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Relation of 25-Hydroxyvitamin D and Parathyroid Hormone Levels with Metabolic Syndrome among US Adults

J Reis, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States
D von Muhlen, Department of Family and Preventive Medicine, University of California, San Diego, San Diego, United States
E Miller, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, United States

Correspondence: Jared Reis, Email: jreis{at}jhsph.edu

Abstract

Objective: Previous research on the combined association of 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) with metabolic syndrome may have been limited by restricted age variability and lack of representation of the general population. This study examined the combined association of 25(OH)D and PTH with Adult Treatment Panel III-defined MetSyn among a nationally representative sample of US adults.

Design and Methods: This population-based cross-sectional study included 834 men and 820 women aged >20 years without diagnosed diabetes who completed a physical examination as part of the 2003-2004 US National Health and Nutrition Examination Survey.

Results: After adjusting for age, sex, race/ethnicity, income, lifestyle factors, total calcium, and energy intake, the odds ratio (OR) for MetSyn in the highest quintile of 25(OH)D (median 88.0 nmol/L) compared with the lowest quintile (median 26.8 nmol/L) was 0.27 (0.15, 0.46; p trend<0.001). This relation was unchanged after additional adjustment for PTH level (OR, 0.26; 0.15, 0.44; p trend<0.001) and did not differ by sex (p interaction 0.6) or age (< or > 50 years) (p interaction 0.2). In contrast, the multivariable-adjusted odds for MetSyn increased with increasing PTH among older men (p trend 0.004), but not younger men (p trend 0.4) or women regardless of age (p trend 0.4 in younger and older women).

Conclusions: These data suggest an inverse association of 25(OH)D with MetSyn, independent of potential confounding factors, calcium intake, and PTH, and a positive association of PTH with MetSyn among older men.