Mukhopadhyay Pradip, Ghosh Sujoy, Bhattacharjee Kingshuk, Chowdhury Subhankar
Department of Endocrinology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
Health Care Management, Senior Medical Scientific Liaison, Metabolics, Biocon Limited, Bengaluru, Karnataka, India.
Indian J Endocrinol Metab. 2019 Jul-Aug;23(4):422-427. doi: 10.4103/ijem.IJEM_322_19.
There is no consensus about the inflection point for 25 hydroxy vitamin D below which the intact PTH level increases.
Determine the relationship/inflection point between 25 hydroxy vitamin D and parathormone levels.
We performed a population-based analysis on a nonobese cohort ( = 405).
Prevalence of vitamin D deficiency was 58.76% ( = 228). Vitamin D insufficiency was found in 34.56% ( = 140). An inverse relationship between 25 hydroxy vitamin D (25(OH)D) and intact PTH exist, but strength of such relationship is weak ( = -0.16, = 0.018). With respect to the 25(OH)D cut-off of 16 ng/mL by IOM (EAR linked), proportion of persons with high intact PTH was higher in the group with lower 25(OH)D compared with higher 25(OH)D group ( = 0.005) and it was similar for RDA linked cut-off of 20 ng/mL also ( = 0.017). LOWESS method revealed two inflection points at which PTH levels change. A less conspicuous inflection point was found at 32 ng/mL (95% CI, 27-36), which reasonably corroborates with the current cutoff of definition of vitamin D sufficiency, and the second, steeper inflection point was found at 16.5 ng/ml (95% CI, 14.9-18.8) which corroborates with the IOM supported EAR linked value of 25(OH)D level in general population and possible definition of vitamin D deficiency.
There are possibly two inflection points at which PTH levels change in relation to 25(OH)D levels.
关于25-羟维生素D低于何值时完整甲状旁腺激素水平会升高，目前尚无共识。
确定25-羟维生素D与甲状旁腺激素水平之间的关系/转折点。
我们对一个非肥胖队列（n = 405）进行了基于人群的分析。
维生素D缺乏的患病率为58.76%（n = 228）。维生素D不足的比例为34.56%（n = 140）。25-羟维生素D（25(OH)D）与完整甲状旁腺激素之间存在负相关关系，但这种关系的强度较弱（r = -0.16，P = 0.018）。对于医学研究所（IOM）（与估计平均需求量相关）定义的25(OH)D临界值16 ng/mL，25(OH)D水平较低组中甲状旁腺激素水平较高的人群比例高于25(OH)D水平较高组（P = 0.005），对于与推荐膳食摄入量相关的25(OH)D临界值20 ng/mL，情况也相似（P = 0.017）。局部加权散点平滑法（LOWESS）显示甲状旁腺激素水平变化存在两个转折点。在32 ng/mL（95%可信区间，27 - 36）处发现一个不太明显的转折点，这与目前维生素D充足定义的临界值合理相符，第二个更明显的转折点在16.5 ng/ml（95%可信区间，14.9 - 18.8）处，这与IOM支持的一般人群中25(OH)D水平的估计平均需求量相关值以及维生素D缺乏的可能定义相符。
甲状旁腺激素水平可能存在两个与25(OH)D水平相关的转折点。
