The prevalence of hypovitaminosis D and secondary hyperparathyroidism in obese Black Americans

被引:108
作者
Yanoff, LB
Parikh, SJ
Spitalnik, A
Denkinger, B
Sebring, NG
Slaughter, P
McHugh, T
Remaley, AT
Yanovski, JA [1 ]
机构
[1] NICHHD, Unit Growth & Obes, NIH, Bethesda, MD 20892 USA
[2] NIH, DHHS, Bethesda, MD 20892 USA
关键词
D O I
10.1111/j.1365-2265.2006.02502.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Context Both obesity (body mass index, BMI >= 30 kg/m(2)) and Black race are associated with a higher risk of vitamin D deficiency and secondary hyperparathyroidism. We hypothesized the risk of hypovitaminosis D would therefore be extraordinarily high in obese Black adults. Objective To study the effects of race and adiposity on 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (iPTH). Design, Setting and Participants Cross-sectional study of 379 Black and White adults from the Washington D.C. area. BMI ranged from 19(.)9 to 58(.)2 kg/m(2). Main Outcome Measures Prevalence of hypovitaminosis D [25(OH)D < 37(.)5 nmol/l] and secondary hyperparathyroidism [25(OH)D < 37(.)5 nmol/l with iPTH > 4(.)2 pmol/l]. Results Obese Black subjects had lower mean 25(OH)D, 40(.)3 (SD, 20(.)3) nmol/l, compared with obese Whites, 64(.)5 (29(.)7), P < 0(.)001, nonobese Blacks, 53(.)3 (26(.)0), P = 0(.)0025 and nonobese Whites, 78(.)0 (33(.)5), P < 0(.)001. The prevalence of hypovitaminosis D increased with increasing BMI, and was greater (P < 0(.)001) in Blacks than Whites within all BMI categories examined. Among subjects with BMI >= 35 kg/m(2), 59% of Blacks vs 18% of Whites had hypovitaminosis D (odds ratio 6(.)5, 95% confidence interval 3(.)0-14(.)2). iPTH was negatively correlated with 25(OH)D (r = -0(.)31, P < 0(.)0001), suggesting those with hypovitaminosis D had clinically important vitamin D deficiency with secondary hyperparathyroidism. For secondary hyperparathyroidism 35(.)2% of Blacks met the criteria, compared to 9(.)7% of Whites (OR 3(.)6, CI 1(.)5-98(.)8). Conclusions Obese Black Americans are at particularly high risk for vitamin D deficiency and secondary hyperparathyroidism. Physicians should consider routinely supplementing such patients with vitamin D or screening them for hypovitaminosis D.
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页码:523 / 529
页数:7
相关论文
共 38 条
[31]  
Roth H J, 2001, Clin Lab, V47, P357
[32]   Assessment of parathyroid function in clinical practice: Which parathyroid hormone assay is better? [J].
Santini, SA ;
Carrozza, C ;
Vulpio, C ;
Capoluongo, E ;
Luciani, G ;
Lulli, P ;
Giardina, B ;
Zuppi, C .
CLINICAL CHEMISTRY, 2004, 50 (07) :1247-1250
[33]  
SCHAKEL SF, 1988, J AM DIET ASSOC, V88, P1268
[34]   Adiposity in relation to vitamin D status and parathyroid hormone levels: A population-based study in older men and women [J].
Snijder, MB ;
van Dam, RM ;
Visser, M ;
Deeg, DJH ;
Dekker, JM ;
Bouter, LM ;
Seidell, JC ;
Lips, P .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2005, 90 (07) :4119-4123
[35]   Relationships with serum parathyroid hormone in old institutionalized subjects [J].
Stein, MS ;
Flicker, L ;
Scherer, SC ;
Paton, LM ;
O'Brien, ML ;
Walton, SC ;
Chick, P ;
Di Carlantonio, M ;
Zajac, JD ;
Wark, JD .
CLINICAL ENDOCRINOLOGY, 2001, 54 (05) :583-592
[36]   Cancer disparities by race/ethnicity and socioeconomic status [J].
Ward, E ;
Jemal, A ;
Cokkinides, V ;
Singh, GK ;
Cardinez, C ;
Ghafoor, A ;
Thun, M .
CA-A CANCER JOURNAL FOR CLINICIANS, 2004, 54 (02) :78-93
[37]   Decreased bioavailability of vitamin D in obesity [J].
Wortsman, J ;
Matsuoka, LY ;
Chen, TC ;
Lu, ZR ;
Holick, MF .
AMERICAN JOURNAL OF CLINICAL NUTRITION, 2000, 72 (03) :690-693
[38]   MINERAL METABOLISM IN OBESE CHILDREN [J].
ZAMBONI, G ;
SOFFIATI, M ;
GIAVARINA, D ;
TATO, L .
ACTA PAEDIATRICA SCANDINAVICA, 1988, 77 (05) :741-746