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Serum PTH is not a good marker for defining a threshold for vitamin D deficiency

Permanent link
https://hdl.handle.net/10037/20382
DOI
https://doi.org/10.1530/EC-20-0067
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Date
2020-04-01
Type
Journal article
Tidsskriftartikkel
Peer reviewed

Author
Jorde, Rolf; Grimnes, Guri
Abstract
Objective: In addition to its skeletal effects, vitamin D may also be important for health in general. It is uncertain what level of serum 25-hydroxyvitamin D (25(OH)D), marker of vitamin D status, is sufficient for these effects. With decreasing serum 25(OH)D levels there is an increase in serum PTH. The point at which this occurs has been considered as a threshold for vitamin D sufficiency. The thresholds found have varied widely and have mainly been based on observational studies. However, to truly establish a threshold for vitamin D effects, this has to be based on randomized controlled trials (RCTs).

Methods: 2803 subjects from a general health survey, the Tromsø study, and pooled individual person data from five vitamin D intervention studies (n = 1544) were included. Serum parathyroid hormone (PTH) and change in PTH after vitamin D supplementation was related to serum 25(OH)D levels in steps of 25 nmol/L (<24, 25-49, 50-74, 75-99, >99 nmol/L).

Results: In the Tromsø study there was in the females a gradual decrease in serum PTH with increasing serum 25(OH)D with no apparent plateau, whereas in the males the decrease in PTH in subjects with serum 25(OH)D >74 nmol/l was marginal. In pooled RCTs, there was a significant reduction in serum PTH by vitamin D supplementation regardless of baseline serum 25(OH)D level.

Conclusions: The use of the serum PTH – 25(OH)D relation from observations studies to determine a threshold for vitamin D sufficiency is highly questionable.

Publisher
BioScientifica
Citation
Jorde, Grimnes. Serum PTH is not a good marker for defining a threshold for vitamin D deficiency. Endocrine Connections. 2020;9(5):396-404
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  • Artikler, rapporter og annet (klinisk medisin) [1974]
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