Association of parathyroid hormone and 25-OH-vitamin D levels with arterial stiffness in postmenopausal women with vitamin D insufficiency.
OBJECTIVE
Vitamin D insufficiency and increased parathyroid hormone (PTH) levels have been suggested as prognostic indices for cardiovascular disease. Arterial stiffness, a surrogate marker for cardiovascular disease, is often increased in patients with primary hyperparathyroidism. PTH levels increase in patients with low 25-OH-vitamin D levels, but the influence of such an increase on arterial stiffness has not been investigated in postmenopausal women with reduced 25-OH-vitamin D levels. We therefore investigated the association between PTH and aortic stiffness in postmenopausal women with reduced 25-OH-vitamin D levels.


METHODS
One hundred fifty postmenopausal women with 25-OH-vitamin D insufficiency (<30 ng/mL) were recruited. Aortic pulse wave velocity (aPWV), a measure of arterial stiffness, PTH and 25-OH-vitamin D levels were measured. Cardiovascular risk factors and markers of bone formation were evaluated.


RESULTS
The 25-OH-vitamin D levels were associated with aPWV (rho=-0.23, p=0.006), but the association was not significant when controlling for PTH. Significant correlates of aPWV included age, body mass index, mean arterial pressure and PTH (rho=0.39, p<0.001). Arterial stiffness was predicted by logarithmically transformed PTH levels (β=0.23, p=0.007), independent of traditional cardiovascular risk factors and factors involved in bone formation. Increased PTH levels (>62 pg/mL) were associated with a 3.0-5.4-fold increased probability of having a mild-severe increase in aortic stiffness, irrespective of confounders.


CONCLUSIONS
Among postmenopausal women with reduced 25-OH-vitamin D levels, elevated PTH levels were a significant predictor of aortic stiffness, irrespective of cardiovascular risk factors and of factors involved in bone formation. PTH accounted for the association between 25-OH-vitamin D levels and aortic stiffness.
Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy. mpirro@unipg.it
Matteo
M
Pirro
Maria Rosaria
MR
Manfredelli
Rony S
RS
Helou
Anna Maria
AM
Scarponi
Giuseppe
G
Schillaci
Francesco
F
Bagaglia
Francesco
F
Melis
Elmo
E
Mannarino
D000368:Aged; D015519:Bone Density; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D017698:Postmenopause / Q000097:blood* / Q000502:physiology*; D063177:Pulse Wave Analysis; D012307:Risk Factors; D059289:Vascular Stiffness / Q000502:physiology*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000150:complications / Q000503:physiopathology*
C470125:PTH protein, human; D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D