The Association Between Dietary Inflammatory Index and Parathyroid Hormone in Adults With/Without Chronic Kidney Disease

Abstract

Aims: We aimed to assess the association between dietary inflammation index (DII) with parathyroid hormone (PTH) and hyperparathyroidism (HP) in adults with/without chronic kidney disease (CKD).Methods: Data were obtained from the 2003–2006 National Health and Nutrition Examination Survey (NHANES). The participants who were <18 years old, pregnant, or missing the data of DII, PTH, and CKD were excluded. DII was calculated based on a 24-h dietary recall interview for each participant. Weighted multivariable regression analysis and subgroup analysis were conducted to estimate the independent relationship between DII with PTH and the HP in the population with CKD/non-CKD.Results: A total of 7,679 participants were included with the median DII of −0.24 (−2.20 to 1.80) and a mean PTH level of 43.42 ± 23.21 pg/ml. The average PTH was 45.53 ± 26.63 pg/ml for the participants in the highest tertile group compared with 41.42 ± 19.74 pg/ml in the lowest tertile group (P < 0.0001). The rate of HP was 11.15% overall, while the rate in the highest DII tertile was 13.28 and 8.60% in the lowest DII tertile (P < 0.0001). The participants with CKD tended to have higher PTH levels compared with their counterparts (61.23 ± 45.62 vs. 41.80 ± 19.16 pg/ml, P < 0.0001). A positive association between DII scores and PTH was observed (β = 0.46, 95% CI: 0.25, 0.66, P ≤ 0.0001), and higher DII was associated with an increased risk of HP (OR = 1.05, 95% CI: 1.02, 1.08, P = 0.0023). The results from subgroup analysis indicated that this association was similar in the participants with different renal function, gender, age, BMI, hypertension, and diabetes statuses and could also be appropriate for the population with CKD.Conclusions: Higher consumption of a pro-inflammatory diet appeared to cause a higher PTH level and an increased risk of HP. Anti-inflammatory dietary management may be beneficial to reduce the risk of HP both in the population with and without CKD.

The Significance of Systemic Immune-Inflammatory Index and Platelet-Neutrophil Ratio on Early Mortality in Septic Shock Patients and their Association with Vitamin D and Parathyroid Hormone Ratio

“…Although patients with vitamin D deficiency had higher mortality rate on day seven compared to the patients with vitamin D insufficiency, the difference was not significant [9 (32%) vs. 1 (9%), p=0.1]. Non-survivors had significantly higher APACHE II and SOFA scores compared to survivors [35 (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) Although patients had similar laboratory parameters at the time of ICU admission, patients with vitamin D insufficiency had higher levels of SII and PNR than those with vitamin D deficiency (Figure 1). While SII significantly decreased (p=0.01) and PNR significantly increased (p=0.04) within the five days of ICU admission in patients with vitamin D insufficiency, we did not observe any significant change in SII (p=0.4) and PNR (p=0.9) in patients with vitamin D deficiency.…”

“…For the comprehensive assessment of any hormone, it is crucial to study the effect of functional regulators of the hormone in conjunction with each other. Also, increased PTH levels may be associated with increased pro-inflammatory cytokines; even the exact mechanism remains unclear [28]. While several pro-inflammatory cytokines, including Interleukin-8, tumor necrosis factor-α, have been shown to enhance PTH secretion in vitro studies, a significant positive association between dietary inflammation index with PTH and hyperparathyroidism was observed in a cross-sectional study with 7,679 adults [28,29].…”

“…Also, increased PTH levels may be associated with increased pro-inflammatory cytokines; even the exact mechanism remains unclear [28]. While several pro-inflammatory cytokines, including Interleukin-8, tumor necrosis factor-α, have been shown to enhance PTH secretion in vitro studies, a significant positive association between dietary inflammation index with PTH and hyperparathyroidism was observed in a cross-sectional study with 7,679 adults [28,29]. Consequently, the ratio of these two opposite hormones can provide more profound information about the course of a disease in which the immune balance is impaired, such as sepsis.…”

Energy-Adjusted Dietary Inflammatory Index Is Associated With 5-Year All Cause and Cardiovascular Mortality Among Chronic Kidney Disease Patients

“…The influence of DII on all-cause and cardiovascular death risk has been documented in general population ( 26 , 27 ), overweight and obese population ( 28 ), cancer patients ( 29 , 30 ), and prediabetics ( 31 ). Interestingly, the previous publications reported DII was also associated with renal function, CKD prevalence and progression and CKD-associated complication including hyperparathyroidism ( 32 – 34 ). However, the influence of DII on mortality among CKD patients remained unclear.…”

Environmental Factors That Affect Parathyroid Hormone and Calcitonin Levels

“…Increased intake of dairy products and decreased intake of highly processed food should increase calcium levels and reduce phosphorus levels [ 51 ]. Processed foods such as sausages, salami, and white bread [ 21 ] and a proinflammatory diet (processed and red meat, refined carbohydrates, and fried food) [ 53 ] have been observed to increase PTH levels. Consumption of this type of food increases BMI, which is positively correlated with PTH levels ( Table 1 ).…”