deficiency or with adequate status.

Conclusions

Our results showed that threshold level of 25(OH)D below which iPTH started to rise was 46.9 nmol/l. There was no negative impact of iPTH on BMD or bone turnover markers in women with severe 25(OH)D deficiency. This might be due to the relatively young age of our participants in whom the unfavorable effect of 25(OH)D deficiency on bone might have not yet appeared.
Literature
1.
go back to reference Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84:18–28 PMID: 16825677CrossRefPubMed Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84:18–28 PMID: 16825677CrossRefPubMed
3.
go back to reference Dawson-Hughes B, Harris SS, Dallal GE (1997) Plasma calcidiol, season, and serum parathyroid hormone concentrations in healthy elderly men and women. Am J Clin Nutr 5:67–71 PMID: 8988915CrossRef Dawson-Hughes B, Harris SS, Dallal GE (1997) Plasma calcidiol, season, and serum parathyroid hormone concentrations in healthy elderly men and women. Am J Clin Nutr 5:67–71 PMID: 8988915CrossRef
5.
go back to reference Carnevale V, Nieddu L, Romagnoli E, Battista C, Mascia ML, Chiodini I, Eller-Vainicher C, Frusciante V, Santini SA, La Porta M, Minisola S, Scillitani A (2010) Regulation of PTH secretion by 25-hydroxyvitamin D and ionized calcium depends on vitamin D status: a study in a large cohort of healthy subjects. Bone 47:626–630. https://doi.org/10.1016/j.bone.2010.06.013 CrossRefPubMed Carnevale V, Nieddu L, Romagnoli E, Battista C, Mascia ML, Chiodini I, Eller-Vainicher C, Frusciante V, Santini SA, La Porta M, Minisola S, Scillitani A (2010) Regulation of PTH secretion by 25-hydroxyvitamin D and ionized calcium depends on vitamin D status: a study in a large cohort of healthy subjects. Bone 47:626–630. https://​doi.​org/​10.​1016/​j.​bone.​2010.​06.​013 CrossRefPubMed
11.
go back to reference Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA (2011) The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 96:53–58. https://doi.org/10.1210/jc.2010-2704 CrossRefPubMed Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, Durazo-Arvizu RA, Gallagher JC, Gallo RL, Jones G, Kovacs CS, Mayne ST, Rosen CJ, Shapses SA (2011) The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 96:53–58. https://​doi.​org/​10.​1210/​jc.​2010-2704 CrossRefPubMed
18.
go back to reference Kaic-Rak A, Antonic K (1990) Food composition tables. Institute of Public Health of Croatia, Orbis, Zagreb Kaic-Rak A, Antonic K (1990) Food composition tables. Institute of Public Health of Croatia, Orbis, Zagreb
19.
go back to reference Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium (2011) In: Ross AC, Taylor CL, Yaktine AL, Del Valle HB (eds) Dietary reference intakes for calcium and vitamin D. National Academies Press (US), Washington (DC) PMID: 21796828 Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium (2011) In: Ross AC, Taylor CL, Yaktine AL, Del Valle HB (eds) Dietary reference intakes for calcium and vitamin D. National Academies Press (US), Washington (DC) PMID: 21796828
20.
go back to reference World Health Organization (1993) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO study group. WHO tech rep Ser 843, Geneva. PMID: 7941614 World Health Organization (1993) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO study group. WHO tech rep Ser 843, Geneva. PMID: 7941614
23.
24.
go back to reference Hernandez JL, Olmos JM, Pariente E, Nan D, Martínez J, Llorca J, Valero C, Obregón E, Gonzalez-Macías J (2013) Influence of vitamin D status on vertebral fractures, bone mineral density, and bone turnover markers in normocalcemic postmenopausal women with high parathyroid hormone levels. J Clin Endocrinol Metab 98:1711–1717. https://doi.org/10.1210/jc.2012-3931 CrossRefPubMed Hernandez JL, Olmos JM, Pariente E, Nan D, Martínez J, Llorca J, Valero C, Obregón E, Gonzalez-Macías J (2013) Influence of vitamin D status on vertebral fractures, bone mineral density, and bone turnover markers in normocalcemic postmenopausal women with high parathyroid hormone levels. J Clin Endocrinol Metab 98:1711–1717. https://​doi.​org/​10.​1210/​jc.​2012-3931 CrossRefPubMed
Metadata
Title
Vitamin D and parathyroid hormone in relation to bone health in Croatian women
Authors
Irena Keser
Selma Cvijetić
Martina Bituh
Ivana Rumora Samarin
Jasminka Z. Ilich
Irena Colić Barić
Ivana Rumbak
Publication date
01-12-2018
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2018
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-018-0483-z

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