PTH levels and establishment of reference intervals: Impact of vitamin D and renal function

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion Pub Date : 2025-02-01 DOI:10.1016/j.endien.2025.101527

Luis Agustín Ramírez Stieben , María Lorena Brance , Marina Verónica Belardinelli , Diamela Bolzán , Estefanía Pustilnik , Rodolfo Néstor Feldman , Lucas Ricardo Brun

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引用次数: 0

Abstract

Introduction

Parathyroid hormone (PTH) and vitamin D are essential components in mineral metabolism. Our aims were to estimate the thresholds of 25-hydroxyvitamin D [25(OH)D] and estimated glomerular filtration rate (eGFR) that inhibit PTH, establish PTH reference intervals (RIs), and the stratify need based on age and gender.

Materials and methods

We conducted a cross-sectional study on participants older than 18 years. Segmented regressions (SR) were performed to determine the thresholds of 25(OH)D and eGFR in relation to PTH levels. Multivariate regression was used to evaluate the associations between PTH and 25(OH)D, gender, age, eGFR, and season. To establish the PTH RIs, extreme percentiles were calculated.

Results

A total of 2794 subjects were analyzed (women, 77.56%). Multivariate regression indicated that age, gender, 25(OH)D, and eGFR explained PTH variation. SR demonstrated that PTH stabilized when eGFR > 46.64 mL/min/1.73 m², and PTH increased when 25(OH)D was <15.8 ng/mL. Stratification by gender and age revealed different RIs, with women and over 70 years showing higher limits.

Conclusion

Our study suggests a stabilization point in PTH with an eGFR > 46.64 mL/min/1.73 m², indicating a significant interaction between renal function and PTH regulation. Additionally, the significant increase in PTH in individuals with 25(OH)D < 15.8 ng/mL emphasizes the importance of vitamin D in regulation. An association between age and PTH was also evident, particularly a substantial increase after the age of 70. Finally, we established the need to define partitioned RIs for PTH based on age and gender.

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甲状旁腺激素水平和参考区间的建立：维生素D和肾功能的影响

甲状旁腺激素（PTH）和维生素D是矿物质代谢的必需成分。我们的目的是估计25-羟基维生素D [25(OH)D]的阈值和估计抑制甲状旁腺激素的肾小球滤过率（eGFR），建立甲状旁腺激素参考区间（RIs），以及基于年龄和性别的分层需求。材料和方法我们对18岁以上的参与者进行了横断面研究。采用分段回归（SR）来确定25(OH)D和eGFR与甲状旁腺激素水平之间的阈值。采用多变量回归评估PTH与25(OH)D、性别、年龄、eGFR和季节之间的关系。为了建立PTH RIs，计算极端百分位数。结果共分析2794例，其中女性占77.56%。多因素回归表明，年龄、性别、25(OH)D和eGFR可以解释甲状旁腺激素的变化。SR表明，当eGFR >；46.64 mL/min/1.73 m2, 25(OH)D = 15.8 ng/mL时PTH升高。性别和年龄分层显示出不同的RIs，女性和70岁以上显示出更高的限制。结论本研究提示甲状旁腺激素的稳定点与eGFR和gt有关；46.64 mL/min/1.73 m2，提示肾功能与甲状旁腺激素调节之间存在显著的相互作用。此外，PTH在25(OH)D <患者中显著升高；15.8 ng/mL强调了维生素D在调节中的重要性。年龄与甲状旁腺激素之间的关系也很明显，尤其是在70岁以后显著增加。最后，我们确定有必要根据年龄和性别定义PTH的分区RIs。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrinologia Diabetes Y Nutricion Multiple-

CiteScore

2.10

自引率

10.50%

发文量

期刊介绍： Endocrinología, Diabetes y Nutrición is the official journal of the Spanish Society of Endocrinology and Nutrition (Sociedad Española de Endocrinología y Nutrición, SEEN) and the Spanish Society of Diabetes (Sociedad Española de Diabetes, SED), and was founded in 1954. The aim of the journal is to improve knowledge and be a useful tool in practice for clinical and laboratory specialists, trainee physicians, researchers, and nurses interested in endocrinology, diabetes, nutrition and related disciplines. It is an international journal published in Spanish (print and online) and English (online), covering different fields of endocrinology and metabolism, including diabetes, obesity, and nutrition disorders, as well as the most relevant research produced mainly in Spanish language territories. The quality of the contents is ensured by a prestigious national and international board, and by a selected panel of specialists involved in a rigorous peer review. The result is that only manuscripts containing high quality research and with utmost interest for clinicians and professionals related in the field are published. The Journal publishes Original clinical and research articles, Reviews, Special articles, Clinical Guidelines, Position Statements from both societies and Letters to the editor. Endocrinología, Diabetes y Nutrición can be found at Science Citation Index Expanded, Medline/PubMed and SCOPUS.