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Calciotropic Hormones and the Prevalence of Vertebral Fractures in Chinese Postmenopausal Women with Vitamin D Insufficiency: Peking Vertebral Fracture Study.
Calcif Tissue Int. 2019 06; 104(6):622-630.CT

Abstract

This case-control study aimed to examine the effect of high serum parathyroid hormone (PTH) level, especially the effect of secondary hyperparathyroidism (SHPT) related to hypovitaminosis D, on bone metabolism and bone phenotypes. We included a total of 830 Chinese postmenopausal women aged ≥ 50 years with serum 25-hydroxyvitamin D (25(OH)D) level < 30 ng/ml, among whom 415 women had prevalent vertebral fractures (VFs) and others were age-matched controls. We measured serum levels of 25(OH)D, PTH and bone turnover markers (BTMs), which included C-terminal telopeptide of type I collagen (β-CTX), N-aminoterminal prepeptide of type I procollagen (P1NP) and osteocalcin (OC). Bone mineral densities (BMDs) at lumbar spine and femoral neck were quantified by dual-energy X-ray absorptiometry. Morphometric VFs were validated by lateral radiograph of thoracolumbar spine. Compared to fracture-free controls, women with VFs exhibited a higher serum level of PTH and a higher percentage of SHPT (both p < 0.05), but had a similar serum level of 25(OH)D (p = 0.166). Positive correlations were depicted between PTH and BTMs (all p < 0.01), and between 25(OH)D and bone formation markers (p = 0.013 for OC, p = 0.068 for P1NP), whereas no significant correlation was identified between both calciotropic hormones and BMDs or between 25(OH)D and β-CTX (all p > 0.05). Increasing PTH was associated with an increased risk of VFs independent of 25(OH)D and BMD [odds ratio (OR) per SD increase in PTH 1.016, 95% confidence interval (95% CI) 1.006-1.027]. Moreover, women with SHPT (i.e., > 68 pg/ml) had about three times odds for VF compared to women with normal PTH levels (OR 3.270, 95% CI 1.581-6.760). These data suggest that evaluated serum PTH level might promote the bone remodeling and then lead to increased risks of VFs among Chinese postmenopausal women with vitamin D insufficiency.

Authors+Show Affiliations

Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, National Commission of Health, Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China.Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, National Commission of Health, Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China.Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, National Commission of Health, Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China.Department of Endocrinology, Beijing Liangxiang Hospital, Beijing, 102401, China.Department of Endocrinology, Peking University Shougang Hospital, Beijing, 100144, China.Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing, 100853, China.Department of Cadre Unit, General Hospital of the Rocket Force, Beijing, 100088, China.Department of Endocrinology, Beijing Haidian Hospital, Beijing, 100080, China.Department of Endocrinology, China Rehabilitation Research Center, Beijing, 100068, China.Department of Endocrinology, Beijing Chaoyang Hospital, Beijing, 100020, China.Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, National Commission of Health, Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China.Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, National Commission of Health, Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China.Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, National Commission of Health, Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China.Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing, Dongcheng District, Beijing, 100730, China.Department of Gynaecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, 100730, China.Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, National Commission of Health, Chinese Academy of Medical Science, No. 1 Shuaifuyuan, Wangfujing Street, Dongcheng District, Beijing, 100730, China. xiaweibo8301@163.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30737534

