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在没有慢性肾脏病的男性中,肾小球滤过率和甲状旁腺激素与 1,25-二羟维生素 D 相关。

Glomerular filtration rate and parathyroid hormone are associated with 1,25-dihydroxyvitamin D in men without chronic kidney disease.

机构信息

Department of Medicine Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.

出版信息

J Intern Med. 2012 Jun;271(6):573-80. doi: 10.1111/j.1365-2796.2011.02471.x. Epub 2011 Nov 15.

Abstract

BACKGROUND AND AIM

Vitamin D, estimated glomerular filtration rate (eGFR) and parathyroid hormone (PTH) are related to cardiovascular disease risk. We examined the associations between the levels of 25-hydroxyvitamin D (25-D) and 1,25-dihydroxyvitamin D (1,25-D) and both eGFR and PTH.

DESIGN AND SETTING

Cross-sectional population-based study in Kuopio, Eastern Finland.

SUBJECTS

A total of 909 men without known chronic kidney disease (CKD) and not receiving antidiabetic medication, aged from 45 to 73 years, were included in the study. Main outcome measures. Fasting levels of 25-D, 1,25-D, creatinine and PTH were measured, and an oral glucose tolerance test (OGTT) was performed.

RESULTS

High levels of 25-D were associated with low levels of eGFR and PTH (β = -0.17, P = 9 × 10(-7) and β = -0.28, P = 6 × 10(-17) , respectively, adjusted for age, body mass index and levels of calcium, phosphorus and glucose in a 2-h OGTT, and also for either eGFR or PTH). By contrast, high 1,25-D levels were associated with high levels of eGFR and PTH (β = 0.17, P = 2 × 10(-6) and β = 0.19, P = 5 × 10(-8) , respectively, adjusted as mentioned earlier and additionally for 25-D). Eighteen per cent of men in the highest 25-D quartile were in the lowest 1,25-D quartile and also had a lower eGFR than men with high levels of both 25-D and 1,25-D (P = 4 × 10(-5) ). Finally, 15% of men in the lowest 25-D quartile were in the highest 1,25-D quartile and also had higher PTH levels than men with low levels of both 25-D and 1,25-D (P = 2 × 10(-3) ).

CONCLUSION

Our findings suggest that both eGFR and PTH are significantly associated with vitamin D metabolism in men without known CKD.

摘要

背景与目的

维生素 D、估算肾小球滤过率(eGFR)和甲状旁腺激素(PTH)与心血管疾病风险相关。我们研究了 25-羟维生素 D(25-D)和 1,25-二羟维生素 D(1,25-D)水平与 eGFR 和 PTH 之间的关联。

设计和设置

在东芬兰的库奥皮奥进行的一项基于人群的横断面研究。

受试者

共纳入了 909 名年龄在 45 至 73 岁之间、无已知慢性肾脏病(CKD)且未接受抗糖尿病药物治疗的男性。主要观察指标:空腹 25-D、1,25-D、肌酐和 PTH 水平,以及口服葡萄糖耐量试验(OGTT)。

结果

高水平的 25-D 与低水平的 eGFR 和 PTH 相关(β=-0.17,P=9×10(-7)和β=-0.28,P=6×10(-17),分别经年龄、体重指数以及 2 小时 OGTT 中钙、磷和葡萄糖水平调整,也经 eGFR 或 PTH 调整)。相比之下,高水平的 1,25-D 与高水平的 eGFR 和 PTH 相关(β=0.17,P=2×10(-6)和β=0.19,P=5×10(-8),分别经上述调整,并额外经 25-D 调整)。在 25-D 最高四分位数的 18%男性处于 1,25-D 最低四分位数,并且其 eGFR 也低于同时具有高 25-D 和 1,25-D 水平的男性(P=4×10(-5))。最后,在 25-D 最低四分位数的 15%男性处于 1,25-D 最高四分位数,并且其 PTH 水平也高于同时具有低 25-D 和 1,25-D 水平的男性(P=2×10(-3))。

结论

我们的研究结果表明,在无已知 CKD 的男性中,eGFR 和 PTH 均与维生素 D 代谢明显相关。

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