Exacerbation of Hyperparathyroidism, Secondary to a Reduction in Kidney Function, in Individuals With Vitamin D Deficiency
Aims/Introduction: Chronic kidney disease (CKD)-mineral and bone disorders (CKD-MBD) are an adverse outcome derived from decreases in kidney function, where abnormality of serum concentrations of calcium (Ca), phosphorus, parathyroid hormone (PTH), and vitamin D can be seen simultaneously. To identi...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-06-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fmed.2020.00221/full |
| _version_ | 1828969836753977344 |
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| author | Makoto Daimon Tomoyuki Fujita Masaya Murabayashi Satoru Mizushiri Hiroshi Murakami Yuki Nishiya Jutaro Tanabe Yuki Matsuhashi Miyuki Yanagimachi Itoyo Tokuda Kaori Sawada Kazushige Ihara |
| author_facet | Makoto Daimon Tomoyuki Fujita Masaya Murabayashi Satoru Mizushiri Hiroshi Murakami Yuki Nishiya Jutaro Tanabe Yuki Matsuhashi Miyuki Yanagimachi Itoyo Tokuda Kaori Sawada Kazushige Ihara |
| author_sort | Makoto Daimon |
| collection | DOAJ |
| description | Aims/Introduction: Chronic kidney disease (CKD)-mineral and bone disorders (CKD-MBD) are an adverse outcome derived from decreases in kidney function, where abnormality of serum concentrations of calcium (Ca), phosphorus, parathyroid hormone (PTH), and vitamin D can be seen simultaneously. To identify individuals at risk for CKD-MBD or secondary hyperparathyroidism, the relationships between estimated glomerular filtration rate (eGFR) and serum PTH concentration were evaluated, allowing for confounding factors, in particular vitamin D status, in a general Japanese population.Materials and Methods: Nine-hundred-and-thirty participants in the population-based Iwaki study conducted in 2016 who were not on drugs affecting mineral metabolism nor hemodialysis, were included in the study (326 men and 604 women; age: 55.4 ± 15.9 years).Results: Regression analysis showed a significant correlation between eGFR and serum intact PTH concentration, after adjustment for possible confounding factors (β = −0.122, p < 0.001). The smoothed spline curve applied for the correlation analysis revealed a biphasic correlation, with a division at an eGFR of ~60 mL/min/1.73 m2, below which the correlation coefficient was higher (β = −0.405, p < 0.001). Stratification on the basis of vitamin D status showed that the correlation was present only in participants with vitamin D deficiency (25-dihydroxyvitamin D3: <15 pg/mL) (β = −0.154, p < 0.001).Conclusions: These results indicate that a reduction in eGFR is a significant risk factor for an increase in serum PTH concentration when it is <60 mL/min/1.73 m2 and vitamin D is deficient, in the general Japanese population. |
| first_indexed | 2024-12-14T12:38:25Z |
| format | Article |
| id | doaj.art-02568cf8965b47e48474fb7216ca7f68 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-14T12:38:25Z |
| publishDate | 2020-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-02568cf8965b47e48474fb7216ca7f682022-12-21T23:00:58ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2020-06-01710.3389/fmed.2020.00221536251Exacerbation of Hyperparathyroidism, Secondary to a Reduction in Kidney Function, in Individuals With Vitamin D DeficiencyMakoto Daimon0Tomoyuki Fujita1Masaya Murabayashi2Satoru Mizushiri3Hiroshi Murakami4Yuki Nishiya5Jutaro Tanabe6Yuki Matsuhashi7Miyuki Yanagimachi8Itoyo Tokuda9Kaori Sawada10Kazushige Ihara11Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, JapanDepartment of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, JapanDepartment of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, JapanDepartment of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, JapanDepartment of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, JapanDepartment of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, JapanDepartment of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, JapanDepartment of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, JapanDepartment of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Hirosaki, JapanDepartment of Oral Healthcare Science, Hirosaki University Graduate School of Medicine, Hirosaki, JapanDepartment of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, JapanDepartment of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, JapanAims/Introduction: Chronic kidney disease (CKD)-mineral and bone disorders (CKD-MBD) are an adverse outcome derived from decreases in kidney function, where abnormality of serum concentrations of calcium (Ca), phosphorus, parathyroid hormone (PTH), and vitamin D can be seen simultaneously. To identify individuals at risk for CKD-MBD or secondary hyperparathyroidism, the relationships between estimated glomerular filtration rate (eGFR) and serum PTH concentration were evaluated, allowing for confounding factors, in particular vitamin D status, in a general Japanese population.Materials and Methods: Nine-hundred-and-thirty participants in the population-based Iwaki study conducted in 2016 who were not on drugs affecting mineral metabolism nor hemodialysis, were included in the study (326 men and 604 women; age: 55.4 ± 15.9 years).Results: Regression analysis showed a significant correlation between eGFR and serum intact PTH concentration, after adjustment for possible confounding factors (β = −0.122, p < 0.001). The smoothed spline curve applied for the correlation analysis revealed a biphasic correlation, with a division at an eGFR of ~60 mL/min/1.73 m2, below which the correlation coefficient was higher (β = −0.405, p < 0.001). Stratification on the basis of vitamin D status showed that the correlation was present only in participants with vitamin D deficiency (25-dihydroxyvitamin D3: <15 pg/mL) (β = −0.154, p < 0.001).Conclusions: These results indicate that a reduction in eGFR is a significant risk factor for an increase in serum PTH concentration when it is <60 mL/min/1.73 m2 and vitamin D is deficient, in the general Japanese population.https://www.frontiersin.org/article/10.3389/fmed.2020.00221/fullCKDPTHvitamin Dpopulation based studyenvironmental interaction |
| spellingShingle | Makoto Daimon Tomoyuki Fujita Masaya Murabayashi Satoru Mizushiri Hiroshi Murakami Yuki Nishiya Jutaro Tanabe Yuki Matsuhashi Miyuki Yanagimachi Itoyo Tokuda Kaori Sawada Kazushige Ihara Exacerbation of Hyperparathyroidism, Secondary to a Reduction in Kidney Function, in Individuals With Vitamin D Deficiency Frontiers in Medicine CKD PTH vitamin D population based study environmental interaction |
| title | Exacerbation of Hyperparathyroidism, Secondary to a Reduction in Kidney Function, in Individuals With Vitamin D Deficiency |
| title_full | Exacerbation of Hyperparathyroidism, Secondary to a Reduction in Kidney Function, in Individuals With Vitamin D Deficiency |
| title_fullStr | Exacerbation of Hyperparathyroidism, Secondary to a Reduction in Kidney Function, in Individuals With Vitamin D Deficiency |
| title_full_unstemmed | Exacerbation of Hyperparathyroidism, Secondary to a Reduction in Kidney Function, in Individuals With Vitamin D Deficiency |
| title_short | Exacerbation of Hyperparathyroidism, Secondary to a Reduction in Kidney Function, in Individuals With Vitamin D Deficiency |
| title_sort | exacerbation of hyperparathyroidism secondary to a reduction in kidney function in individuals with vitamin d deficiency |
| topic | CKD PTH vitamin D population based study environmental interaction |
| url | https://www.frontiersin.org/article/10.3389/fmed.2020.00221/full |
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