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正常范围内血清甲状旁腺激素与糖尿病及糖尿病前期成年人患病率和预后的关联:基于美国国家健康和营养检查调查(NHANES)2003 - 2006年数据的见解

Association of serum parathyroid hormone within normal range with the prevalence and prognosis among adults with diabetes and prediabetes: insight from NHANES 2003-2006 data.

作者信息

Chen Guangshu, Che Li, Wen Xueman, Lai Meizheng, Wei Ting, Zhu Ping, Ran Jianmin

机构信息

Department of Endocrinology and Metabolism, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, China.

Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China.

出版信息

Ther Adv Endocrinol Metab. 2025 Apr 2;16:20420188251328806. doi: 10.1177/20420188251328806. eCollection 2025.

Abstract

BACKGROUND

Previous research has established a link between high blood levels of parathyroid hormone (PTH) levels and hyperglycemia, as well as early mortality. However, the extent of this relationship and the predictive value of PTH for mortality risk in hyperglycemic populations have been minimally explored.

METHODS

The National Health and Nutrition Examination Survey study conducted from 2003 to 2006 identified 932 adults with diabetes and 1645 adults with prediabetes. A weighted multivariate logistic regression analysis was utilized to examine the association between PTH levels and hyperglycemia. Furthermore, Cox proportional hazards regression models were employed to examine the correlation between PTH levels and both cardiovascular and overall mortality within the hyperglycemia cohort.

RESULTS

(1) The research findings revealed a negative association between PTH levels (per 10-pg/mL increase) and diabetes status (OR, 0.79; 95% confidence interval (CI), 0.73-0.86). (2) There was a significant correlation between the risk of all-cause mortality (hazard ratios (HR), 1.13; 95% CI, 1.01-1.29) and cardiovascular disease mortality (HR, 1.39; 95% CI, 1.05-1.84) among individuals with diabetes for every 10-pg/mL increase in PTH levels.

CONCLUSION

The current research shows that individuals with elevated PTH spectrum within the normal range are less likely to have diabetes, while those with higher PTH levels in adults with diabetes are linked to worse outcomes, particularly cardiovascular mortality.

摘要

背景

先前的研究已经证实甲状旁腺激素(PTH)水平升高与高血糖以及早期死亡率之间存在关联。然而,这种关系的程度以及PTH对高血糖人群死亡风险的预测价值尚未得到充分探索。

方法

2003年至2006年进行的美国国家健康与营养检查调查研究确定了932名糖尿病成年人和1645名糖尿病前期成年人。采用加权多变量逻辑回归分析来检验PTH水平与高血糖之间的关联。此外,使用Cox比例风险回归模型来检验PTH水平与高血糖队列中心血管死亡率和总体死亡率之间的相关性。

结果

(1)研究结果显示PTH水平每升高10 pg/mL与糖尿病状态呈负相关(比值比(OR),0.79;95%置信区间(CI),0.73 - 0.86)。(2)糖尿病患者中,PTH水平每升高10 pg/mL,全因死亡率风险(风险比(HR),1.13;95% CI,1.01 - 1.29)和心血管疾病死亡率(HR,1.39;95% CI,1.05 - 1.84)之间存在显著相关性。

结论

当前研究表明,正常范围内PTH谱升高的个体患糖尿病的可能性较小,而糖尿病成年人中PTH水平较高者与更差的结局相关,尤其是心血管死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e194/11967215/57b23a6af36e/10.1177_20420188251328806-fig1.jpg

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