Racial differences in the relationship between vitamin D, bone mineral density, and parathyroid hormone in the National Health and Nutrition Examination Survey

Gutiérrez, Orlando M.; Farwell, Wildon; Kermah, Dulcie; Taylor, Eric N.

doi:10.1007/s00198-010-1383-2

Cited by 280 publications

(281 citation statements)

References 46 publications

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“…25 (30)(31)(32)(33). Çalışmamızda sadece ilkbahar mevsimi olarak üç aylık süreç değerlendirilmiştir.…”

Section: Discussionunclassified

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Evidence-Based Laboratory: Determining the Insufficiency Level of Vitamin D

Vurgun¹,

Evliyaoğlu²,

Yildirmak³

2016

Haseki

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ÖzAmaç: Türkiye'de yaşayan erişkinlerde D vitamini yetersizliğinin ve eksikliğinin tanımları açısından D vitamini düzeylerinin paratiroid hormon ile olan ilişkisine ait çalışmalara ihtiyaç vardır. Biz de paratiroid hormon düzeyinin 25-hidroksi vitamin D düzeyine göre sapma noktasını saptayıp, coğrafyamızdaki D vitamini yetersizliğinin ve eksikliğinin sınır değerleri açısından literatüre katkıda bulunmayı amaçladık.Yöntemler: Laboratuvar yazılım sisteminden 01.03.2015 ile 01.06.2015 tarihleri arasında çalışılmış tetkikleri olan hastalar tarandı. Eş zamanlı olarak istenmiş olan tetkiklerinden; kalsiyum, inorganik fosfat, kreatinin, intakt paratiroid hormon düzeyleri referans aralıkları içerisinde olup, 25-hidroksi vitamin D düzeyi <50 ng/mL olan 18 yaşından büyük 803 hasta retrospektif olarak çalışmaya dahil edildi. Bulgular:Yirmi beş-hidroksi vitamin D düzeyi 15-10 ile 10-5 ng/mL olan gruplardaki intakt paratiroid hormon düzeyleri arasında anlamlı farklılık tespit edildi (p=0,05). 25-hidroksi vitamin D düzeyleri 30 ile 10 ng/mL arasında iken, intakt paratiroid hormon düzeyleri arasındaki anlamlı farklılığın 22 ng/mL düzeyinde yani 50-22 ile 22-10 ng/ mL grupları arasında başladığı tespit edildi (p=0,01). Böylece, azalan 25-hidroksi vitamin D düzeylerine anlamlı intakt paratiroid hormon artışının ilk olarak 22 ng/mL düzeyinde olduğu ve daha sonra ilk artışa göre de anlamlı ikinci artışın 10 ng/mL düzeyinde olduğu tespit edildi. the results of patients older than 18 years were scanned from the laboratory information system. Eight hundred three patients, whose simultaneously analyzed serum levels of calcium, inorganic phosphate, creatinine and intact parathyroid hormone were within the reference ranges and 25-hydroxyvitamin D was <50 ng/mL, were included in the study. Results:There was a significant difference in intact parathyroid hormone levels between subjects with 25-hydroxyvitamin D levels of 15-10 and those with 10-5 ng/mL (p=0.05). A significant increase in intact parathyroid hormone levels (p=0.01) was found to start with a 25-hydroxyvitamin D level below 22 ng/mL within the range of 30 to 10 ng/mL. Consequently, we determined the first 25-hydroxyvitamin D threshold in which intact parathyroid hormone levels significantly increase to be 22 ng/mL and the second threshold as 10 ng/mL. Conclusion:Evaluation of parathyroid hormone which has a major role in the regulation of vitamin D should be done to define and diagnose vitamin D deficiency and insufficiency correctly.Keywords: Vitamin D deficiency, parathyroid hormone, calcium Abs tractYa z›fl maAd re si/Ad dressforCor res pon den ce:Eren Vurgun

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“…25 (30)(31)(32)(33). Çalışmamızda sadece ilkbahar mevsimi olarak üç aylık süreç değerlendirilmiştir.…”

Section: Discussionunclassified

“…Son dönemde, çeşitli ırksal ve etnik popülasyonlarda yapılmış olan iki çalışmada da iPTH düzeylerinin maksimal süprese olduğu 25-OH D seviyelerinin Afrika asıllı Amerikalı grupta beyaz ırka göre daha düşük olduğu gösterilmiştir (30,31 …”

