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Horm Metab Res 2020; 52(07): 509-516
DOI: 10.1055/a-1148-2546
Endocrine Care

Moderators of the Association Between Serum Parathyroid Hormone and Metabolic Syndrome in Participants with Elevated Parathyroid Hormone: NHANES 2003–2006

Liang Chen
1   Department of Endocrinology, Guangdong Provincial People’s Hospital Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
,
Jian-Hao Pei
1   Department of Endocrinology, Guangdong Provincial People’s Hospital Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
,
Jian Kuang
1   Department of Endocrinology, Guangdong Provincial People’s Hospital Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
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Abstract

This cross-sectional study extracted data of 392 NHANES participants with elevated serum parathyroid hormone (PTH) concentrations from 2 cycles of the US National Health and Nutrition Examination Survey (NHANES) 2003–2006 and evaluated the association between serum (PTH) concentration and metabolic syndrome (MetS) to identify dietary and lifestyle factors that may modify that association. The primary outcome was MetS severity scores. Results of univariate linear regression analyses revealed that serum PTH concentrations correlated positively and significantly with MetS severity scores (β=0.399, p=0.030). After adjusting for gender, age, race, and alcohol consumption, results of multivariate analysis revealed that increased serum PTH concentration correlated significantly with higher MetS severity scores (β=0.413, p=0.045) in participants with moderate physical activity over the past 30 days. Serum PTH concentration also correlated significantly with higher MetS severity scores in participants with serum 25-hydroxyvitamin D deficiency (β=0.456 and p=0.014), those without vitamin D supplementation (β=0.524, p=0.028) and with higher protein intake (β=0.586 and p=0.030). In conclusion, increased serum PTH concentration is associated with higher MetS severity scores in participants with elevated serum PTH at baseline. The association between PTH concentration and MetS severity is moderated by participants’ physical activity levels, status of serum vitamin D, vitamin D supplementation, and daily protein intake.

Key words

parathyroid hormone - hyperparathyroidism - dietary and lifestyle factors - metabolic syndrome - National Health and Nutritional Examination Survey

