Povaliaeva Alexandra, Zhukov Artem, Bogdanov Viktor, Bondarenko Axenia, Senko Oleg, Kuznetsova Anna, Kodryan Maxim, Ioutsi Vitaliy, Pigarova Ekaterina, Rozhinskaya Liudmila, Mokrysheva Natalia
Endocrinology Research Centre 11, Dmitriya Ul'yanova street, Moscow 117292, Russia.
Life Sciences Research Center, Moscow Institute of Physics and Technology, Dolgoprudniy, Russia.
Bone Rep. 2024 Aug 26;22:101800. doi: 10.1016/j.bonr.2024.101800. eCollection 2024 Sep.
A commonly used method for determining vitamin D sufficiency is the suppression of excess PTH secretion. Conventionally, the main circulating vitamin D metabolite 25(OH)D is used for this assessment, however, the cut-off data for this parameter vary widely in the literature. The role of other metabolites as markers of vitamin D status is actively debated. The aim of our study was to assess the relationship between PTH, age and parameters characterizing vitamin D status, both "classical" - 25(OH)D, and "non-classical" - 24,25(OH)D and 25(OH)D/24,25(OH)D (vitamin D metabolite ratio, VMR). This prospective non-controlled cohort study included 162 apparently healthy Caucasian adult volunteers. When PTH was binarized according to the median value, at VMR < 14.9, 25(OH)D > 9.7 ng/mL and 24,25(OH)D > 0.64 ng/mL there was a pronounced relationship between PTH and age ( = 0.001, = 0.023 and = 0.0134 respectively), with the prevalence of higher PTH levels in older individuals and vice versa. Moreover, at an age of <40.3 years, there was a pronounced relationship between PTH and VMR ( < 0.001), and similarly at an age of <54.5 years, there was a pronounced relationship between PTH and 25(OH)D ( = 0.002) as well as between PTH and 24,25(OH)D ( = 0.0038): in younger people, higher PTH values prevailed only in the range of vitamin D insufficiency, while in the older age group this relationship was not demonstrated and PTH values were in general above the median. VMR controlled the correlation between PTH and age more strongly than metabolites 25(OH)D and 24,25(OH)D ( = 0.0012 vs. > 0.05 and = 0.0385 respectively). The optimal threshold was found equal to 11.7 for VMR such that the relationship between PTH and age in the subset of participants with VMR < 11.7 was characterized by a correlation coefficient of ρ = 0.68 ( < 0.001), while the cohort with VMR > 11.7 was characterized by a very weak correlation coefficient of ρ = 0.12 ( = 0.218), which is non-significant. In summary, our findings suggest that the relationship between PTH and vitamin D is age-dependent, with a greater susceptibility to elevated PTH among older individuals even with preserved renal function, likely due to the resistance to vitamin D function. We propose VMR can be considered as a potential marker of vitamin D status. These findings require confirmation in larger population-based studies.
一种常用的确定维生素D充足性的方法是抑制过量甲状旁腺激素（PTH）的分泌。传统上，主要的循环维生素D代谢产物25(OH)D用于此评估，然而，该参数的截断数据在文献中差异很大。其他代谢产物作为维生素D状态标志物的作用正在积极讨论中。我们研究的目的是评估PTH、年龄与表征维生素D状态的参数之间的关系，包括“经典”的25(OH)D以及“非经典”的24,25(OH)D和25(OH)D/24,25(OH)D（维生素D代谢产物比值，VMR）。这项前瞻性非对照队列研究纳入了162名表面健康的白种成年志愿者。当根据中位数对PTH进行二分类时，在VMR < 14.9、25(OH)D > 9.7 ng/mL和24,25(OH)D > 0.64 ng/mL时，PTH与年龄之间存在显著关系（分别为P = 0.001、P = 0.023和P = 0.0134），老年个体中PTH水平较高的患病率较高，反之亦然。此外，在年龄<40.3岁时，PTH与VMR之间存在显著关系（P < 0.001），同样在年龄<54.5岁时，PTH与25(OH)D之间存在显著关系（P = 0.002）以及PTH与24,25(OH)D之间存在显著关系（P = 0.0038）：在年轻人中，仅在维生素D不足范围内PTH值较高，而在老年组中这种关系未得到证实且PTH值总体上高于中位数。VMR比代谢产物25(OH)D和24,25(OH)D更强烈地控制PTH与年龄之间的相关性（分别为P = 0.0012 vs. P > 0.05和P = 0.0385）。发现VMR的最佳阈值等于11.7，使得VMR < 11.7参与者亚组中PTH与年龄之间的关系以相关系数ρ = 0.68为特征（P < 0.001），而VMR > 11.7的队列以非常弱的相关系数ρ = 0.12为特征（P = 0.218），这无统计学意义。总之，我们的研究结果表明PTH与维生素D之间的关系是年龄依赖性的，即使肾功能正常，老年个体对PTH升高的易感性更高，这可能是由于对维生素D功能的抵抗。我们建议VMR可被视为维生素D状态的潜在标志物。这些发现需要在更大规模的基于人群的研究中得到证实。