Section: Discussionunclassified

Evidence-Based Laboratory: Determining the Insufficiency Level of Vitamin D

Vurgun¹,

Evliyaoğlu²,

Yildirmak³

2016

Haseki

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“…This finding is relevant in the context of recent findings that racial and geographic differences modulate the effects of low vitamin D status on bone mass and other parameters of bone metabolism. [26][27][28] Singapore is a South East Asian country with a unique ethnic population mix of Chinese (76.8%), Malay (13.9%), Indian (7.9%), and others (1.4%). 29 Racial differences in fracture rates and vitamin D levels have been shown to exist in Singapore 30,31 with the highest age-adjusted rates of hip fractures reported to be amongst the Chinese.…”

Section: Figure 1 Scatter Plot Of Ipth Versus 25(oh)d Among All Patimentioning

confidence: 99%

Vitamin D Levels, Physical and Biochemical Characteristicsof South East Asian Patients with Osteoporotic Hip Fractures

Chandran

Howe

Goh

et al. 2012

JAFES

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Objective. Limited information exists on the physical characteristics, bone mineral density (BMD), 25-hydroxyvitamin D [25(OH)D] levels and other biochemical parameters in patients with hip fractures in Asia. We aimed to explore whether these parameters differ between trochanteric and femoral neck (cervical) hip fractures in Singaporean patients.Methodology. 275 patients with osteoporotic hip fractures were evaluated. Multivariate regression models were used to investigate the relationship between physical characteristics, biochemical parameters, renal function, BMD and type of hip fracture.Results. The mean 25(OH)D level noted was 20.4 (8.1) ng/mL. Fifty percent of patients had levels less than 20 ng/mL. Patients with trochanteric fractures were heavier than those with cervical fractures (p=0.021). Logistic regression analysis showed that males were more likely to have trochanteric fractures (OR=1.79, 95% CI 1.03-3.11), and females with trochanteric fractures were older than those with cervical fractures (OR=0.97, 95% CI 0.94-1.00).Conclusion. Vitamin D deficiency was prevalent in half of our population of hip fracture patients. Trochanteric fractures were more common than cervical fractures in men and in older women. In contrast to findings noted in Caucasian populations, neither BMD nor other bone metabolic parameters examined were associated with the preferential occurrence of one type of osteoporotic hip fracture over the other.

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“…69 Practice guidelines subsequently released by the Endocrine Society,agreed with the dietary reference intakes established by the IOM committee and the IOM recommendations not to screen the general population routinely for vitamin D deficiency. However, they also said thatserum 25,(OH) D levels of 30 ng/ml or higher compared with 20 ng/ml would provide increased health benefits; that 30 ng/ml was the desirable level of serum 25, (OH)D level based on the observations that elevated PTH levels were lowered to a plateau when serum 25,(OH)D was 30 ng/ml or higher; there was a reduction of falls among older persons at serum 25 (OH)D levels of 30 ng/ml or higher and the observation that calcium absorption was maximal at these serum levels of 25(OH)D. 70 The relation between vitamin D levels, bone density, and osteoporotic fractures is not clearly defined in all populations 71,72 and it may be likely that race-specific ranges of optimal vitamin D are needed. The results of meta-analyses examining the relationship between vitamin D supplementation and fracture reduction also have been inconsistent.…”

Section: Secondary Osteoporosismentioning

confidence: 99%

A Review of the 2008 Singapore Ministry of Health Clinical Practice Guidelines on Osteoporosis and an Update

Tan

Bee

Chandran

2012

JAFES

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Osteoporosis is a major public health problem worldwide and it is of particular significance in a rapidly aging society such as Singapore. In order to prevent the devastating sequelae of osteoporosis, it is important, to diagnose the condition early, to identify its associated risk factors and to initiate pharmacotherapy promptly when required. In addition, it is important to increase awareness of this condition amongst both health care professionals and the public. The Singapore Ministry of Health (MOH) Clinical Practice Guidelines published in 2008 was an update of a previously published version in 2002. It aimed at providing the best evidence-based recommendations for diagnosis, classification, evaluation and multidisciplinary management of osteoporosis and osteoporotic fractures in Singapore. This article summarizes the guidelines, discusses their applicability and utilization in Singapore and briefly outlines updates in management since the publication of the CPG.

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Racial differences in the relationship between vitamin D, bone mineral density, and parathyroid hormone in the National Health and Nutrition Examination Survey

Cited by 280 publications

References 46 publications

Evidence-Based Laboratory: Determining the Insufficiency Level of Vitamin D

Evidence-Based Laboratory: Determining the Insufficiency Level of Vitamin D

Vitamin D Levels, Physical and Biochemical Characteristicsof South East Asian Patients with Osteoporotic Hip Fractures

A Review of the 2008 Singapore Ministry of Health Clinical Practice Guidelines on Osteoporosis and an Update

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