Serum level vitamin D and parathyroid hormone, and mortality, with or without chronic kidney disease
- 14 Downloads
Levels of vitamin D and parathyroid hormone (PTH) are closely associated with renal function. We evaluated the associations among 25-hydroxyvitamin D (25OHD) levels, PTH levels, and mortality, and whether these associations varied by renal function. We used data from the Dong-gu Study, a population-based cohort in Korean adults. We analyzed the associations among intact PTH, 25OHD levels and mortality in 8580 participants. Hazard ratios (HRs) for mortality were calculated using Cox proportional hazards regression after adjusting for age, sex, month of sampling, lifestyle, and comorbidities. We also evaluated the effects of chronic kidney disease (CKD). A total of 860 deaths occurred during the follow-up period of 7.6 years. Compared to the first 25OHD quartile, the HRs of the second, third, and fourth quartiles were 0.96 [95% confidence interval (CI) 0.79–1.16], 0.84 (95% CI 0.68–1.02), and 0.71 (95% CI 0.57–0.89), respectively. The association between intact PTH levels and mortality varied by renal function, and was both nonlinear and significant only in subjects with CKD. Compared to the second intact PTH quartile in such subjects, the HRs for the first, third, and fourth quartiles were 1.61 (95% CI 0.92–2.81), 1.97 (95% CI 1.17–3.31), and 2.19 (95% CI 1.33–3.59), respectively. In conclusion, we demonstrated that low serum levels of 25OHD are associated with an increased risk of mortality. Serum levels of intact PTH are nonlinearly associated with mortality only in subjects with CKD, with the lowest risk for mortality being evident in the second quartile.
KeywordsParathyroid hormone Vitamin D Cohort studies Mortality Renal insufficiency
This study was supported by a Grant (CRI13904–21) from Chonnam National University Hospital Biomedical Research Institute.
Study design: CKC and MHS. Study conduct: CKC and MHS. Data collection: SSK, YHL, HSN, KSP, SYR, SWC, SAK, and MHS. Data interpretation: CKC, SSK, YHL, HSN, KSP, SYR, SWC, SAK, and MHS. Drafting manuscript: CKC, and MHS. Approving final version of manuscript: CKC, SSK, YHL, HSN, KSP, SYR, SWC, SAK, and MHS. MHS takes responsibility for the integrity of the data analysis.
Compliance with ethical standards
Conflict of interest
Chang Kyun Choi, Sun-Seog Kweon, Young-Hoon Lee, Hae-Sung Nam, Kyeong-Soo Park, So-Yeon Ryu, Seong-Woo Choi, Sun A Kim, and Min-Ho Shin declare that they have no conflict of interest.
- 10.Daraghmeh AH, Bertoia ML, Al-Qadi MO et al (2016) Evidence for the vitamin D hypothesis: the NHANES III extended mortality follow-up. Atherosclerosis 255:96–101. https://doi.org/10.1016/j.atherosclerosis.2016.04.007 CrossRefGoogle Scholar
- 13.Domiciano DS, Machado LG, Lopes JB et al (2016) bone mineral density and parathyroid hormone as independent risk factors for mortality in community-dwelling older adults: a population-based prospective cohort study in brazil. the sao paulo ageing & health (SPAH) study. J Bone Miner Res 31:1146–1157. https://doi.org/10.1002/jbmr.2795 CrossRefGoogle Scholar
- 23.Levey AS, Coresh J, Greene T et al (2006) Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med 145:247. https://doi.org/10.7326/0003-4819-145-4-200608150-00004 CrossRefGoogle Scholar
- 25.Pilz S, Grübler M, Gaksch M et al (2016) Vitamin D and mortality. Anticancer Res 36:1379–1387Google Scholar
- 31.Parfitt AM (2003) Renal bone disease: a new conceptual framework for the interpretation of bone histomorphometry. Curr Opin Nephrol Hypertens 12:387–403. https://doi.org/10.1097/01.mnh.0000079687.89474.dc CrossRefGoogle Scholar