Establishing Indian Population-Specific Vitamin D Thresholds Associated with Secondary Hyperparathyroidism Using Machine Learning Algorithm

Parathyroid hormone (PTH) controls calcium and phosphate levels in blood and calcium in bones. Secondary hyperparathyroidism is usually due to insufficient amounts of calcium in blood, which may occur during Vitamin D deficiency, which lead to increased PTH production. The incidence of vitamin D def...

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Published inIndian journal of clinical biochemistry Vol. 34; no. S1; p. S122
Main Authors Kumari, J. Ashwini, Kanukurti, Jyothirmayi, Mohan, Iyyapu Krishna, Khan, Siraj Ahmed, Kumar, B. Sheshu, Bhaskar, M. Vijaya, Baba, K.S.S. Sai
Format Journal Article
LanguageEnglish
Published Springer 24.05.2022
Subjects
Alfacalcidol
Algorithms
Analysis
Calcifediol
Data mining
Hyperparathyroidism
Machine learning
Parathyroid hormone
Phosphates
Vitamin D
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Summary:Parathyroid hormone (PTH) controls calcium and phosphate levels in blood and calcium in bones. Secondary hyperparathyroidism is usually due to insufficient amounts of calcium in blood, which may occur during Vitamin D deficiency, which lead to increased PTH production. The incidence of vitamin D deficiency is high in India despite the fact that it is a tropical country. In view of high prevalence of vitamin D deficiency in Indian population, we have aimed to establish cutoff value of Vitamin D where PTH levels start raising (secondary hyperparathyroidism) in healthy Indian population. We have enrolled a total of 1026 subjects (678 men and 348 women) in the age group of 50.7 [+ or -] 16.5 years whose vitamin D levels were < 30 ng/ml. Intact parathyroid hormone (PTH) and Vitamin D total assays are performed on ADVIA Centaur[R] XP Immunoassay system using kits manufactured by Siemens Healthcare Diagnostics Inc., U.S.A. A total of 542 subjects (52.8%) had normal PTH levels despite vitamin D deficiency. Machine learning tools were used to deduce the threshold of Vitamin D associated with secondary hypothyroidism. This analysis revealed that the cut-off value of vitamin D is <6.3 ng/ml, which is associated with secondary hyperparathyroidism (PTHM55.4 ng/L). This study emphasizes the need to evaluate factors that contribute to the absence of PTH response in more than 50% of our population with either Vit D deficiency or insufficiency. As per the existing data, vitamin D <6.3 ng/ml might be associated with significant influence on bone markers due to secondary hyperparathyroidism.
ISSN:0970-1915