title: Association between Parathyroid Hormone, 25 (OH) Vitamin D, and Chronic Kidney Disease: A Population-Based Study.
abstract: Identification of the accurate risk factor for CKD remains mandatory to combat the high prevalence of diseases. Growing evidence suggests the association of serum vitamin D with diverse health conditions. However, the relationship between vitamin D, intact parathyroid hormone (PTH), and calcium-phosphate metabolism and development of CKD remains controversial. We conduct this cross-sectional observational study to investigate the association between serum 25 (OH) vitamin D, intact PTH, and calcium and phosphate levels with eGFR and albuminuria, as a surrogate marker of CKD, in a community population. A total of 4080 participants were recruited. The mean age was 58.4 ± 13.3 years and 1480 (36.3%) were men. The mean eGFR was 94.1 ± 26.3 mL/min/1.73 m2. The prevalence of CKD was 19.8%. Serum 25 (OH) vitamin D and log intact PTH levels were inversely correlated with eGFR but positively correlated with log albuminuria. Logistic regression analysis identified the log intact PTH as an independent factor associated with eGFR ≤ 60 mL/min/1.73 m2and proteinuria. This association was consistent when serum intact PTH was analyzed as continuous as well as categorical variables (as hyperparathyroidism). The relationship remains significant using resampling subset analysis with comparable baseline characteristics and adjustment for 25 (OH) vitamin D, calcium, and phosphate levels. This finding warranted further research to clarify the causal relationship of PTH/25 (OH) vitamin D with the risk of CKD in the general population.
authors.affiliation: Department of Nephrology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Wei-Hao
authors.initials: WH
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology and Hepatology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Chen
authors.affiliation: Department of Nephrology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Chin-Chan
authors.identifier: 0000-0001-9128-2936
authors.initials: CC
authors.lastname: Lee
authors.affiliation: Department of Nephrology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Chiao-Yin
authors.initials: CY
authors.lastname: Sun
authors.affiliation: Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Yu-Chiau
authors.identifier: 0000-0003-1747-2226
authors.initials: YC
authors.lastname: Shyu
authors.affiliation: Department of Nephrology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Heng-Rong
authors.initials: HR
authors.lastname: Hsu
authors.affiliation: Department of Gastroenterology and Hepatology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Rong-Nang
authors.initials: RN
authors.lastname: Chien
authors.affiliation: Department of Nephrology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: I-Wen
authors.identifier: 0000-0001-8535-3582
authors.initials: IW
authors.lastname: Wu
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000473:pathology; D002118:Calcium / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D010710:Phosphates / Q000097:blood; D011153:Population; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000453:epidemiology / Q000473:pathology; D014807:Vitamin D / Q000097:blood*
chemical_list: D010281:Parathyroid Hormone; D010710:Phosphates; D014807:Vitamin D; D002118:Calcium