The Association Between Dietary Inflammatory Index and Parathyroid Hormone in Adults With/Without Chronic Kidney Disease.

Zheng Qin,Qinbo Yang,Baihai Su,Ruoxi Liao

doi:10.3389/fnut.2021.688369

Abstract

Aims: We aimed to assess the association between dietary inflammation index (DII) with parathyroid hormone (PTH) and hyperparathyroidism (HP) in adults with/without chronic kidney disease (CKD).Methods: Data were obtained from the 2003–2006 National Health and Nutrition Examination Survey (NHANES). The participants who were <18 years old, pregnant, or missing the data of DII, PTH, and CKD were excluded. DII was calculated based on a 24-h dietary recall interview for each participant. Weighted multivariable regression analysis and subgroup analysis were conducted to estimate the independent relationship between DII with PTH and the HP in the population with CKD/non-CKD.Results: A total of 7,679 participants were included with the median DII of −0.24 (−2.20 to 1.80) and a mean PTH level of 43.42 ± 23.21 pg/ml. The average PTH was 45.53 ± 26.63 pg/ml for the participants in the highest tertile group compared with 41.42 ± 19.74 pg/ml in the lowest tertile group (P < 0.0001). The rate of HP was 11.15% overall, while the rate in the highest DII tertile was 13.28 and 8.60% in the lowest DII tertile (P < 0.0001). The participants with CKD tended to have higher PTH levels compared with their counterparts (61.23 ± 45.62 vs. 41.80 ± 19.16 pg/ml, P < 0.0001). A positive association between DII scores and PTH was observed (β = 0.46, 95% CI: 0.25, 0.66, P ≤ 0.0001), and higher DII was associated with an increased risk of HP (OR = 1.05, 95% CI: 1.02, 1.08, P = 0.0023). The results from subgroup analysis indicated that this association was similar in the participants with different renal function, gender, age, BMI, hypertension, and diabetes statuses and could also be appropriate for the population with CKD.Conclusions: Higher consumption of a pro-inflammatory diet appeared to cause a higher PTH level and an increased risk of HP. Anti-inflammatory dietary management may be beneficial to reduce the risk of HP both in the population with and without CKD.

Highlights

Parathyroid hormone (PTH) is a single-stranded peptide hormone, containing 84 amino acids, which are synthesized and secreted by the chief cells of the parathyroid gland, with the main function of increasing the serum Ca2+ and decreasing the serum phosphorus levels [1]
Among different tertiles of Dietary inflammatory index (DII), gender, race, education level, systolic blood pressure, diastolic blood pressure, serum iron, serum C-reactive protein (CRP), serum 25 (OH) D, urinary creatinine, serum creatinine, parathyroid hormone, and HP, whether having hypertension, diabetes, low eGFR and chronic kidney disease (CKD), were significantly different, while no significant difference was observed in BMI, serum glucose, serum phosphorus, serum calcium, urinary albumin, eGFR, and whether having albuminuria between different tertiles
As for the PTH levels of the participants based on different renal conditions, the participants with albuminuria, low eGFR, and CKD tended to have higher PTH levels compared with their counterparts

Summary

Introduction

Parathyroid hormone (PTH) is a single-stranded peptide hormone, containing 84 amino acids, which are synthesized and secreted by the chief cells of the parathyroid gland, with the main function of increasing the serum Ca2+ and decreasing the serum phosphorus levels [1]. The secretion of PTH is mainly regulated by th zvbe concentration of serum Ca2+ and phosphorus [2, 3]. Serum Ca2+ regulates PTH secretion through the interaction with calcium-sensitive receptors (CASR) on the surface of parathyroid cells [4, 5]. For a variety of pathological reasons, the parathyroid glands can secrete excessive PTH and cause hyperparathyroidism (HP), which can be classified as primary, secondary, and tertiary [10]. HP appeared to be associated with an increased risk of poor clinical outcomes and death, which is often observed in patients with chronic kidney disease (CKD) [11]

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Results

Conclusion