Associations between serum-intact parathyroid hormone, serum 25-hydroxyvitamin D, oral vitamin D analogs and metabolic syndrome in peritoneal dialysis patients: a multi-center cross-sectional study.
BACKGROUND
Although previous studies have suggested associations between serum intact parathyroid hormone (iPTH), 25-hydroxyvitamin D (25(OH)D) and metabolic syndrome (MS) in the general population, these associations are still uncharacterized in peritoneal dialysis (PD) patients.


METHODS
In total, 837 prevalent PD patients from 5 centers in China were enrolled between April 1, 2011 and November 1, 2011. The demographic data, biochemical parameters and medical records were collected, except for serum 25(OH)D which was measured in 347 of 837 patients. The definition of MS was modified from National Cholesterol Education Program Third Adult Treatment Panel (NCEP-ATPIII).


RESULTS
55.4% of 837 patients were found to have MS. The median concentration of iPTH, 25(OH)D and doses of oral vitamin D analogs for participants with MS was significantly lower than those without MS. The iPTH, 25(OH)D values and doses of vitamin D analogs were all associated with one or more components of MS. After multivariate adjustment, low serum iPTH values and oral vitamin D analogs, rather than serum 25(OH)D, were significantly associated with the presence of MS, abnormal fasting blood glucose (FBG) and high-density lipoprotein cholesterol (HDL-C). Compared to iPTH < 130 pg/mL, iPTH 130-585 pg/mL and > 585 pg/mL were associated with a lower risk of MS with adjusted odds ratio (OR) of 0.59 and 0.33, respectively. Taking vitamin D analogs was also associated with a lower risk of MS with adjusted OR of 0.55.


CONCLUSIONS
Serum iPTH and the use of active vitamin D supplements rather than serum 25(OH)D were independently associated with the presence of MS in patients on PD.
Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China; Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China; Department of Nephrology, General Hospital of Ningxia Medical University, Ningxia, China; Department of Nephrology, Peking University People's Hospital, Beijing, China; and Department of Nephrology, Huashan Hospital of Fudan University, Shanghai, China.
Jie
J
Dong
Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China; Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China; Department of Nephrology, General Hospital of Ningxia Medical University, Ningxia, China; Department of Nephrology, Peking University People's Hospital, Beijing, China; and Department of Nephrology, Huashan Hospital of Fudan University, Shanghai, China.
Qin
Q
Wang
Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China; Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China; Department of Nephrology, General Hospital of Ningxia Medical University, Ningxia, China; Department of Nephrology, Peking University People's Hospital, Beijing, China; and Department of Nephrology, Huashan Hospital of Fudan University, Shanghai, China.
Meng-Hua
MH
Chen
Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China; Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China; Department of Nephrology, General Hospital of Ningxia Medical University, Ningxia, China; Department of Nephrology, Peking University People's Hospital, Beijing, China; and Department of Nephrology, Huashan Hospital of Fudan University, Shanghai, China.
Hui-Ping
HP
Zhao
Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China; Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China; Department of Nephrology, General Hospital of Ningxia Medical University, Ningxia, China; Department of Nephrology, Peking University People's Hospital, Beijing, China; and Department of Nephrology, Huashan Hospital of Fudan University, Shanghai, China.
Tong-Ying
TY
Zhu
Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China; Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China; Department of Nephrology, General Hospital of Ningxia Medical University, Ningxia, China; Department of Nephrology, Peking University People's Hospital, Beijing, China; and Department of Nephrology, Huashan Hospital of Fudan University, Shanghai, China.
Na
N
Tian
Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China; Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China; Department of Nephrology, General Hospital of Ningxia Medical University, Ningxia, China; Department of Nephrology, Peking University People's Hospital, Beijing, China; and Department of Nephrology, Huashan Hospital of Fudan University, Shanghai, China.
Mei
M
Wang
Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China; Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China; Department of Nephrology, General Hospital of Ningxia Medical University, Ningxia, China; Department of Nephrology, Peking University People's Hospital, Beijing, China; and Department of Nephrology, Huashan Hospital of Fudan University, Shanghai, China.
Chuan-Ming
CM
Hao
Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China; Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China; Department of Nephrology, General Hospital of Ningxia Medical University, Ningxia, China; Department of Nephrology, Peking University People's Hospital, Beijing, China; and Department of Nephrology, Huashan Hospital of Fudan University, Shanghai, China.
Ye-Ping
YP
Ren
Renal Division, Department of Medicine, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, Beijing, China; Department of Nephrology, Second Affiliated Hospital of Harbin Medical University, Heilongjiang, China; Department of Nephrology, General Hospital of Ningxia Medical University, Ningxia, China; Department of Nephrology, Peking University People's Hospital, Beijing, China; and Department of Nephrology, Huashan Hospital of Fudan University, Shanghai, China.
Hai-Yan
HY
Wang
D000328:Adult; D000368:Aged; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000209:etiology; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D010530:Peritoneal Dialysis; D012307:Risk Factors; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood
D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D
Metabolic syndrome; parathyroid hormone; peritoneal dialysis; vitamin D