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CLINICAL STUDY |
ARC Epidemiology Unit, The University of Manchester, Manchester M13 9PT, UK1 Manchester Diabetes Centre, The University of Manchester, Manchester, UK2 Division of Gerontology and Geriatrics and Centre for Musculoskeletal Research, Department of Experimental Medicine3 , Department of Andrology and Endocrinology4 Department of Experimental Medicine, Katholieke Universiteit Leuven, Leuven, Belgium5 Department of Obstetrics, Gynaecology and Andrology, Albert Szent-Gyorgy Medical University, Szeged, Hungary6 Department of Medicine, Santiago de Compostela University, Complejo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Spain7 CIBER de Fisiopatología Obesidad y Nutrición (CB06/03), Instituto Salud Carlos III, Santiago de Compostela, Spain8 Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy9 Reproductive Medicine Centre, Malmö University Hospital, University of Lund, Malmö, Sweden10 Department of Endocrinology, Royal Free and University College Hospital Medical School, Royal Free Hospital, Hampstead, London, UK11 Department of Reproductive Biology, Imperial College London, Hammersmith Campus, London, UK12 Department of Andrology and Reproductive Endocrinology, Medical University of Lodz, Lodz, Poland13 Department of Human Nutrition, University of Glasgow, Glasgow, UK14 Clinical Gerontology, The University of Manchester, Hope Hospital, Salford, UK15 Andrology Unit, United Laboratories of Tartu University Clinics, Tartu, Estonia16 Department of Endocrinology, Manchester Royal Infirmary, The University of Manchester, Manchester, UK
(Correspondence should be addressed to D M Lee; Email: david.m.lee{at}manchester.ac.uk)
Objectives: Low serum 25-hydroxyvitamin D (25(OH)D) and elevated parathyroid hormone (PTH) levels have been linked to insulin resistance, the metabolic syndrome (MetS) and its components. Data in healthy, community-dwelling Europeans are lacking, and previous studies have not excluded subjects receiving drug treatments that may distort the relationship between 25(OH)D/PTH and MetS. The aim of our analysis was to examine the association of 25(OH)D and PTH with Adult Treatment Panel III-defined MetS in middle-aged and older European men.
Design: This was a population-based, cross-sectional study of 3369 men aged 40–79 years enrolled in the European Male Ageing Study.
Results: After exclusion of subjects with missing data, 3069 men with a mean (±S.D.) age of 60±11 years were included in the analysis. Age-adjusted 25(OH)D levels were inversely associated with waist circumference, systolic blood pressure (BP), triglycerides, and glucose (all P<0.01). Age-adjusted PTH levels were only associated with waist and diastolic BP (both P<0.05). After adjusting for age, centre, season and lifestyle factors the odds for MetS decreased across increasing 25(OH)D quintiles (odds ratios 0.48 (95% confidence intervals 0.36–0.64) highest versus lowest quintile; Ptrend<0.001). This relationship was unchanged after adjustment for PTH, but was attenuated after additional adjustment for homoeostasis model assessment of insulin resistance (0.60 (0.47–0.78); Ptrend<0.001). There was no association between PTH and MetS.
Conclusions: Our results demonstrate an inverse relationship between 25(OH)D levels and MetS, which is independent of several confounders and PTH. The relationship is partly explained by insulin resistance. The clinical significance of these observations warrants further study.
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