25-Hydroxyvitamin D,parathyroid Hormone And Carotid Intima-Media Thickness In Middle-aged And Elderly Population

Objectives To investigate the level of serum 25-hydroxyvitamin D(25(OH)D)and parathyroid hormone(PTH)and to explore the association of serum 25(OH)D and PTH with carotid intimal-media thickness(CIMT)in a middle-aged and elderly community population.Methods A resident group of 877 subjects aged 40 years or older was selected for a cross-sectional survey from April to June 2016 and from April to June 2017 in two communities in Fujian Province.All subjects completed basic data collection,physical examination and related laboratory examination and carotid ultrasound examination.The measurement data of normal distribution were compared with independent sample t-test or one-way analysis of variance.The counting data were compared with chi-square test.Partial correlation analysis was used to compare the correlation between the two factors.The multivariate linear regression analysis was applied to explore the relationship between CIMT with related risk factors.Binary logistic regression or covariance analysis was used to analyze the relative risk factors of CIMT.Results 1.A total of 877 people were enrolled in this study,including 497 subjects from Zhangzhou district and 380 subjects from Wuyishan district.There were 328 male and 549 female,with the average age of 54.61±9.30 years and male female ratio of 1:1.67.The average serum 25(OH)D and PTH concentration was 31.59±8.89nmol/L and 49.46±26.81ng/L,respectively.The average CIMT was 0.90±0.21 mm.2.Men had higher prevalence of smoking and drinking,blood pressure,body mass index,waistline,uric acid,serum creatinine,CIMT,carotid plaque,education level,and annual income than women,while women had higher vegetarian and fruit intake(all P < 0.05).3.Men from Zhangzhou district had lower age,serum 25(OH)D concentration,CIMT,carotid plaque,hemoglobin A1c(Hb Alc),estimated glomerular filtration rate(e GFR),meat intake,sodium intake than men from Wuyishan district.They had higher diastolic blood pressure,body mass index,total cholesterol,education level,annual income,the proportion of balanced diet,milk or yogurt intake than men from Wuyishan district(all P < 0.05).4.Women from Zhangzhou district had lower age,serum 25(OH)D,PTH concentration,CIMT,carotid plaque,Hb Alc,average diastolic blood pressure,waistline,triglyceride,e GFR,meat intake,sodium intake than the women from Wuyishan district(P<0.05).They had higher body mass index,total cholesterol,high-density lipoprotein cholesterol(HDL-C),serum creatinine,education level,annual income,the proportion of balanced diet,milk or yogurt intake,vegetable and fruits intake than the women from Wuyishan district(all P < 0.05).5.The age,CIMT,proportions of male,smoking,lack of physical activity,carotid plaque were increased significantly from the lowest to the highest quartile of serum 25(OH)D,showing a positive correlation with 25(OH)D concentration(all P < 0.05).While serum PTH concentration and body mass index showed a negative correlation with the quartile of serum 25(OH)D(all P < 0.05).6.Serum 25(OH)D concentration,total cholesterol,low-density lipoprotein cholesterol(LDL-C),uric acid and the proportion of smoking were decreased significantly from the lowest to the highest quartile of serum PTH(all P < 0.05).While there was a positive correlation between PTH concentration and CIMT(P < 0.05).7.All subjects were divided into normal CIMT group and increased CIMT group,the latter defined as CIMT of more than 1.0 mm.The increased CIMT group had higher age,serum 25(OH)D,PTH,blood pressure,Hb Alc,LDL-C,uric acid,e GFR,the proportions of male,smoking,carotid plaques,meat and sodium intake than normal group(all P< 0.05).And the education level,average annual income,milk/yogurt intake were significantly lower in increased CIMT group(all P < 0.05).8.Multivariate linear regression analysis showed that after adjustment for age,sex,smoking,alcohol drinking,lack of exercise,waist circumference,body mass index,blood pressure,lipid profiles,Hb Alc and other factors,CIMT was linear positive correlation with serum PTH(r = 0.113,P<0.05)and 25(OH)D(r = 0.082 P<0.05).And the regression coefficient of age,Hb Alc,LDL-C,HDL-C,uric acid and education level was 0.453,0.093,0.141,-0.088,0.127,-0.096,respectively.9.Binary logistic regression analysis showed that after adjustment for age,sex,smoking,alcohol drinking,lack of exercise,body mass index,waist circumference,blood pressure,hypertension,diabetes,lipid profiles,and other factors,the OR value of increased CIMT in the highest quartile of serum 25(OH)D was 1.79(95%CI:1.025-3.218,P < 0.05).There was no significant correlation between serum PTH and increased CIMT.The OR value of education level,age,Hb Alc,LDL-C,uric acid was 0.756,1.153,1.291,1.864 and 1.005,respectively with the risk of increased CIMT.Conclusions The serum level of 25(OH)D was very low in this community middle-aged and elderly population.PTH,age,uric acid,Hb A1 c and LDL-C may be the risk factors for the carotid atherosclerosis.The control of blood glucose,lipid profiles and uric acid level from the middle age is beneficial to prevent the occurrence of carotid atherosclerosis.