TABLE 1.
Summary of systematic review of literature reporting a parathyroid hormone (PTH)– 25-hydroxyvitamin D [25(OH)D] threshold1
| Reference | n | Health of population | Sex | Age | Optimal 25 (OH)D | 25(OH)D | PTH | Correlation2 | PTH plateau | Dietary vitamin D | Dietary calcium | 25(OH)D assay method | Assay manufacturer3 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| y | nmol/L | nmol/L | pg/mL | pg/mL | μg/d | mg/d | |||||||
| Aloia et al (5) | 208 | Healthy | F | 60.5 ± 6.254,5 | 44 | 57.0 ± 27.35 | 37.8 ±16.65 | −0.23 | 33 | 4.6 ± 4.55 | 1330 ± 1815 | RIA | DiaSorin |
| Chapuy et al (7) | 1569 | Healthy | M/F | 50 ± 6 | 78 | 61.0 ± 30.0 | 40.0 ± 16.0 | −0.076 | 36 | 3.4 ± 7.6 | 849 ± 481 | RIA | DiaSorin |
| Cheng et al (8) | 193 | Healthy | F | 117 | 408 | 32.6 ± 10.85 | 39.0 ± 13.05 | −0.31 | 33 | 2.7 | 733 | RIA | DiaSorin |
| Dawson-Hughes et al (9) | 391 | Osteoporosis | M/F | 70.8 ± 4.55 | 110 | 75.2 ± 33.95 | 37.3 ± 16.25 | NA | NA | 4.75 ± 2.675 | 734 ± 3555 | CPB | —9 |
| Fuleihan et al (11) | 346 | Healthy | M/F | 13.3 ± 1.655 | 75 | 49.0 ± 18.85 | 42.510 | −0.37 | NA | 3.75 ± 3.985 | 661 ± 4585 | RIA | DiaSorin |
| Gallagher et al (12) | 735 | Osteoporosis | M/F | 70.9 ± 45 | 100 | 76.3 ± 24.35 | 36.8 ± 13.44 | −0.31 | 28 | 3.95 ± 2.525 | 640 ± 3765 | CPB | — |
| Gannage-Yared et al (13) | 316 | Healthy | M/F | 40 ± 5.6 | 25 | 24.2 ± 17.7 | 43.3 ± 21.4 | −0.35 | NA | 2.51 ± 1.70 | 683 ± 276 | RIA | DiaSorin |
| Gloth et al (16) | 208 | Other11 | M/F | 77.9 ± 7.25 | 37.5 | 42.2 ± 19.35 | 43.7 ± 22.45 | −0.42 | NA | NA | NA | RIA | — |
| Gomez-Alonso et al (17) | 268 | Osteoporosis | M/F | 68 ± 8.55 | 75 | 41.0 ± 21.8 | 51.5 ± 22.55 | −0.30 | NA | NA | NA | RIA | IDS |
| Guillemant et al (20) | 394 | Healthy | M | 157 | 82.8 | 39.6 ± 8.25 | 33.1 ± 10.45 | −0.50 | 23 | NA | 809 ± 409 | CPB | — |
| Haden et al (21) | 237 | Osteoporosis | F | 56 ± 14 | 62.5 | 57.5 ± 27.512,13 | 37.012 | −0.30 | 49 | NA | 80812 | RIA | DiaSorin |
| Harkness and Cromer (22) | 393 | Healthy | F | 15.5 ± 1.6 | 90 | 55.0 ± 30.4 | 39.4 ± 20.6 | −0.34 | 30 | NA | NA | CPB | Nichols |
| Harris and Cromer (23) | 246 | Osteoporosis | M/F | 75.6 ± 7.65 | 50 | 54.1 ± 26.8 | 58.1 ± 38.3 | −0.30 | NA | NA | NA | CPB | — |
| Holick et al (24) | 1536 | Osteoporosis | F | 71.1 ± 9.0 | 74.5 | 76.0 ± 33.0 | 31.010 | −0.29 | 27.2 | NA | NA | CPB | Nichols |
| Isaia et al (25) | 700 | Osteoporosis | F | 67.8 ± 5.7 | 82.5 | 27.3 ± 25.0 | 36.6 ± 28.3 | −0.38 | NA | NA | 784 ± 395 | RIA | DiaSorin |
| Jesudason et al (26) | 486 | Osteoporosis | F | 63 ± 9.5 | 60 | 62.8 ± 25.0 | 50.4 ± 27.6 | −0.24 | 47.5 | NA | NA | RIA | IDS |
| Kauppinen-Makelin et al (27) | 205 | Other14 | M/F | 54.3 | 50 | 35.3 ± 18.013 | 39.0 | −0.236 | NA | NA | NA | RIA | DiaSorin |
| Kinyamu et al (30) | 376 | Osteoporosis | F | 71 ± 35 | 122 | 78.6 ± 24.95 | 35.6 ± 13.15 | −0.33 | 28 | 6.95 ± 2.15 | 744 ± 3075 | CPB | — |
| Lamberg-Allardt et al (31) | 202 | Healthy | F | 38 ± 3 | 80 | 47.0 ± 34.0 | 30.0 ± 13.0 | −0.235 | 26 | 4.7 ± 2.5 | 962 ± 423 | RIA | DiaSorin |
