title: Vitamin D status and parathyroid hormone levels in patients with obstructive sleep apnea.
abstract: BACKGROUND
  Vitamin D insufficiency and high levels of parathyroid hormone (PTH) appear to be emerging risk factors for metabolic syndrome (MS), diabetes and cardiovascular disease, conditions that occur frequently in patients with obstructive sleep apnea syndrome (OSAS).
  
  
  OBJECTIVE
  This study examined whether serum concentrations of 25-hydroxyvitamin D [25(OH)D] and PTH were associated with the presence of MS, diabetes and hypertension among an OSAS population.
  
  
  METHODS
  A total of 826 patients (635 men and 191 women) with newly diagnosed OSAS were studied. The occurrence of the MS was analyzed according to the National Cholesterol Education Program Adult Treatment Panel III clinical criteria. Serum levels of 25(OH)D, PTH, glucose, triglycerides, cholesterol, HDL cholesterol, creatinine and uric acid were determined.
  
  
  RESULTS
  In 55.3% of the men and in 63.2% of the women, the serum 25(OH)D level was less than 30 ng/ml (insufficient status). After adjusting for age, sex and seasonality, there was a significant trend of decreasing odds for diabetes [odds ratio (OR) 0.55, 95% confidence interval (CI) 0.33-0.94, ptrend = 0.038] and MS (OR 0.34, 95% CI 0.21-0.56, ptrend < 0.001) with increasing vitamin D levels. Higher PTH levels were associated with a higher prevalence of obesity (OR 2.05, 95% CI 1.06-3.09, ptrend < 0.001) and hypertension (OR 1.83, 95% CI 1.01-3.05, ptrend = 0.049).
  
  
  CONCLUSIONS
  These data suggest an inverse association of 25(OH)D with diabetes and MS and a positive association of PTH with obesity and hypertension among patients with OSAS. Based on our observational study, the causative nature of the associations cannot be established. These findings require further examination in prospective studies including clinical trials.
authors.affiliation: Servei d'Anàlisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
authors.forename: Antonia
authors.initials: A
authors.lastname: Barceló
authors.forename: Cristina
authors.initials: C
authors.lastname: Esquinas
authors.forename: Javier
authors.initials: J
authors.lastname: Piérola
authors.forename: Mónica
authors.initials: M
authors.lastname: De la Peña
authors.forename: Manuel
authors.initials: M
authors.lastname: Sánchez-de-la-Torre
authors.forename: Josep María
authors.initials: JM
authors.lastname: Montserrat
authors.forename: José María
authors.initials: JM
authors.lastname: Marín
authors.forename: Joaquín
authors.initials: J
authors.lastname: Duran
authors.forename: Meritxell
authors.initials: M
authors.lastname: Arqué
authors.forename: Josep Miquel
authors.initials: JM
authors.lastname: Bauça
authors.forename: Ferrán
authors.initials: F
authors.lastname: Barbé
mesh_terms: D000328:Adult; D000368:Aged; D048909:Diabetes Complications / Q000097:blood / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D015995:Prevalence; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D014807:Vitamin D / Q000097:blood*
chemical_list: D010281:Parathyroid Hormone; D014807:Vitamin D