Citation

Jiajue, Ruizhi, et al. "Calciotropic Hormones and the Prevalence of Vertebral Fractures in Chinese Postmenopausal Women With Vitamin D Insufficiency: Peking Vertebral Fracture Study." Calcified Tissue International, vol. 104, no. 6, 2019, pp. 622-630.
Jiajue R, Jiang Y, Qi X, et al. Calciotropic Hormones and the Prevalence of Vertebral Fractures in Chinese Postmenopausal Women with Vitamin D Insufficiency: Peking Vertebral Fracture Study. Calcif Tissue Int. 2019;104(6):622-630.
Jiajue, R., Jiang, Y., Qi, X., Wang, Q., Wang, W., Pei, Y., Wang, X., Huang, W., Zheng, X., Ning, Z., Wang, O., Li, M., Xing, X., Yu, W., Xu, L., & Xia, W. (2019). Calciotropic Hormones and the Prevalence of Vertebral Fractures in Chinese Postmenopausal Women with Vitamin D Insufficiency: Peking Vertebral Fracture Study. Calcified Tissue International, 104(6), 622-630. https://doi.org/10.1007/s00223-019-00531-2
Jiajue R, et al. Calciotropic Hormones and the Prevalence of Vertebral Fractures in Chinese Postmenopausal Women With Vitamin D Insufficiency: Peking Vertebral Fracture Study. Calcif Tissue Int. 2019;104(6):622-630. PubMed PMID: 30737534.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Calciotropic Hormones and the Prevalence of Vertebral Fractures in Chinese Postmenopausal Women with Vitamin D Insufficiency: Peking Vertebral Fracture Study. AU - Jiajue,Ruizhi, AU - Jiang,Yan, AU - Qi,Xuan, AU - Wang,Qiuping, AU - Wang,Wenbo, AU - Pei,Yu, AU - Wang,Xiran, AU - Huang,Wei, AU - Zheng,Xin, AU - Ning,Zhiwei, AU - Wang,Ou, AU - Li,Mei, AU - Xing,Xiaoping, AU - Yu,Wei, AU - Xu,Ling, AU - Xia,Weibo, Y1 - 2019/02/08/ PY - 2018/12/02/received PY - 2019/01/28/accepted PY - 2019/2/10/pubmed PY - 2020/8/29/medline PY - 2019/2/10/entrez KW - Bone mineral density KW - Bone turnover markers KW - Chinese postmenopausal women KW - Secondary hyperparathyroidism KW - Vertebral fractures KW - Vitamin D insufficiency SP - 622 EP - 630 JF - Calcified tissue international JO - Calcif. Tissue Int. VL - 104 IS - 6 N2 - This case-control study aimed to examine the effect of high serum parathyroid hormone (PTH) level, especially the effect of secondary hyperparathyroidism (SHPT) related to hypovitaminosis D, on bone metabolism and bone phenotypes. We included a total of 830 Chinese postmenopausal women aged ≥ 50 years with serum 25-hydroxyvitamin D (25(OH)D) level < 30 ng/ml, among whom 415 women had prevalent vertebral fractures (VFs) and others were age-matched controls. We measured serum levels of 25(OH)D, PTH and bone turnover markers (BTMs), which included C-terminal telopeptide of type I collagen (β-CTX), N-aminoterminal prepeptide of type I procollagen (P1NP) and osteocalcin (OC). Bone mineral densities (BMDs) at lumbar spine and femoral neck were quantified by dual-energy X-ray absorptiometry. Morphometric VFs were validated by lateral radiograph of thoracolumbar spine. Compared to fracture-free controls, women with VFs exhibited a higher serum level of PTH and a higher percentage of SHPT (both p < 0.05), but had a similar serum level of 25(OH)D (p = 0.166). Positive correlations were depicted between PTH and BTMs (all p < 0.01), and between 25(OH)D and bone formation markers (p = 0.013 for OC, p = 0.068 for P1NP), whereas no significant correlation was identified between both calciotropic hormones and BMDs or between 25(OH)D and β-CTX (all p > 0.05). Increasing PTH was associated with an increased risk of VFs independent of 25(OH)D and BMD [odds ratio (OR) per SD increase in PTH 1.016, 95% confidence interval (95% CI) 1.006-1.027]. Moreover, women with SHPT (i.e., > 68 pg/ml) had about three times odds for VF compared to women with normal PTH levels (OR 3.270, 95% CI 1.581-6.760). These data suggest that evaluated serum PTH level might promote the bone remodeling and then lead to increased risks of VFs among Chinese postmenopausal women with vitamin D insufficiency. SN - 1432-0827 UR - https://www.unboundmedicine.com/medline/citation/30737534/Calciotropic_Hormones_and_the_Prevalence_of_Vertebral_Fractures_in_Chinese_Postmenopausal_Women_with_Vitamin_D_Insufficiency:_Peking_Vertebral_Fracture_Study_ L2 - https://dx.doi.org/10.1007/s00223-019-00531-2 DB - PRIME DP - Unbound Medicine ER -