Relationship between Parathyroid Hormone, Vitamin D and Bone Turnover Markers in Korean Postmenopausal Women / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: The purpose of this study was to evaluate the relationship between parathyroid hormone (PTH), vitamin D status, bone mineral density (BMD) and bone turnover markers in Korean postmenopausal women. METHODS: The subjects were 263 healthy postmenopausal women recruited in Seoul, Korea. The research was performed from January to March, 1999. Serum PTH level was measured with immunoradiometric assay (IRMA). Serum 25 (OH) vitamin D concentration was measured by radioimmunoassay (RIA) for the evaluation of vitamin D nutritional status. The averages of BMD were attained from the 2nd and 3rd lumbar spine. Two serum levels of bone turnover markers such as osteocalcin and N- telopeptide were also measured by IRMA and enzyme linked immunosorbent assay (ELISA) respectively. RESULTS: Severe, moderate, mild vitamin D deficiency and normal vitamin D status groups were found in 16 (6.1%), 94 (35.7%), 127 (48.3%), and 26 (9.9%) subjects respectively. Among the four groups, no significant differences were found in terms of age, weight, height, bady mass index (BMI). The serum vitamin D levels were 3.18 +/- 1.5 ng/ml, 7.8 +/- 1.4 ng/ml, 13.9 +/- 2.7 ng/ml 25.2 +/- 1.3 ng/ml in severe, moderate, mild, vitamin D deficiency and normal vitamin D status group respectively. Serum PTH levels were 28.6 +/- 14.9 pg/ ml, 22.7 +/- 10.4 pg/ml, 19.5 +/- 12.9 pg/ml, 15.1 +/- 10.3 pg/ml in severe, moderate, mild vitamin D deficiency and normal vitamin D, respectively, and a siginificant difference was found (p<0.05). In comparison with the normal vitamin D group, PTH concentration level was significantly increased by 90.1%, 50.4%, 29.4%, in severe, moderate, mild vitamin D deficiency groups respectively (p<0.05). The serum PTH concentration and 25 (OH) vitamin D were inversely related (r=-0.219, p<0.05). The correlations between the serum PTH level and other factors, such as age, weight, height, BMI, BMD, and bone turnover markers, were insignificant. CONCLUSION: Korean postmenopausal women showed an increase in serum PTH levels in case of vitamin D deficiency, and about 90% of women were suffering from vitamin D deficiency. Therefore, it is recommendable to prescribe the supplemental vitamin D for the most of Korean postmenopausal women.