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Vitamin D status and 5-year changes in urine albumin creatinine ratio and parathyroid hormone in a general population

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Abstract

Vitamin D is associated with cardiovascular disease and renal function but the mechanisms are as yet unexplained. Microalbuminuria is associated with a higher risk of kidney function loss, cardiovascular disease, and mortality. Parathyroid hormone is a predictor of cardiovascular mortality and negatively correlated with glomerular filtration rate. We investigated the association between vitamin D status and 5-year changes in urine albumin creatinine ratio (UACR) and parathyroid hormone (PTH). A random sample of 6,784 individuals aged 30−60 years from a general population participated in the Inter99 study in 1999–2001. Vitamin D (serum-25-hydroxyvitamin D) was measured at baseline by high-performance liquid chromatography. UACR and PTH were measured at baseline and follow-up. Increased UACR was defined as UACR >4.0 mg/g reflecting the upper quartile at baseline. We included 4,330 individuals who participated at 5-year follow-up. In multivariable linear regression analysis, a 10-nmol/l higher baseline level of vitamin D was associated with a 5-year decrease in UACR by 0.92 % (95 % confidence interval, CI 0.13, 1.71). In multivariable logistic regression analysis, the odds ratio of developing increased UACR during follow-up was 0.96 (95 % CI 0.92, 0.98) per 10 nmol/l higher baseline vitamin D level. We found a significant inverse cross-sectional (p < 0.0001) but no prospective association (p = 0.6) between baseline vitamin D status and parathyroid hormone. We found low vitamin D status to be a predictor of long-term development of increased UACR. It remains to be proven whether vitamin D deficiency is a causal and reversible factor in the development of albuminuria.

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Acknowledgments

We would like to thank the participants and all members of the Inter99 staff at Research Centre for Prevention and Health. The Inter99 study was initiated by Torben Jørgensen, DMSci (principal investigator); Knut Borch-Johnsen, DMSci, (co-principal investigator); Troels Thomsen, PhD; and Hans Ibsen, DMSci. The Steering Committee comprises the former two and Charlotta Pisinger, PhD, MPH.

Ethical standards

Participants gave their informed consent, and the study was approved by the local Ethics Committees and the Danish Data Protection Agency. The recommendations of the Declaration of Helsinki were followed.

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Authors and Affiliations

  1. Research Centre for Prevention and Health, Glostrup Hospital, Nordre Ringvej 57, 2600, Glostrup, Denmark

    Tea Skaaby, Lise Lotte Nystrup Husemoen, Charlotta Pisinger, Torben Jørgensen, Betina Heinsbæk Thuesen & Allan Linneberg

  2. Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark

    Torben Jørgensen

  3. Faculty of Medicine, Alborg University, Alborg, Denmark

    Torben Jørgensen

  4. Department of Medicine, Roskilde University Hospital, Roskilde, Denmark

    Knud Rasmussen

  5. Department of Clinical Biochemistry, Hvidovre Hospital, Hvidovre, Denmark

    Mogens Fenger

  6. Steno Diabetes Center, Gentofte, Denmark

    Peter Rossing

  7. University of Copenhagen, Copenhagen, Denmark

    Peter Rossing

  8. University of Aarhus, Aarhus, Denmark

    Peter Rossing

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  1. Tea Skaaby
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  2. Lise Lotte Nystrup Husemoen
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  9. Allan Linneberg
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Correspondence to Tea Skaaby.

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Skaaby, T., Husemoen, L.L.N., Pisinger, C. et al. Vitamin D status and 5-year changes in urine albumin creatinine ratio and parathyroid hormone in a general population. Endocrine 44, 473–480 (2013). https://doi.org/10.1007/s12020-013-9887-0

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  • DOI: https://doi.org/10.1007/s12020-013-9887-0

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