Parathyroid hormone, but not vitamin D, is associated with the metabolic syndrome in morbidly obese women and men: a cross-sectional study.
Parathyroid hormone, but not vitamin D, is associated with the metabolic syndrome in morbidly obese women and men: a cross-sectional study.
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DOI：
10.1186/1475-2840-8-7
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发表时间：
2009-02-03
影响因子：
9.3
通讯作者：
Bollerslev J
中科院分区：
文献类型：
--
作者：
Hjelmesaeth J;Hofsø D;Aasheim ET;Jenssen T;Moan J;Hager H;Røislien J;Bollerslev J
在病态肥胖人群中，维生素D不足和继发性甲状旁腺功能亢进的患病率很高。此外，血清25-羟基维生素D （25 [OH]D）和镁的低水平与代谢综合征（MS）的风险增加有关，最近，PTH和MS之间可能存在联系。尽管众所周知PTH的合成和分泌受血清钙、磷酸盐、镁和25(OH)D水平的调节，但对这些参数与MS的可能的集群关系知之甚少。我们旨在探讨MS是否与病态肥胖患者中PTH、25(OH)D和镁的异常血清水平相关。在一项对1017例连续病态肥胖患者（68%为女性）的横断面队列研究中，评估了空腹血清25(OH)D、甲状旁腺激素和镁的水平。在校正混杂因素后，采用多元logistic回归分析评估PTH、25(OH)D和镁对MS （National Cholesterol Education Program [NCEP]）患病几率的独立影响。68%的多发性硬化症患者与非多发性硬化症患者相比，多发性硬化症患者的平均血清镁（P < 0.001）和平均甲状旁腺激素（P = 0.067）较低，而平均25(OH)D没有显著差异。在校正25(OH)D、镁、钙、磷酸盐、肌酐、年龄、性别、血清取样季节、BMI、吸烟史、蛋白尿、CRP、胰岛素抵抗和2型糖尿病后，PTH水平在第二至第四四分位数的患者患病率较高（比值比分别为1.47 [95% CI 0.92-2.35]、2.33 [95% CI 1.40-3.87]和2.09 [95% CI 1.23-3.56]）。此外，PTH与收缩压和舒张压显著相关（均P < 0.001），但与MS的其他成分无关。在多变量模型中，25(OH)D和镁的水平与MS无关。PTH水平，而不是维生素D水平，是寻求病态肥胖白人女性和男性治疗时多发性硬化症的独立预测因子。有必要进行随机对照临床试验，包括降低甲状旁腺激素的不同治疗策略，如补充钙/维生素D和减轻体重，以探索任何因果关系。
The prevalence of vitamin D insufficiency and secondary hyperparathyroidism is high among morbidly obese subjects. Further, low serum levels of 25-hydroxyvitamin D (25 [OH]D) and magnesium have been associated with increased risk of the metabolic syndrome (MS), and recently, a possible link between PTH and MS has been reported. Although it is well known that the synthesis and secretion of PTH is regulated by serum levels of calcium, phosphate, magnesium and 25(OH)D, less is known about the possible clustered affiliation of these parameters with MS. We aimed to explore whether MS is associated with abnormal serum levels of PTH, 25(OH)D and magnesium in a population of morbidly obese patients. Fasting serum levels of 25(OH)D, PTH and magnesium were assessed in a cross-sectional cohort study of 1,017 consecutive morbidly obese patients (68% women). Multiple logistic regression analyses were used to assess the independent effect of PTH, 25(OH)D and magnesium on the odds for MS (National Cholesterol Education Program [NCEP]) after adjustment for confounding factors. Sixty-eight percent of the patients had MS. Patients with MS had lower mean serum magnesium (P < 0.001) and higher mean PTH (P = 0.067) than patients without MS, whereas mean 25(OH)D did not differ significantly. Patients with PTH levels in the second to fourth quartiles had higher odds of prevalent MS (odds ratio 1.47 [95% CI 0.92–2.35], 2.33 [95% CI 1.40–3.87] and 2.09 [95% CI 1.23–3.56], respectively), after adjustment for 25(OH)D, magnesium, calcium, phosphate, creatinine, age, gender, season of serum sampling, BMI, current smoking, albuminuria, CRP, insulin resistance and type 2 diabetes. Further, PTH was significantly correlated with systolic and diastolic pressure (both P < 0.001), but not with the other components of MS. The levels of 25(OH)D and magnesium were not associated with MS in the multivariate model. The PTH level, but not the vitamin D level, is an independent predictor of MS in treatment seeking morbidly obese Caucasian women and men. Randomized controlled clinical trials, including different therapeutic strategies to lower PTH, e.g. calcium/vitamin D supplementation and weight reduction, are necessary to explore any cause-and-effect relationship.
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影响因子：
13.6
作者：
de Jong, Paul E.;Curhan, Gary C.
通讯作者：
Curhan, Gary C.
影响因子：
2.8
作者：
Haffner, SM
通讯作者：
Haffner, SM
影响因子：
16.2
作者：
Ford, ES;Ajani, UA;Liu, S
通讯作者：
Liu, S
影响因子：
3.8
作者：
Guerrero-Romero, F;Rodríguez-Morán, M
通讯作者：
Rodríguez-Morán, M
影响因子：
7.7
作者：
Sun, G;Vasdev, S;Zhang, HW
通讯作者：
Zhang, HW