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In a population study, can parathyroid hormone aid the definition of adequate vitamin D status? A study of people aged 65 years and over from the British National Diet and Nutrition Survey

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Abstract

The British National Diet and Nutrition Survey of people aged 65 years and over in 1994–5 provided nationally representative estimates of food and nutrient intakes and biochemical status indices. In a further analysis study, parathyroid hormone (PTH) concentrations were measured in plasma samples from 773 subjects and were analyzed with the existing data on vitamin D intake, plasma 25-hydroxyvitamin D (25OHD), total plasma calcium and albumin. As predicted, a strong inverse relationship was observed between PTH and 25OHD. In the free-living respondents aged 65–84 years (n=507) there was a continuous decline in PTH with increasing 25OHD and no plateau, whereas in free-living people aged 85+ years (n=86) there was a significant deviation from a simple inverse relationship, with unexpectedly high PTH values in some people with satisfactory 25OHD status. There was a relationship between both PTH (inverse) and plasma 25OHD (direct) with calcium intake. A direct relationship between 25OHD and total plasma calcium was not significant when calcium was corrected for albumin. Geographically, 25OHD, and to a lesser extent PTH, exhibited a north–south gradient, and 25OHD was associated with self-reported health status. Both 25OHD and PTH were associated with self-reported physical activity. Low calcium intake and 25OHD was associated with receipt of state benefits. The relationship between plasma 25OHD and vitamin D intake revealed a striking seasonal cycle. 25OHD was strongly influenced by vitamin D intake in the winter in free-living subjects, but this was not observed in the summer. In people living in institutions such as nursing homes, who are less likely to be exposed to sunlight throughout the year, plasma 25OHD levels were lower throughout the year.

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Acknowledgements

The National Diet and Nutrition Survey Series is commissioned jointly by MAFF, whose survey role has now passed to the Food Standards Agency (FSA), and by the Department of Health. The survey of people aged 65 years and over was performed by Social and Community Planning Research (SCPR: now the National Centre for Social Research) and the MRC Dunn Nutrition Unit (of which the Micronutrient Status Laboratory is now part of MRC Human Nutrition Research).

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Authors and Affiliations

  1. Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge, CB1 9NL, UK

    C. J. Bates, G. D. Mishra & A. Prentice

  2. Chemical Pathology Department, Imperial College School of Medicine, Charing Cross Campus, London, UK

    G. D. Carter

  3. Department of Investigative Endocrinology, St Vincent's Hospital, Dublin 4, Ireland

    D. O'Shea

  4. Endocrine Laboratory, Charing Cross Hospital, Fulham Palace Road, London, W6 8RF, UK

    J. Jones

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  1. C. J. Bates
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  2. G. D. Carter
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  4. D. O'Shea
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  5. J. Jones
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  6. A. Prentice
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Correspondence to C. J. Bates.

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Bates, C.J., Carter, G.D., Mishra, G.D. et al. In a population study, can parathyroid hormone aid the definition of adequate vitamin D status? A study of people aged 65 years and over from the British National Diet and Nutrition Survey. Osteoporos Int 14, 152–159 (2003). https://doi.org/10.1007/s00198-002-1338-3

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  • DOI: https://doi.org/10.1007/s00198-002-1338-3

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