[Relationship between vitamin D and parathyroid hormone in Chinese elderly people]

To explore the relationship between serum 25-hydroxyvitamin D(25(OH)D) and serum parathyroid hormone(PTH) level in Chinese people aged 50 years and above, and to probe the optimum threshold for vitamin D sufficiency preliminarily, and apply this threshold to predict the risk of metabolic syndrome(Mets) in this population.

A total of 750 serum samples were selected from the biological samples' bank of Chinese Chronic Diseases and Nutritional Survey(CCDNS, 2015-2017) by stratified sampling, basic information(including age, gender, season, etc. ) were collected from questionnaire and physical measurement of the subjects were conducted unified. Serum 25(OH)D concentration was determined by high performance liquid chromatography tandem mass spectrometer, and PTH and interleukin-6(IL-6) were detected by electrochemiluminescence method. Phosphorus, albumin(Alb), creatinine(Cr) in blood were detected by automatic biochemical analyzer. Factors affecting the concentration of 25(OH)D and PTH were found by multiple linear regression and adjusted by generalized additive model separately, threshold was predicted by locally weighted regression and smoothing scatterplot, abbreviated as LOESS, and the exact threshold of 25(OH)D was found when PTH reached the plateau by nonlinear least squares estimation and segmented regression. Relationship between 25(OH)D and Mets was analyzed by multivariate logistic regression using the different cut-off points in Chinese elderly people.

Reference threshold for vitamin D deficiency in Chinese elderly people can be preliminarily discovered as serum total 25(OH)D was 19.62 ng/mL, and 28.44 ng/mL can be used as reference threshold for sufficient vitamin D. Sufficient 25(OH)D(≥28.44 ng/mL) could reduce the risk of Mets significantly(OR=0.617(0.439-0.869)) after adjusting for confounding factors such as sex, age, region, season, ect. A plateau in PTH was observed at a 25(OH)D concentration of 20.03-28.43 ng/mL for male whereas 13.12-26.33 ng/mL for female by gender stratification analysis, but no cut-off point was obtained statistically.

Reference threshold for vitamin D sufficiency in Chinese elderly people was preliminarily observed in the range of 19.62-28.44 ng/mL when PTH was maximally inhibited, and the threshold may vary with gender. Applying the threshold we also found that more sufficient levels of vitamin D were protective against Mets in this population.