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Vitamin d, parathyroid hormone levels, and the prevalence of metabolic syndrome in community-dwelling older adults

¹Department of Family and Preventive Medicine, University of California, San Diego, 9500 Gilman Drive, 0607, La Jolla, CA, 92093-0607
²Graduate School of Public Health, San Diego State University, San Diego, CA, 92182

ebarrettconnor{at}ucsd.edu

ABSTRACT

OBJECTIVE:: Accumulating research suggests low circulating vitamin D concentrations [25-hydroxyvitamin-D or 25(OH)D] may be associated with an increased prevalence of metabolic syndrome (MetSyn); however, previous studies have not accounted for parathyroid hormone (PTH) levels. We examined the association of 25(OH)D and PTH with the prevalence of MetSyn in a community-based cohort of older adults.

METHODS:: Participants included 410 men and 660 women, 44-96 years, who completed a follow-up clinic visit in 1997-1999 as part of the Rancho Bernardo Study. Sex-specific logistic regression models were fit to estimate the odds of Adult Treatment Panel III-defined MetSyn across quintiles of 25(OH)D and PTH adjusting for age, season, and major lifestyle factors.

RESULTS:: In men, there was a significant trend (p=0.03) of increasing adjusted odds for MetSyn with increasing PTH concentrations primarily due to an odds ratio of 2.02 (95% CI=0.96, 4.24) in men in the top quintile (63 ng/L) of PTH concentration. This association remained unchanged after taking into account 25(OH)D levels and excluding men with diabetes or impaired renal function; it was attenuated after adjustment for homeostatic model assessment-insulin resistance. Neither PTH in women nor 25(OH)D levels in either sex were related to the MetSyn.

CONCLUSIONS:: These findings suggest an increased risk of MetSyn with elevated PTH levels in older men and no effect of 25(OH)D concentrations in either sex. The reason for the sex difference in the PTH-MetSyn association is unknown. Prospective studies are necessary to better determine the roles of 25(OH)D and PTH in the etiology of MetSyn.

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