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Seasonal periodicity of serum parathyroid hormone and its relation with vitamin D in Romania

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Abstract

Summary

We measured serum parathyroid hormone in 8409 Romanian subjects and found a mild seasonal variation with highest levels in March and lowest levels in September. PTH was dependent on serum vitamin D, particularly below 12.82 ng/mL. Together, these suggest that vitamin D supplementation is warranted only in at-risk groups.

Purpose

Seasonal variation of parathyroid hormone (PTH) and its dependency on serum 25-hydroxy vitamin D (25(OH)D) levels are well-described. However, there are few studies from Europe, and genetic, nutritional, and cultural differences are important. We describe the seasonal variation of serum PTH and its relation with serum 25(OH)D levels in Romania.

Methods

We retrieved from our endocrinology center database all PTH measurements between 2011 and 2019 together with age, sex, diagnosis, and date of blood sampling. Simultaneous serum 25(OH)D levels were partially available. Intact PTH was measured using the same electrochemiluminescence assay.

Results

There were 8409 subjects (median age 49 (36, 60) years; 20.5% men) without a diagnosis of hyperparathyroidism (primary or secondary to chronic kidney disease), hypoparathyroidism, or low bone mass. Serum PTH showed a mild seasonal variation with highest levels at the end of March (47.61 pg/mL) and lowest levels at the end of September (43.15 pg/mL). All sex and age subgroups showed highest levels in the spring and lowest levels in the fall. Males had significantly lower PTH levels than females irrespective of season. PTH correlated inversely with serum 25(OH)D with a breakpoint of 12.82 ng/mL in 2800 subjects who had a simultaneous measurement of 25(OH)D. Increasing age was associated with increasing PTH levels independently of serum 25(OH)D.

Conclusions

We showed a mild seasonal variation of serum PTH in Romania, at an inverse sinusoidal pattern than serum 25(OH)D. The breakpoint on the PTH–25(OH)D correlation suggests that vitamin D supplementation is warranted only in at-risk groups.

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References

  1. Lips P, Duong T, Oleksik A, Black D, Cummings S, Cox D, Nickelsen T (2001) A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcomes of raloxifene evaluation clinical trial. J Clin Endocrinol Metab 86:1212–1221. https://doi.org/10.1210/jcem.86.3.7327

    Article  CAS  PubMed  Google Scholar 

  2. Kasahara AK, Singh RJ, Noymer A et al (2013) Vitamin D (25OHD) serum seasonality in the United States. PLoS One 8:e65785. https://doi.org/10.1371/journal.pone.0065785

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Niculescu DA, Capatina CAM, Dusceac R, Caragheorgheopol A, Ghemigian A, Poiana C (2017) Seasonal variation of serum vitamin D levels in Romania. Arch Osteoporos 12:113. https://doi.org/10.1007/s11657-017-0407-3

    Article  PubMed  Google Scholar 

  4. Chirita-Emandi A, Socolov D, Haivas C, Calapiș A, Gheorghiu C, Puiu M (2015) Vitamin D status: a different story in the very young versus the very old Romanian patients. PLoS One 10:e0128010. https://doi.org/10.1371/journal.pone.0128010

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Sai AJ, Walters RW, Fang X, Gallagher JC (2011) Relationship between vitamin D, parathyroid hormone, and bone health. J Clin Endocrinol Metab 96:E436–E446. https://doi.org/10.1210/jc.2010-1886

    Article  CAS  PubMed  Google Scholar 

  6. Grigorie D, Sucaliuc A, Ivan M et al (2008) High prevalence of vitamin D deficiency in 1048 Romanian women with postmenopausal osteoporosis. Acta Endocrinol 4:33–45. https://doi.org/10.4183/aeb.2008.33

    Article  CAS  Google Scholar 

  7. Valcour A, Blocki F, Hawkins DM, Rao SD (2012) Effects of age and serum 25-OH-vitamin D on serum parathyroid hormone levels. J Clin Endocrinol Metab 97:3989–3995. https://doi.org/10.1210/jc.2012-2276

    Article  CAS  PubMed  Google Scholar 

  8. Shah S, Chiang C, Sikaris K, Lu Z, Bui M, Zebaze R, Seeman E (2017) Serum 25-hydroxyvitamin D insufficiency in search of a bone disease. J Clin Endocrinol Metab 102:2321–2328. https://doi.org/10.1210/jc.2016-3189

