Establishment of a normal reference value of parathyroid hormone in a large healthy Chinese population and evaluation of its relation to bone turnover and bone mineral density

• Published in: Osteoporosis international Vol. 27; no. 5; pp. 1907 - 1916
• Main Authors: Li, M., Lv, F., Zhang, Z., Deng, W., Li, Y., Deng, Z., Jiang, Y., Wang, O., Xing, X., Xu, L., Xia, W.
• Format: Journal Article
• Language: English
• Published: London Springer London 01.05.2016; Springer Nature B.V
• Subjects: 25-Hydroxyvitamin D; Adolescent; Adult; Age; Aged; Aged, 80 and over; Aging - blood; Anthropometry - methods; Asian Continental Ancestry Group - statistics & numerical data; Biomarkers - blood; Body Mass Index; Bone density; Bone Density - physiology; Bone growth; Bone mineral density; Bone Remodeling - physiology; Bone resorption; Bone turnover; Collagen (type I); Collagen Type I - blood; Cross-Sectional Studies; Dual energy X-ray absorptiometry; Endocrinology; Female; Femur; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Orthopedics; Osteogenesis; Osteoporosis; Parathyroid; Parathyroid hormone; Parathyroid Hormone - blood; Parathyroid Hormone - physiology; Peptide Fragments - blood; Peptides - blood; Procollagen; Procollagen - blood; Reference Values; Rheumatology; Sex Characteristics; Vitamin D; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin deficiency; Young Adult; BMD; 25OHD; Bone turnover; β-CTX; PTH; P1NP
• ISSN: 0937-941X; 1433-2965; 1433-2965
• DOI: 10.1007/s00198-015-3475-5

Summary A normal reference value of parathyroid hormone (PTH) was established for the first time in a large sample of healthy Chinese subjects by completely excluding interference of vitamin D deficiency. A high PTH level correlated significantly with an elevated bone turnover and a reduced bone mineral density (BMD). Introduction The aims of this study are to establish a normal reference value for serum PTH and to evaluate the effect of parathyroid gland status on bone turnover and BMD. Methods Our cross-sectional study included 1436 healthy individuals from 5 different Chinese cities. Concentrations of serum PTH, 25-hydroxyvitamin D (25OHD), procollagen I N-terminal peptide (P1NP, a bone formation marker), and carboxyl-terminal telopeptide of type I collagen (β-CTX, a bone resorption marker) were measured by electrochemiluminescence immunoassay. BMD was measured by dual-energy X-ray absorptiometry. The relation of PTH concentration to age, gender, height, and weight was examined. Reference values of PTH were established for all subjects and for subjects categorized by serum 25OHD concentrations. Correlations of PTH levels with bone turnover biomarkers and BMD were statistically analyzed. Results Reference values of PTH were 8.84–69.95 pg/mL in all the subjects and 7.48–60.73 and 5.83–56.78 pg/mL in the subjects with serum 25OHD concentrations of ≥20 and ≥30 ng/mL, respectively. Serum PTH showed a negative linear correlation with 25OHD, and the breakpoint was 18.21 ng/mL, below which the PTH level rapidly increased. The increase in PTH levels with age showed a positive linear correlation with P1NP and β-CTX concentrations and a negative linear correlation with BMD at the lumbar spines and the femoral neck. Conclusions A reference value of PTH was established in a large sample of healthy Chinese subjects according to 25OHD status, gender, and age. A high PTH level correlated significantly with an elevated bone turnover and a reduced BMD.