Insights into the Association of Vitamin D Deficiency with Parathyroid Hormone Levels with Relevance to Renal Function and Insulin Resistance

Author(s): Iyyapu K. Mohan* , Siraj A. Khan , Rachel Jacob , Kompella S.S.S. Baba , Tajamul Hussain , Salman A. Alrokayan , Shaik Mohammad Naushad .

Journal Name: Current Nutrition & Food Science

Volume 15 , Issue 2 , 2019

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Abstract:

Background: In majority of the studies inverse association between vitamin D and parathyroid hormone levels is documented.

Objective: The rationale of the current study was to investigate whether this inverse association is agedependent and whether it has any role in modulating renal function and insulin resistance.

Methods: To test this hypothesis, we have carried out a hospital based study enrolling 848 subjects (558 men and 290 women) with the mean age of 50.9 ± 15.9 y. Chemiluminometric competitive immune assays were performed using commercial kits to determine 25-OH vitamin D and Parathyroid Hormone (PTH) levels. Fasting glucose levels and serum creatinine were used to evaluate diabetes and renal function.

Results: Vitamin D deficiency was predominant irrespective of age group (p = 0.21) and gender (p = 0.12). An inverse association between vitamin D and PTH was observed (r = -0.24) in middle age subjects (p = 0.02). The data segregation based on plasma vitamin D levels which were <20 ng/ml, 20.1- 30 ng/ml and >30 ng/ml confirmed the inverse association between vitamin D and PTH levels (ptrend: 0.007). Subjects with low plasma vitamin D and increased PTH exhibited elevated blood urea, serum creatinine and blood glucose. Subjects with 25-OHD deficiency showed a 3.03-folds (95% CI: 2.26- 4.07) and 2.09-fold (1.41-3.10) increased risk for diabetes and renal disease, respectively.

Conclusion: Based on the results of the present study, it is suggested that those with vitamin D deficiency need to be evaluated for possible presence of renal dysfunction, diabetes/insulin resistance in addition to assessing their PTH status.

Keywords: Diabetes, hyperparathyroidism, insulin resistance, parathyroid hormone, vitamin D, serum creatinine.

[1]
Agarwal KS, Mughal MZ, Upadhyay P, Berry JL, Mawer EB, Puliyel JM. The impact of atmospheric pollution on vitamin D status of infants and toddlers in Delhi, India. Arch Dis Child 2002; 87(2): 111-3.
[2]
Vupputuri MR, Goswami R, Gupta N, Ray D, Tandon N, Kumar N. Prevalence and functional significance of 25-hydroxyvitamin D deficiency and vitamin D receptor gene polymorphisms in Asian Indians. Am J Clin Nutr 2006; 83(6): 1411-9.
[3]
Neme A, Nurminen V, Seuter S, Carlberg C. The vitamin D-dependent transcriptome of human monocytes. J Steroid Biochem Mol Biol 2016; 164: 180-7.
[4]
Pradeep PV, Jayashree B, Mishra A, Mishra SK. Systematic review of primary hyperparathyroidism in India: The past, present, and the future trends. Int J Endocrinol 2011; 2011: 921814.
[5]
Jabbar Z, Aggarwal PK, Chandel N, et al. Noninvasive assessment of bone health in Indian patients with chronic kidney disease. Indian J Nephrol 2013; 23(3): 161-7.
[6]
Hari P, Gupta N, Hari S, Gulati A, Mahajan P, Bagga A. Vitamin D insufficiency and effect of cholecalciferol in children with chronic kidney disease. Pediatr Nephrol 2010; 25(12): 2483-8.
[7]
Ha J, Jo K, Lim DJ, et al. Parathyroid hormone and vitamin D are associated with the risk of metabolic obesity in a middle-aged and older Korean population with preserved renal function: A cross-sectional study. PLoS One 2017; 12(4): e0175132.
[8]
Tosunbayraktar G, Bas M, Kut A, Buyukkaragoz AH. Low serum 25(OH) D levels are assocıated to hıgher BMI and metabolic syndrome parameters in adult subjects in Turkey. Afr Health Sci 2015; 15(4): 1161-9.
[9]
Clemente-Postigo M, Muñoz-Garach A, Serrano M, et al. Serum 25-hydroxyvitamin D and adipose tissue vitamin D receptor gene expression: Relationship with obesity and type 2 diabetes. J Clin Endocrinol Metab 2015; 100(4): E591-5.
[10]
Sarathy H, Pramanik V, Kahn J, et al. The effects of short-term vitamin D supplementation on glucose metabolism in dialysis patients: A systematic review and meta-analysis. Int Urol Nephrol 2015; 47(3): 537-49.
[11]
Khadilkar AV, Kajale NA. Bone health status in Indian women. Indian J Med Res 2013; 137(1): 7-9.
[12]
Martins JS, Palhares MO, Teixeira OC, Gontijo RM. Vitamin D status and its association with parathyroid hormone concentration in Brazilians. J Nutr Metab 2017; 2017: 9056470.
[13]
Sahu M, Bhatia V, Aggarwal A, et al. Vitamin D deficiency in rural girls and pregnant women despite abundant sunshine in northern India. Clin Endocrinol (Oxf) 2009; 70(5): 680-4.
[14]
Au LE, Harris SS, Dwyer JT, Jacques PF, Sacheck JM. Association of serum 25-hydroxyvitamin D with race/ethnicity and constitutive skin color in urban school children. J Pediatr Endocrinol Metab 2014; 27(11-12): 1095-100.
[15]
Puri S, Marwaha RK, Agarwal N, et al. Vitamin D status of apparently healthy schoolgirls from two different socioeconomic strata in Delhi: Relation to nutrition and lifestyle. Br J Nutr 2008; 99(4): 876-82.
[16]
Karnchanasorn R, Ou HY, Chiu KC. Plasma 25-hydroxyvitamin D levels are favorably associated with β-cell function. Pancreas 2012; 41(6): 863-8.
[17]
Ivarsson KM, Clyne N, Almquist M, Akaberi S. Hyperparathyroidism and new onset diabetes after renal transplantation. Transplant Proc 2014; 46: 145-50.
[18]
Carey RM, Siragy HM. The intrarenal renin-angiotensin system and diabetic nephropathy. Trends Endocrinol Metab 2003; 14(6): 274-81.
[19]
Li YC. Renoprotective effects of vitamin D analogs. Kidney Int 2010; 78(2): 134-9.
[20]
Stanley T, Bredella MA, Pierce L, Misra M. The ratio of parathyroid hormone to vitamin D is a determinant of cardiovascular risk and insulin sensitivity in adolescent girls. Metab Syndr Relat Disord 2013; 11: 56-62.
[21]
Deo R, Katz R, Shlipak MG, et al. Vitamin D, parathyroid hormone, and sudden cardiac death: Results from the Cardiovascular Health Study. Hypertension 2011; 58(6): 1021-8.
[22]
Pirro M, Manfredelli MR, Helou RS, et al. Association of parathyroid hormone and 25-OH-vitamin D levels with arterial stiffness in postmenopausal women with vitamin D insufficiency. J Atheroscler Thromb 2012; 19(10): 924-31.
[23]
Maetani M, Maskarinec G, Franke AA, Cooney RV. Association of leptin, 25-hydroxyvitamin D, and parathyroid hormone in women. Nutr Cancer 2009; 61(2): 225-31.


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Article Details

VOLUME: 15
ISSUE: 2
Year: 2019
Page: [196 - 200]
Pages: 5
DOI: 10.2174/1573401313666170920145038
Price: $58

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