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The role of serum total and free 25-hydroxyvitamin D and PTH values in defining vitamin D status at the end of winter: a representative survey

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Abstract

We sought the lowest serum total 25-hydroxyvitamin D (t-25OHD) values in geographic areas with four seasons and investigated whether the calculation of serum free 25-hydroxyvitamin D (f-25OHD) could provide additional information on vitamin D status. This is a representative, cross-sectional study restricted to a sampling period at the end of winter, using a non-probability, stratified sample of the adult community-dwelling Hungarian population (n = 882). We measured t-25OHD, vitamin D binding protein (DBP), parathyroid hormone (PTH), and albumin levels. f-25OHD concentrations were calculated. We assessed environmental factors that could affect vitamin D levels and diseases possibly related to vitamin D deficiency. Mean t-25OHD values of the total population were 41.3 ± 20.6 nmol/L. t-25OHD levels were below 75, 50, and 30 nmol/L in 97, 77, and 34 % of participants not receiving vitamin D supplementation, respectively. t-25OHD values weakly positively correlated with DBP (r = 0.174; p = 0.000), strongly with f-25OHD (r = 0.70; p = 0.000). The association between t-25OHD and f-25OHD and between t-25OHD and PTH were non-linear (p squared term = 0.0004 and 0.004, respectively). t-25OHD levels were not affected by gender, age, place of residence; however, they were related to body mass index, sunbed sessions, and tropical travel. In contrast, f-25OHD levels were different in males and females but were not related to obesity. t- and f-25OHD were lower among people with cardiovascular diseases (p = 0.012). Nearly the entire Hungarian population is vitamin D insufficient at the end of winter. The use of t-25OHD could show a spurious association with obesity; however, it does not reflect the obvious sex difference.

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Acknowledgments

This work was supported by scientific grants from the MPPOE Foundation (Budapest, Hungary) the Osseus Foundation (Budapest, Hungary), and the Hungarian Society of Osteoporosis and Osteoarthrology. There are no other organizations with any financial interest in the subject matter or material discussed in this manuscript.

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Authors and Affiliations

  1. 1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Korányi Sándor u. 2/a, Budapest, 1083, Hungary

    Boglárka Szabó, Balázs Szili, Bence Bakos, Bernadett Balla, János Pál Kósa, Péter Lakatos & István Takács

  2. Department of Epidemiology and Public Health, University College London, London, UK

    Ádám G. Tabák

  3. Faculty of Health Science, Institute of Diagnostics, University of Pécs, Pécs, Hungary

    Erzsébet Toldy

  4. Central Laboratory, Markusovszky Teaching Hospital, Szombathely, Hungary

    Erzsébet Toldy

  5. National Institute of Rheumatology and Physiotherapy, Budapest, Hungary

    László Szekeres

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  1. Boglárka Szabó
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Correspondence to István Takács.

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Szabó, B., Tabák, Á.G., Toldy, E. et al. The role of serum total and free 25-hydroxyvitamin D and PTH values in defining vitamin D status at the end of winter: a representative survey. J Bone Miner Metab 35, 83–90 (2017). https://doi.org/10.1007/s00774-015-0729-4

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  • DOI: https://doi.org/10.1007/s00774-015-0729-4

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