The Mutual Interplay between Bone, Glucose and Lipid Metabolism: The Role of Vitamin D and PTH

Abstract

Background. We sought to investigate the mutual interplay between bone, glucose and lipid metabolism in a wide cohort of community-based subjects. Methods. We studied 1240 blood donors (F/M ratio 1/3.2, mean age 41.9 ± 11.7 SD). Serum ionized (Ca++), magnesium (Mg++), 25-hydroxy-vitamin D [25(OH)D], PTH-1-84, 1,25-dihydroxyvitamin D [1,25(OH)2D], total cholesterol (C), HDL-C, triglycerides and glucose were measured and LDL-C levels were calculated in all subjects. Results. 25(OH)D negatively correlated with BMI (R = −0.11), PTH (R = −0.16) (p < 0.0001), total C (R = −0.06, p < 0.05) and triglycerides (R = −0.13, p < 0.0001) and positively with 1,25(OH)2D (R = 0.12) and creatinine (R = 0.17) (p < 0.0001). Serum PTH positively correlated with total C (R = 0.08, p < 0.01), LDL-C (R = 0.1, p < 0.001), triglycerides (R = 0.09, p < 0.01) and glucose (R = 0.15, p < 0.0001) and negatively with HDL-C (R = −0.09, p < 0.01). The odds of showing abnormal serum triglycerides and HDL-C increased as 25(OH)D decreased (p < 0.0001 and p < 0.03) and PTH increased (p < 0.03 and p = 0.05), while the odds of showing abnormal LDL-C levels increased in association with elevated PTH (p < 0.01). Conclusion. Vitamin D, PTH, glucose and lipid metabolism are mutually influenced. Hypovitaminosis D predisposes toward worsening lipid profiles through the actions of PTH, while serum PTH levels per se associate with higher glucose and LDL-C levels.

Vitamin D Status in the Adult Population of Romania—Results of the European Health Examination Survey

“…Moreover, hypercholesterolemic women showed lower odds of vitamin D insufficiency compared with those with normal cholesterol levels. This is a paradoxical finding of our study, considering the results of studies that have analyzed the influences between bone, glucose, and lipid metabolism and found that hypovitaminosis D predisposes people toward worsening lipid profiles [ 70 ]. This is possibly because of the underdiagnosis of cardiovascular and metabolic diseases for the age groups included in this study.…”

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“…Patients with OA, particularly postmenopausal women and those with established osteoporosis, have shown that hypovitaminosis D and altered PTH response can affect bone turnover and mortality, stressing the need for adequate Vitamin D levels for bone health and overall mortality risk management [ 4 ]. The mutual relationship between the Vitamin D-PTH axis and lipid and glucose metabolism highlights a significant, synergistic role in influencing not only bone metabolism but also plasma glucose and serum lipid levels [ 12 ].…”

Effect of 2 Years of Monthly Calcifediol Administration in Postmenopausal Women with Vitamin D Insufficiency

“…Briefly, blood samples were taken between 8.00 and 10.00 a.m. for the measurement of serum ionised calcium (Ca ++ ), 25-hydroxyvitamin D, creatinine and isoenzymes of alkaline phosphatase in the fasting state. Details for the measurement of blood chemistries and bone mineral density have been previously described [ 16 , 17 ]. More specifically, except for Ca ++ , the level of which was measured immediately after collection (within 2 h of sampling, while the room temperature was kept at 4 °C), aliquoted blood samples were stored at −80 °C and assayed at a later time in batches.…”