    Article  PubMed  Google Scholar 

  9. Kroll MH, Bi C, Garber CC, Kaufman HW, Liu D, Caston-Balderrama A, Zhang K, Clarke N, Xie M, Reitz RE, Suffin SC, Holick MF (2015) Temporal relationship between vitamin D status and parathyroid hormone in the United States. PLoS One 10:e0118108. https://doi.org/10.1371/journal.pone.0118108

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Hegarty V, Woodhouse P, Khaw K-T (1994) Seasonal variation in 25-hydroxyvitamin D and parathyroid hormone concentrations in healthy elderly people. Age Ageing 23:478–482. https://doi.org/10.1093/ageing/23.6.478

    Article  CAS  PubMed  Google Scholar 

  11. Pasco JA, Henry MJ, Kotowicz MA, Sanders KM, Seeman E, Pasco JR, Schneider HG, Nicholson GC (2004) Seasonal periodicity of serum vitamin D and parathyroid hormone, bone resorption, and fractures: the Geelong Osteoporosis Study. J Bone Miner Res 19:752–758. https://doi.org/10.1359/JBMR.040125

    Article  CAS  PubMed  Google Scholar 

  12. Piirainen R, Englund E, Henriksson AE (2016) The impact of seasonal variation of 25-hydroxyvitamin D and parathyroid hormone on calcium levels. Clin Biochem 49:850–853. https://doi.org/10.1016/j.clinbiochem.2016.06.009

    Article  CAS  PubMed  Google Scholar 

  13. González-Molero I, Morcillo S, Valdés S, Pérez-Valero V, Botas P, Delgado E, Hernández D, Olveira G, Rojo G, Gutierrez-Repiso C, Rubio-Martín E, Menéndez E, Soriguer F (2011) Vitamin D deficiency in Spain: a population-based cohort study. Eur J Clin Nutr 65:321–328. https://doi.org/10.1038/ejcn.2010.265

    Article  CAS  PubMed  Google Scholar 

  14. Nevo-Shor A, Kogan S, Joshua B-Z, Bahat-Dinur A, Novack V, Fraenkel M (2016) Seasonal changes in serum calcium, PTH and vitamin D levels in patients with primary hyperparathyroidism. Bone 89:59–63. https://doi.org/10.1016/j.bone.2016.05.012

    Article  CAS  PubMed  Google Scholar 

  15. Kleine C-E, Obi Y, Streja E, Hsiung JT, Park C, Holick MF, Kalantar-Zadeh K (2019) Seasonal variation of serum 25-hydroxyvitamin D and parameters of bone and mineral disorder in dialysis patients. Bone 124:158–165. https://doi.org/10.1016/j.bone.2019.03.003

    Article  CAS  PubMed  Google Scholar 

  16. Itoh H, Mori I, Matsumoto Y et al (2011) Vitamin D deficiency and seasonal and inter-day variation in circulating 25-hydroxyvitamin D and parathyroid hormone levels in indoor daytime workers: a longitudinal study. Ind Health 49:475–481. https://doi.org/10.2486/indhealth.ms1255

    Article  CAS  PubMed  Google Scholar 

  17. Gaksch M, Jorde R, Grimnes G, et al (2017) Vitamin D and mortality: individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortium. PLoS One 12: . doi: https://doi.org/10.1371/journal.pone.0170791

  18. Grant WB, Fakhoury HMA, Karras SN, al Anouti F, Bhattoa HP (2019) Variations in 25-hydroxyvitamin d in countries from the middle east and europe: the roles of UVB exposure and diet. Nutrients 11: . doi: https://doi.org/10.3390/nu11092065

  19. Farrell CJL, Nguyen L, Carter AC (2018) Parathyroid hormone: data mining for age-related reference intervals in adults. Clin Endocrinol 88:311–317. https://doi.org/10.1111/cen.13486

    Article  CAS  Google Scholar 

  20. Weinstein JR, Anderson S (2010) The aging kidney: physiological changes. Adv Chronic Kidney Dis 17:302–307

    Article  Google Scholar 

  21. Carrivick SJ, Walsh JP, Brown SJ, Wardrop R, Hadlow NC (2015) Brief report: does PTH increase with age, independent of 25-hydroxyvitamin D, phosphate, renal function, and ionized calcium? J Clin Endocrinol Metab 100:2131–2134. https://doi.org/10.1210/jc.2014-4370

