Vitamin D, parathyroid hormone and the metabolic syndrome in middle-aged and older European men.
OBJECTIVE
Low serum 25-hydroxyvitamin D (25(OH)D) and elevated parathyroid hormone (PTH) levels have been linked to insulin resistance, the metabolic syndrome (MetS) and its components. Data in healthy, community-dwelling Europeans are lacking, and previous studies have not excluded subjects receiving drug treatments that may distort the relationship between 25(OH)D/PTH and MetS. The aim of our analysis was to examine the association of 25(OH)D and PTH with Adult Treatment Panel III-defined MetS in middle-aged and older European men.


METHODS
This was a population-based, cross-sectional study of 3369 men aged 40-79 years enrolled in the European Male Ageing Study.


RESULTS
After exclusion of subjects with missing data, 3069 men with a mean (+/-s.d.) age of 60+/-11 years were included in the analysis. Age-adjusted 25(OH)D levels were inversely associated with waist circumference, systolic blood pressure (BP), triglycerides, and glucose (all P<0.01). Age-adjusted PTH levels were only associated with waist and diastolic BP (both P<0.05). After adjusting for age, centre, season and lifestyle factors the odds for MetS decreased across increasing 25(OH)D quintiles (odds ratios 0.48 (95% confidence intervals 0.36-0.64) highest versus lowest quintile; P(trend)<0.001). This relationship was unchanged after adjustment for PTH, but was attenuated after additional adjustment for homoeostasis model assessment of insulin resistance (0.60 (0.47-0.78); P(trend)<0.001). There was no association between PTH and MetS.


CONCLUSIONS
Our results demonstrate an inverse relationship between 25(OH)D levels and MetS, which is independent of several confounders and PTH. The relationship is partly explained by insulin resistance. The clinical significance of these observations warrants further study.
ARC Epidemiology Unit, The University of Manchester, Manchester M13 9PT, UK. david.m.lee@manchester.ac.uk
David M
DM
Lee
Martin K
MK
Rutter
Terence W
TW
O'Neill
Steven
S
Boonen
Dirk
D
Vanderschueren
Roger
R
Bouillon
Gyorgy
G
Bartfai
Felipe F
FF
Casanueva
Joseph D
JD
Finn
Gianni
G
Forti
Aleksander
A
Giwercman
Thang S
TS
Han
Ilpo T
IT
Huhtaniemi
Krzysztof
K
Kula
Michael E J
ME
Lean
Neil
N
Pendleton
Margus
M
Punab
Alan J
AJ
Silman
Frederick C W
FC
Wu
D000328:Adult; D000368:Aged; D000375:Aging / Q000097:blood; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D012621:Seasons; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D