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韩国成年人血清25-羟维生素D、甲状旁腺激素与肾小球滤过率之间的关系:2009年至2011年韩国国家健康与营养检查调查

The Relationship between Serum 25-Hydroxyvitamin D, Parathyroid Hormone and the Glomerular Filtration Rate in Korean Adults: The Korea National Health and Nutrition Examination Survey between 2009 and 2011.

作者信息

Han Sung-Woo, Kim Sung-Jin, Lee Duck-Joo, Kim Kwang-Min, Joo Nam-Seok

机构信息

Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea.

出版信息

Korean J Fam Med. 2014 Mar;35(2):98-106. doi: 10.4082/kjfm.2014.35.2.98. Epub 2014 Mar 24.

Abstract

BACKGROUND

The glomerular filtration rate (GFR) decreases with age, while parathyroid hormone (PTH) increases. There are a few reports only on the relationship between GFR and PTH under the category of serum 25-hydroxyvitamin D (25[OH]D) concentration.

METHODS

Using the Korea National Health and Nutrition Examination Survey (KNHANES) data, a cross-sectional study was conducted on the association between serum 25(OH)D concentration, GFR and PTH in Korean adults aged 50 years or older. Serum PTH concentration was compared to the tertiles of GFR after adjustment for relevant variables. In addition, the serum PTH concentration was compared with the GFR under the category of serum 25(OH) D concentration (<20, 20-30, >30 ng/mL).

RESULTS

The mean estimated GFR (eGFR) was 74.8 mL/min in men and 73.1 mL/min in women. The mean PTH and 25(OH) D was 66.8 pg/mL, 20.5 ng/mL in men and 69.0 pg/mL, 18.2 ng/mL in women. The serum PTH concentration showed a significant negative correlation with the serum 25(OH) D and eGFR in both genders. The serum PTH concentration significantly increased at the lower tertile of eGFR in male adults In addition, a decrease of serum PTH concentration was marked in the vitamin D sufficient male adults (>30 ng/mL).

CONCLUSION

This present study demonstrated that serum PTH concentration showed negative correlation with eGFR, however, serum PTH increase may be minimized by maintaining proper serum 25(OH)D concentrations under similar eGFR status in Korean adults aged 50 and above.

摘要

背景

肾小球滤过率(GFR)随年龄增长而下降,而甲状旁腺激素(PTH)则升高。关于血清25-羟维生素D(25[OH]D)浓度类别下GFR与PTH之间的关系,仅有少数报告。

方法

利用韩国国家健康与营养检查调查(KNHANES)数据,对50岁及以上韩国成年人血清25(OH)D浓度、GFR和PTH之间的关联进行了横断面研究。在对相关变量进行调整后,将血清PTH浓度与GFR的三分位数进行比较。此外,在血清25(OH)D浓度类别(<20、20 - 30、>30 ng/mL)下,将血清PTH浓度与GFR进行比较。

结果

男性的平均估计肾小球滤过率(eGFR)为74.8 mL/分钟,女性为73.1 mL/分钟。男性的平均PTH和25(OH)D分别为66.8 pg/mL、20.5 ng/mL,女性为69.0 pg/mL、18.2 ng/mL。血清PTH浓度在两性中均与血清25(OH)D和eGFR呈显著负相关。在成年男性中,血清PTH浓度在eGFR较低三分位数时显著升高。此外,维生素D充足的成年男性(>30 ng/mL)血清PTH浓度明显降低。

结论

本研究表明,血清PTH浓度与eGFR呈负相关,然而,在50岁及以上韩国成年人中,在类似的eGFR状态下,通过维持适当的血清25(OH)D浓度,血清PTH的升高可能会降至最低。

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