Parathyroid hormone, but not vitamin D, is associated with the metabolic syndrome in morbidly obese women and men: a cross-sectional studyReportar como inadecuado

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Cardiovascular Diabetology

, 8:7

First Online: 03 February 2009Received: 17 December 2008Accepted: 03 February 2009


BackgroundThe prevalence of vitamin D insufficiency and secondary hyperparathyroidism is high among morbidly obese subjects. Further, low serum levels of 25-hydroxyvitamin D 25 OHD and magnesium have been associated with increased risk of the metabolic syndrome MS, and recently, a possible link between PTH and MS has been reported. Although it is well known that the synthesis and secretion of PTH is regulated by serum levels of calcium, phosphate, magnesium and 25OHD, less is known about the possible clustered affiliation of these parameters with MS. We aimed to explore whether MS is associated with abnormal serum levels of PTH, 25OHD and magnesium in a population of morbidly obese patients.

MethodsFasting serum levels of 25OHD, PTH and magnesium were assessed in a cross-sectional cohort study of 1,017 consecutive morbidly obese patients 68% women. Multiple logistic regression analyses were used to assess the independent effect of PTH, 25OHD and magnesium on the odds for MS National Cholesterol Education Program NCEP after adjustment for confounding factors.

ResultsSixty-eight percent of the patients had MS. Patients with MS had lower mean serum magnesium P < 0.001 and higher mean PTH P = 0.067 than patients without MS, whereas mean 25OHD did not differ significantly. Patients with PTH levels in the second to fourth quartiles had higher odds of prevalent MS odds ratio 1.47 95% CI 0.92–2.35, 2.33 95% CI 1.40–3.87 and 2.09 95% CI 1.23–3.56, respectively, after adjustment for 25OHD, magnesium, calcium, phosphate, creatinine, age, gender, season of serum sampling, BMI, current smoking, albuminuria, CRP, insulin resistance and type 2 diabetes. Further, PTH was significantly correlated with systolic and diastolic pressure both P < 0.001, but not with the other components of MS. The levels of 25OHD and magnesium were not associated with MS in the multivariate model.

ConclusionThe PTH level, but not the vitamin D level, is an independent predictor of MS in treatment seeking morbidly obese Caucasian women and men. Randomized controlled clinical trials, including different therapeutic strategies to lower PTH, e.g. calcium-vitamin D supplementation and weight reduction, are necessary to explore any cause-and-effect relationship.

AbbreviationsMSThe metabolic syndrome

25 OHD25-hydroxyvitamin D

PTHParathyroid hormone.

Electronic supplementary materialThe online version of this article doi:10.1186-1475-2840-8-7 contains supplementary material, which is available to authorized users.

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Autor: Jøran Hjelmesæth - Dag Hofsø - Erlend T Aasheim - Trond Jenssen - Johan Moan - Helle Hager - Jo Røislien - Jens Bolle


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