Department of Epidemiology, Maastricht University, The Netherlands.
Am J Hypertens. 2011 Jan;24(1):102-9. doi: 10.1038/ajh.2010.124. Epub 2010 Jul 1.
Parathyroid hormone (PTH) and vitamin D interactively regulate calcium fluxes across membranes, and thereby modulate insulin sensitivity, blood pressure, and arterial calcification. We hypothesized that lower calcium intake as reflected by circulating PTH and 25-OH-D₃ might be associated with the metabolic syndrome (MS) and arterial calcification.
In a random population sample (n = 542; 50.5% women; mean age, 49.8 ± 13.1 years), we measured MS prevalence (International Diabetes Federation (IDF) and American Heart Association (AHA) criteria), PTH and 25-OH-D₃, serum and 24-h urinary calcium, MS components, carotid intima-media thickness (CIMT), and calcium intake from dairy products. We assessed associations in multivariable-adjusted analyses, using linear and logistic regressions.
The prevalence of MS was 21.0% (IDF criteria) and 23.6% (AHA criteria). MS prevalence, blood pressure, waist circumference, body mass index, fasting blood glucose, insulin and triglycerides, and CIMT increased (P ≤ 0.042) across quartiles of the PTH/25-OH-D₃ ratio, whereas serum and 24-h urinary calcium decreased (P ≤ 0.029). Waist circumference and fasting blood glucose decreased across quartiles of habitual calcium intake (P ≤ 0.04). In models that included MS (IDF) and PTH/25-OH-D₃, the regression coefficients relating CIMT to PTH/25-OH-D₃ ratio and MS were +51 µm (P = 0.013) and +19 µm (P = 0.45), respectively. Multivariable-adjusted analyses were confirmatory.
MS prevalence and CIMT were positively associated with PTH/25-OH-D₃. CIMT was not associated with MS. Prospective studies and intervention trials should address the causality of these associations.
甲状旁腺激素（PTH）和维生素 D 相互作用调节跨膜钙通量，从而调节胰岛素敏感性、血压和动脉钙化。我们假设，循环 PTH 和 25-羟维生素 D₃ 所反映的较低钙摄入量可能与代谢综合征（MS）和动脉钙化有关。
在一个随机的人群样本中（n=542；50.5%女性；平均年龄 49.8±13.1 岁），我们测量了 MS 患病率（国际糖尿病联合会（IDF）和美国心脏协会（AHA）标准）、PTH 和 25-羟维生素 D₃、血清和 24 小时尿钙、MS 成分、颈动脉内膜中层厚度（CIMT）和乳制品中的钙摄入量。我们使用线性和逻辑回归在多变量调整分析中评估了相关性。
MS 的患病率为 21.0%（IDF 标准）和 23.6%（AHA 标准）。随着 PTH/25-羟维生素 D₃ 比值的四分位间距增加，MS 患病率、血压、腰围、体重指数、空腹血糖、胰岛素和甘油三酯以及 CIMT 增加（P≤0.042），而血清和 24 小时尿钙则降低（P≤0.029）。随着习惯性钙摄入量的四分位间距增加，腰围和空腹血糖降低（P≤0.04）。在包含 MS（IDF）和 PTH/25-羟维生素 D₃ 的模型中，与 PTH/25-羟维生素 D₃ 比值相关的 CIMT 回归系数分别为+51µm（P=0.013）和+19µm（P=0.45）。多变量调整分析是验证性的。
MS 患病率和 CIMT 与 PTH/25-羟维生素 D₃ 呈正相关。CIMT 与 MS 无关。前瞻性研究和干预试验应解决这些关联的因果关系。
