Response of Parathyroid Hormone to Vitamin D Deficiency in Otherwise Healthy Individuals

Abstract

Background and objectives Vitamin D deficiency is a global public health issue, which affects people of all ages and ethnicities. However, severe deficiency seems to be more prevalent in the Middle East and South Asia. Evidence suggests that low serum 25-hydroxycholicalciferol [25(OH)D] levels are associated with an increase in parathyroid hormone (PTH). Yet, the 25-OHD levels leading to serum PTH increase are still a matter of debate. The objective of this study is to assess deficiency of vitamin D in otherwise healthy individuals, and to determine the response of the PTH to vitamin D deficiency. Methods This observational study was conducted from January 2018 to May 2018. A total of 43 individuals were selected from three separate clinics in Libya (Alrazy clinic, Alhaya clinic, and Alnukbah clinic). Blood drawn from these individuals was assessed for serum calcium, phosphorus, 25(OH)D, and PTH. These data were collected and analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0 for Windows (SPSS Inc., Chicago, IL). Results The mean age and standard (SD) of the study participants was 47.4 ± 12.4. The age range was 19-67 years. The ratio of male to female was 1:2. The percentage of individuals with vitamin D deficiency in the study group was 95.3%, whereas the percentage of vitamin D insufficiency was 4.7%. These data suggest that individuals with severe deficiency show higher PTH values (75.66 ng/ml), whereas those with insufficiency showed lower PTH values (37.5 ng/ml). Conclusion The population in the present study was overall deficient in 25-OH vitamin D, which indicates a greater need for supplementation with vitamin D. However, not all the individuals with vitamin D deficiency have high levels of PTH, a finding that agrees with the need for new criteria in the management of vitamin D deficiency and the importance of PTH testing.

Vitamin D Status and Its Relationship with Age, Gender and Parathyroid Hormone

“…Vitamin D concentration in both healthy groups is higher than the other groups with parathyroid problems. According to other studies findings, not all the individuals with vitamin D deficiency have high levels of PTH, a finding that agrees with the need for new criteria in the management of vitamin D deficiency and the importance of PTH testing (Malik et al, 2020).…”

“…The American Academy of Dermatology declared ultraviolet radiation to be a known skin carcinogen, so it may not be safe or efficient to obtain vitamin D via sun exposure or other artificial sources (Chang & Lee, 2019). Although vitamin D can be directly taken from food sources, such as dairy products, fishes, and oils, a major portion of the body's vitamin D is synthesized de novo via exposure of skin to sunlight (UVB rays), resulting in cholecalciferol (vitamin D3), which is further converted to 25-hydroxycholecalciferol [25(OH)D], in the liver (Malik et al, 2020).…”

Interactions of vitamin D with parathyroid glands; an updated mini-review

“…Once in the body, vitamin D converts to its active form, calcitriol. Calcitriol then acts on the intestines, bones, and kidneys to regulate calcium and phosphorus homeostasis.. enlargement by suppressing PTH secretion (4,12).…”

Vitamin D and microRNAs: Role in the pathogenesis and prognosis of breast cancer (Review)

“…In the case of VitD deficiency, the absorption of calcium is reduced by 15% (and by up to 60% for phosphorus), thus reducing the levels of ionized calcium in the blood. The decrease is detected by the calcium sensors in the parathyroid glands, which respond with an increase in the secretion of parathyroid hormone (PTH), whose function is to maintain adequate blood levels of calcium (43). As per definition, the minimum blood level of 25(OH)D required for the intestinal absorption of calcium and for the prevention of the pathological increase in PTH is ≥30 ng/ml or 75 nmol/l, which also protects bones in the case of osteoporosis (44).…”