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Serum PTH is not a good marker for defining a threshold for vitamin D deficiency
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 PT...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Bioscientifica Ltd
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274551/ https://www.ncbi.nlm.nih.gov/pubmed/32412426 http://dx.doi.org/10.1530/EC-20-0067 |
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author | Jorde, Rolf Grimnes, Guri |
author_facet | Jorde, Rolf Grimnes, Guri |
author_sort | Jorde, Rolf |
collection | PubMed |
description | 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: The study included 2803 subjects from a general health survey, the Tromsø study, and pooled individual person data from five vitamin D intervention studies (n = 1544). Serum parathyroid hormone (PTH) and change in PTH after vitamin D supplementation were related to serum 25(OH)D levels in steps of 25 nmol/L (<24, 25–49, 50–74, 75–99, and >99 nmol/L). RESULTS: In the Tromsø study, in the females there was 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 observational studies to determine a threshold for vitamin D sufficiency is highly questionable. |
format | Online Article Text |
id | pubmed-7274551 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Bioscientifica Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-72745512020-06-10 Serum PTH is not a good marker for defining a threshold for vitamin D deficiency Jorde, Rolf Grimnes, Guri Endocr Connect Research 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: The study included 2803 subjects from a general health survey, the Tromsø study, and pooled individual person data from five vitamin D intervention studies (n = 1544). Serum parathyroid hormone (PTH) and change in PTH after vitamin D supplementation were related to serum 25(OH)D levels in steps of 25 nmol/L (<24, 25–49, 50–74, 75–99, and >99 nmol/L). RESULTS: In the Tromsø study, in the females there was 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 observational studies to determine a threshold for vitamin D sufficiency is highly questionable. Bioscientifica Ltd 2020-04-21 /pmc/articles/PMC7274551/ /pubmed/32412426 http://dx.doi.org/10.1530/EC-20-0067 Text en © 2020 The authors http://creativecommons.org/licenses/by-nc/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Research Jorde, Rolf Grimnes, Guri Serum PTH is not a good marker for defining a threshold for vitamin D deficiency |
title | Serum PTH is not a good marker for defining a threshold for vitamin D deficiency |
title_full | Serum PTH is not a good marker for defining a threshold for vitamin D deficiency |
title_fullStr | Serum PTH is not a good marker for defining a threshold for vitamin D deficiency |
title_full_unstemmed | Serum PTH is not a good marker for defining a threshold for vitamin D deficiency |
title_short | Serum PTH is not a good marker for defining a threshold for vitamin D deficiency |
title_sort | serum pth is not a good marker for defining a threshold for vitamin d deficiency |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7274551/ https://www.ncbi.nlm.nih.gov/pubmed/32412426 http://dx.doi.org/10.1530/EC-20-0067 |
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