    Article  CAS  PubMed  Google Scholar 

  22. Steingrimsdottir L, Gunnarsson O, Indridason OS et al (2005) Relationship between serum parathyroid hormone levels, vitamin D sufficiency, and calcium intake. J Am Med Assoc 294:2336–2341. https://doi.org/10.1001/jama.294.18.2336

    Article  CAS  Google Scholar 

  23. Patel P, Zulf Mughal M, Patel P et al (2016) Dietary calcium intake influences the relationship between serum 25-hydroxyvitamin D3(25OHD) concentration and parathyroid hormone (PTH) concentration. Arch Dis Child 101:316–319. https://doi.org/10.1136/archdischild-2015-308985

    Article  PubMed  Google Scholar 

  24. Portale AA, Lonergan ET, Tanney DM, Halloran BP (1997) Aging alters calcium regulation of serum concentration of parathyroid hormone in healthy men. Am J Phys 272:E139–E146. https://doi.org/10.1152/ajpendo.1997.272.1.E139

    Article  CAS  Google Scholar 

  25. Stagi S, Cavalli L, Ricci S, Mola M, Marchi C, Seminara S, Brandi ML, de Martino M (2015) Parathyroid hormone levels in healthy children and adolescents. Horm Res Paediatr 84:124–129. https://doi.org/10.1159/000432399

    Article  CAS  PubMed  Google Scholar 

  26. Rapuri PB, Karimi Kinyamu H, Christopher Gallagher J, Haynatzka V (2002) Seasonal changes in calciotropic hormones, bone markers, and bone mineral density in elderly women. J Clin Endocrinol Metab 87:2024–2032. https://doi.org/10.1210/jcem.87.5.8475

    Article  CAS  PubMed  Google Scholar 

  27. Martinaityte I, Kamycheva E, Didriksen A, Jakobsen J, Jorde R (2017) Vitamin D stored in fat tissue during a 5-year intervention affects serum 25-hydroxyvitamin d levels the following year. J Clin Endocrinol Metab 102:3731–3738

    Article  Google Scholar 

  28. Bikle DD (2014) Vitamin D metabolism, mechanism of action, and clinical applications. Chem Biol 21:319–329

    Article  CAS  Google Scholar 

  29. National Institute of Public Health (2019) Nutritional Status and Food Consumption in Romania - 2018 (Starea de nutritie si consumul de alimente in Romania - 2018). https://cnmrmc.insp.gov.ro/images/rapoarte/starea-de-nutritie.pdf. Accessed 22 Apr 2020

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Authors and Affiliations

  1. Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 34-38 Aviatorilor Blvd., 011863, Bucharest, Romania

    Dan Alexandru Niculescu, Roxana Dusceac & Catalina Poiana

  2. Department of Pituitary and Neuroendocrine Disorders, C. I. Parhon National Institute of Endocrinology, 34-38 Aviatorilor Blvd., 011863, Bucharest, Romania

    Laura Georgiana Deacu

  3. Research Laboratory, C. I. Parhon National Institute of Endocrinology, 34-38 Aviatorilor Blvd., 011863, Bucharest, Romania

    Andra Caragheorgheopol

  4. Department of Pediatric Endocrinology, C. I. Parhon National Institute of Endocrinology, 34-38 Aviatorilor Blvd., Bucharest, Romania

    Camelia Procopiuc

  5. Department of Adrenal and Bone Diseases, C. I. Parhon National Institute of Endocrinology, 34-38 Aviatorilor Blvd., Bucharest, Romania

    Rodica Petris

Authors
  1. Dan Alexandru Niculescu
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  2. Laura Georgiana Deacu
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  3. Andra Caragheorgheopol
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Correspondence to Dan Alexandru Niculescu.

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Niculescu, D.A., Deacu, L.G., Caragheorgheopol, A. et al. Seasonal periodicity of serum parathyroid hormone and its relation with vitamin D in Romania. Arch Osteoporos 15, 66 (2020). https://doi.org/10.1007/s11657-020-00744-1

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