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Serum level vitamin D and parathyroid hormone, and mortality, with or without chronic kidney disease

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Abstract

Levels of vitamin D and parathyroid hormone (PTH) are closely associated with renal function. We evaluated the associations among 25-hydroxyvitamin D (25OHD) levels, PTH levels, and mortality, and whether these associations varied by renal function. We used data from the Dong-gu Study, a population-based cohort in Korean adults. We analyzed the associations among intact PTH, 25OHD levels and mortality in 8580 participants. Hazard ratios (HRs) for mortality were calculated using Cox proportional hazards regression after adjusting for age, sex, month of sampling, lifestyle, and comorbidities. We also evaluated the effects of chronic kidney disease (CKD). A total of 860 deaths occurred during the follow-up period of 7.6 years. Compared to the first 25OHD quartile, the HRs of the second, third, and fourth quartiles were 0.96 [95% confidence interval (CI) 0.79–1.16], 0.84 (95% CI 0.68–1.02), and 0.71 (95% CI 0.57–0.89), respectively. The association between intact PTH levels and mortality varied by renal function, and was both nonlinear and significant only in subjects with CKD. Compared to the second intact PTH quartile in such subjects, the HRs for the first, third, and fourth quartiles were 1.61 (95% CI 0.92–2.81), 1.97 (95% CI 1.17–3.31), and 2.19 (95% CI 1.33–3.59), respectively. In conclusion, we demonstrated that low serum levels of 25OHD are associated with an increased risk of mortality. Serum levels of intact PTH are nonlinearly associated with mortality only in subjects with CKD, with the lowest risk for mortality being evident in the second quartile.

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Acknowledgements

This study was supported by a Grant (CRI13904–21) from Chonnam National University Hospital Biomedical Research Institute.

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Authors and Affiliations

  1. Department of Preventive Medicine, Chonnam National University Medical School, 264, Seoyang-ro Hwasun-eup, Hwasun, 58128, Jeollanam-do, Korea

    Chang Kyun Choi, Sun-Seog Kweon, Sun A. Kim & Min-Ho Shin

  2. Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Republic of Korea

    Young-Hoon Lee

  3. Department of Preventive Medicine, Chungnam National University Medical School, Daejeon, Republic of Korea

    Hae-Sung Nam

  4. Cardiocerebrovascular Center, Mokpo Jung-Ang Hospital, Mokpo, Republic of Korea

    Kyeong-Soo Park

  5. Department of Preventive Medicine, Chosun University Medical School, Gwangju, Republic of Korea

    So-Yeon Ryu & Seong-Woo Choi

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  1. Chang Kyun Choi
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Contributions

Study design: CKC and MHS. Study conduct: CKC and MHS. Data collection: SSK, YHL, HSN, KSP, SYR, SWC, SAK, and MHS. Data interpretation: CKC, SSK, YHL, HSN, KSP, SYR, SWC, SAK, and MHS. Drafting manuscript: CKC, and MHS. Approving final version of manuscript: CKC, SSK, YHL, HSN, KSP, SYR, SWC, SAK, and MHS. MHS takes responsibility for the integrity of the data analysis.

Corresponding author

Correspondence to Min-Ho Shin.

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Conflict of interest

Chang Kyun Choi, Sun-Seog Kweon, Young-Hoon Lee, Hae-Sung Nam, Kyeong-Soo Park, So-Yeon Ryu, Seong-Woo Choi, Sun A Kim, and Min-Ho Shin declare that they have no conflict of interest.

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Kyun Choi, C., Kweon, SS., Lee, YH. et al. Serum level vitamin D and parathyroid hormone, and mortality, with or without chronic kidney disease. J Bone Miner Metab 37, 825–834 (2019). https://doi.org/10.1007/s00774-018-0979-z

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  • DOI: https://doi.org/10.1007/s00774-018-0979-z

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