| Lamberg-Allardt et al (31) | 126 | Healthy | M | 37 ± 4 | 40 | 45.0 ± 35.0 | 24.0 ± 12.0 | −0.206 | 23 | 5.6 ± 3.2 | 1037 ± 489 | RIA | DiaSorin |
| Malabanan et al (33) | 35 | Healthy | 67 ± 8 | 50 | 87.5 ± 14.8 | 45.0 ± 17.8 | NA | NA | NA | 1250 | CPB | Nichols | |
| Melin et al (34) | 104 | Osteoporosis | M/F | 85 ± 45 | 75 | 66.1 ± 28.55 | 51.1 ± 21.75 | −0.30 | 43 | NA | 525 ± 2395 | RIA | DiaSorin |
| Need et al (35) | 496 | Osteoporosis | F | 62 ± 8.7 | 40 | 61.0 ± 24.5 | 41.6 ± 19.5 | −0.28 | NA | NA | NA | CPB | — |
| Need et al (36) | 918 | Osteoporosis | F | 64 ± 9.3 | 50 | 61.0 ± 25.0 | 47.0 ± 24.0 | −0.21 | NA | NA | NA | RIA | DiaSorin |
| Ooms et al (37) | 330 | Healthy | F | 80.3 ± 5.6 | 25 | 28.1 ± 13.0 | 37.1 ± 22.8 | NA | NA | NA | 1100 | CPB | — |
| Outila et al (38) | 178 | Healthy | F | 15.3 ± 0.6 | 408 | 39.0 ± 14.0 | 30.0 ± 14.0 | −0.186 | 30 | 4.3 ± 2.8 | 1216 ± 591 | RIA | DiaSorin |
| Soontrupa et al (44) | 106 | Healthy | F | 69.4 ± 6.8 | 87.5 | 83.3 ± 17.8 | 32.3 ± 18.0 | −0.423 | 25 | NA | NA | RIA | DiaSorin |
| Souberbielle et al (45) | 280 | Healthy | M/F | 69.57 | 30 | 28.8 ± 9.3 | 35.0 ± 20.0 | −0.31 | NA | NA | NA | CPB | — |
| Steingrimsdottir et al (46) | 944 | Healthy | M/F | 55.7 ± 15.35 | 45 | 46.2 ± 19.55 | 38.0 ± 16.15 | NA | NA | 13.0 ± 9.85 | 1233 ± 5405 | RIA | DiaSorin |
| Thomas et al (47) | 290 | Other15 | M/F | 62.0 ± 19.0 | 37.5 | 37.5 ± 22.5 | 46.8 ± 44.45 | NA | NA | 7.5 ± 7.3 | NA | CPB | Nichols |
| Vieth et al (48) | 1741 | Other16 | M/F | 56.9 ± 14.8 | 7317 | 52.5 ± 22.08,13 | 40.48 | NA | 29.517 | NA | NA | RIA | DiaSorin |
RIA, radioimmunoassay; CPB, competitive protein binding; IDS, Immuno Diagnostic Systems; NA, not available.
Correlation between PTH and 25(OH)D.
DiaSorin, Stillwater, MN; IDS, Boldon, United Kingdom; Nichols Advantage, San Clemente, CA.
x̄ ± SD (all such values).
For some studies with subgroups, the mean ± SD was reported only for each subgroup for some variables; in these cases, the weighted mean was computed and the overall SD was estimated from the pooled variance.
For a few studies, the correlation was computed but not reported; in these cases, the correlation was estimated from the reported sample size and P value.
For a few studies, the mean age was not reported; in these cases, it was estimated by taking the average of the minimum and maximum ages.
Outila et al (38) inferred the optimal vitamin D status from concentrations of PTH above the mean; Cheng et al (8) simply confirmed higher PTH values below the value reported by Outila et al.
Not specified in the report.
For a few studies, the mean was estimated from the provided graphic—eg, box plot or bar graph.
Elderly patients (homebound, nursing home residents, and ambulatory).
Median.
Estimated from the range.
Inpatients on general medical wards and healthy outpatients.
Inpatients on general medical wards.
Patients with thyroid disease or osteoporosis.
The threshold was not detected after log transformation, and Vieth et al concluded that there is no threshold.