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Brief report: Does PTH increase with age, independent of 25-hydroxyvitamin D, phosphate, renal function, and ionized
Simon J Carrivick1, John P Walsh, Suzanne J Brown
1Department of Clinical Biochemistry (S.J.C., R.W., N.C.H.), PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Nedlands, Western Australia 6009, Australia; Department of Endocrinology and Diabetes (S.J.C., J.P.W., S.J.B.), Sir Charles Gairdner Hospital, Nedlands, Western Australia 6009, Australia; and School of Medicine and Pharmacology (J.P.W.) and School of Pathology and Laboratory Medicine (N.C.H.), The University of Western Australia, Crawley, Western Australia 6009, Australia.
Context:
Circulating PTH concentrations increase with age. It is uncertain whether an age-related PTH increase occurs independent of changes in circulating 25-hydroxyvitamin D, phosphate, renal function, and ionized calcium.
Objective:
The purpose of this article was to analyze the relationship between PTH and age, controlling for 25-hydroxyvitamin D, phosphate, renal function, and ionized calcium.
Methods:
This was a retrospective, cross-sectional study analyzing the relationship between PTH and age in 2 independent datasets (laboratory 1, n = 17 275 and laboratory 2, n = 4878). We further analyzed subgroups after excluding participants with estimated glomerular filtration rate of <60 mL/min/1.73 m(2) or 25-hydroxyvitamin D of <50 nmol/L (for subgroups, n = 12 051 for laboratory 1 and 3473 for laboratory 2).
Results:
After adjustment for sex, ionized calcium, 25-hydroxyvitamin D, phosphate, and estimated glomerular filtration rate, each 10-year increase in age was associated with a 5.0% increase in PTH (95% confidence interval [CI], 4.4%-5.6%; P < .001) in laboratory 1 and a 4.2% increase in laboratory 2 (95% CI, 3.0%-5.4%; P < .001). In the subgroups, each 10-year increase in age was associated with a 6.1% increase in PTH (95% CI, 5.5%-6.8%; P < .001) in laboratory 1 and a 4.9% increase (95% CI 3.5%-6.2%; P < .001) in laboratory 2.
Conclusion:
PTH concentrations increase with age, independent of 25-hydroxyvitamin D, ionized calcium, phosphate, and renal function. Further research is required to explore the underlying mechanisms and clinical relevance and to determine whether the use of age-related PTH reference ranges improves diagnostic accuracy, particularly in elderly individuals.
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