Supplementary Material



Publication History

Received: 05 August 2019

Accepted: 18 March 2020

Article published online:
23 April 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Fu S, Yao Y, Luan F. et al. Prevalence of metabolic syndrome risk factors and their relationships with renal function in Chinese centenarians. Sci Rep 2018; 8: 9863
    CrossrefPubMedGoogle Scholar
  • 2 Galassi A, Reynolds K, He J. Metabolic syndrome and risk of cardiovascular disease: A meta-analysis. Am J Med 2006; 119: 812-819
    CrossrefPubMedGoogle Scholar
  • 3 Saklayen MG. The global epidemic of the metabolic syndrome. Curr Hypertens Rep 2018; 20: 12-16
    CrossrefPubMedGoogle Scholar
  • 4 Reis JP, von Muhlen D, Kritz-Silverstein D. et al. Vitamin D, parathyroid hormone levels, and the prevalence of metabolic syndrome in community-dwelling older adults. Diabetes Care 2007; 30: 1549-1555
    CrossrefPubMedGoogle Scholar
  • 5 Reis JP, von Muhlen D, Miller ER. Relation of 25-hydroxyvitamin D and parathyroid hormone levels with metabolic syndrome among US adults. Eur J Endocrinol 2008; 159: 41-48
    CrossrefPubMedGoogle Scholar
  • 6 Silverberg SJ, Walker MD, Bilezikian JP. Asymptomatic primary hyperparathyroidism. J Clin Densitom 2013; 16: 14-21
    CrossrefPubMedGoogle Scholar
  • 7 Kayaniyil S, Vieth R, Harris SB. et al. Association of 25(OH)D and PTH with metabolic syndrome and its traditional and nontraditional components. J Clin Endocrinol Metab 2011; 96: 168-175
    CrossrefPubMedGoogle Scholar
  • 8 Paik JM, Farwell WR, Taylor EN. Demographic, dietary, and serum factors and parathyroid hormone in the National Health and Nutrition Examination Survey. Osteoporos Int 2012; 23: 1727-1736
    CrossrefPubMedGoogle Scholar
  • 9 Aloia JF, Feuerman M, Yeh JK. Reference range for serum parathyroid hormone. Endocr Pract 2006; 12: 137-144
    CrossrefPubMedGoogle Scholar
  • 10 Vilarrasa N, Vendrell J, Maravall J. et al. Is plasma 25(OH) D related to adipokines, inflammatory cytokines and insulin resistance in both a healthy and morbidly obese population?. Endocrine 2010; 38: 235-242
    CrossrefPubMedGoogle Scholar
  • 11 Raposo L, Martins S, Ferreira D. et al. Vitamin D, parathyroid hormone and metabolic syndrome - the PORMETS study. BMC Endocr Disord 2017; 17: 71
    CrossrefPubMedGoogle Scholar
  • 12 Kim J. Association between serum vitamin D, parathyroid hormone and metabolic syndrome in middle-aged and older Korean adults. Eur J Clin Nutr 2015; 69: 425-430
    CrossrefPubMedGoogle Scholar
  • 13 Sotunde OF, Kruger HS, Wright HH. et al. Association of 25-hydroxyvitamin D and parathyroid hormone with the metabolic syndrome in black South African women. Appl Physiol Nutr Metab 2017; 42: 413-419
    CrossrefPubMedGoogle Scholar
  • 14 Yin X, Sun Q, Zhang X. et al. Serum 25(OH)D is inversely associated with metabolic syndrome risk profile among urban middle-aged Chinese population. Nutr J 2012; 11: 68
    CrossrefPubMedGoogle Scholar
  • 15 Ford ES, Zhao G, Li C, Pearson WS. Serum concentrations of vitamin D and parathyroid hormone and prevalent metabolic syndrome among adults in the United States. J Diabetes 2009; 1: 296-303
    CrossrefPubMedGoogle Scholar
  • 16 (CDC) CfDCaP. NHANES 2005–2006. Available at http://wwwcdcgov/nchs/about/major/nhanes/nhanes2005-2006/nhanes05_06htm
    PubMed
  • 17 DeBoer MD, Gurka MJ. Clinical utility of metabolic syndrome severity scores: Considerations for practitioners. Diabetes Metab Syndr Obes 2017; 10: 65-72
    CrossrefPubMedGoogle Scholar
  • 18 Munns CF. Global Consensus Recommendations on prevention and management of nutritional rickets. J Clin Endocrinol Metab 2016; 101: 394-415
    CrossrefPubMedGoogle Scholar
  • 19 Tsai J, Ford ES, Li C.. et al. Past and current alcohol consumption patterns and elevations in serum hepatic enzymes among US adults. Addict Behav 2012; 37: 78-84
    CrossrefPubMedGoogle Scholar
  • 20 Scholl TO, Chen X, Stein TP. Vitamin D, secondary hyperparathyroidism, and preeclampsia. Am J Clin Nutr 2013; 98: 787-793
    CrossrefPubMedGoogle Scholar
  • 21 Zalesin KC, Miller WM, Nori Janosz KE. et al. Controversies in vitamin D: Deficiency and supplementation after Roux-en-Y-gastric bypass surgery. Therapy 2007; 4: 561-574
    CrossrefPubMedGoogle Scholar
  • 22 Saab G, Whaley-Connell A, Bombeck A. et al. The Association between parathyroid hormone levels and the cardiorenal metabolic syndrome in non-diabetic chronic kidney disease. Cardiorenal Med 2011; 1: 123-130
    CrossrefPubMedGoogle Scholar
  • 23 George JA, Norris SA, van Deventer HE. et al. The association of 25 hydroxyvitamin D and parathyroid hormone with metabolic syndrome in 2 ethnic groups in South Africa. PLoS One 2013; 8: e61282
    CrossrefPubMedGoogle Scholar
  • 24 Bouassida A, Latiri I, Bouassida S. et al. Parathyroid hormone and physical exercise: A brief review. J Sports Sci Med 2006; 5: 367-374
    PubMedGoogle Scholar
  • 25 Lorenzo V, Martin M, Rufino M. et al. Protein intake, control of serum phosphorus, and relatively low levels of parathyroid hormone in elderly hemodialysis patients. Am J Kidney Dis 2001; 37: 1260-1266
    CrossrefPubMedGoogle Scholar
  • 26 Richter M, Baerlocher K, Bauer JM. et al. German Nutrition Society (DGE). Revised reference values for the intake of protein. Protein.Ann Nutr Metab 2019; 74: 242-250
    PubMedGoogle Scholar