{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:37:49Z","timestamp":1760236669593,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T00:00:00Z","timestamp":1639094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chinese National Natural Science Foundation Project","award":["81872627"],"award-info":[{"award-number":["81872627"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: The aim of this study was to assess the relationship between serum 25-hydroxyvitamin D [25(OH)D] and serum intact parathyroid hormone (PTH) in Chinese childbearing women, and to estimate the optimum threshold of 25(OH)D that maximally inhibits the PTH, which is considered to be the optimal status for vitamin D sufficiency. Methods: Serum samples were selected from the biological samples\u2019 bank of the Chinese Chronic Diseases and Nutrition Survey (CCDNS) 2015. The serum 25(OH)D concentration was determined by liquid chromatography tandem mass spectrometry and the serum PTH was determined by electronic chemiluminescence. Simple linear and partial correlation analysis, locally weighted regression smooth scatterplot (LOESS), nonlinear least squares estimation (NLS), and segmented regression (SR) were utilized to estimate the relationship of 25(OH)D and PTH, and to determine the threshold of 25(OH)D. Results: A total of 1568 serum samples of 25(OH)D concentration and PTH concentration were analyzed. A significant inverse relationship between 25(OH)D and PTH concentration was observed below 15.25 (14.22\u201316.28) ng\/mL, and PTH decreased slowly with the increase of 25(OH)D above 16.75 (15.43\u201318.06) ng\/mL after adjusting by age, latitude, city type, season, corrected calcium, and phosphorus. A very short plateau of PTH was found at 15.25 ng\/mL and 16.75 ng\/mL in terms of 25(OH)D according to LOESS, NLS, and SR. Conclusions: The serum 25(OH)D was negatively correlated with the serum PTH. The threshold of VitD sufficiency was found in the range of 14.22\u201318.06 ng\/mL in terms of serum 25(OH)D concentration for Chinese childbearing women aged 18\u201344 years old.<\/jats:p>","DOI":"10.3390\/ijerph182413060","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T01:28:11Z","timestamp":1639358891000},"page":"13060","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Threshold for Relationship between Vitamin D and Parathyroid Hormone in Chinese Women of Childbearing Age"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0423-9169","authenticated-orcid":false,"given":"Yichun","family":"Hu","sequence":"first","affiliation":[{"name":"Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, China CDC, Beijing 100050, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siran","family":"Li","sequence":"additional","affiliation":[{"name":"Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, China CDC, Beijing 100050, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Wang","sequence":"additional","affiliation":[{"name":"Physical and Chemical Laboratory, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deqiang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huidi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, China CDC, Beijing 100050, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Yu","sequence":"additional","affiliation":[{"name":"Physical and Chemical Laboratory, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijia","family":"Zhu","sequence":"additional","affiliation":[{"name":"Physical and Chemical Laboratory, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9849-2351","authenticated-orcid":false,"given":"Zhen","family":"Liu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, China CDC, Beijing 100050, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoguang","family":"Yang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, China CDC, Beijing 100050, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lichen","family":"Yang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, China CDC, Beijing 100050, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1210\/en.2003-0718","article-title":"Effects of alpha 25-dihydroxy-vitamin D3 and growth hormone on apoptosis and proliferation in UMR 106 osteoblast-like cells","volume":"145","author":"Morales","year":"2004","journal-title":"Endocrinology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"16785","DOI":"10.1093\/ajcn\/80.6.1678S","article-title":"Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease","volume":"80","author":"Holick","year":"2004","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1087S","DOI":"10.1093\/ajcn\/87.4.1087S","article-title":"Blood biomarkers of vitamin D status","volume":"87","author":"Zerwekh","year":"2008","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1210\/jc.2011-0385","article-title":"Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline","volume":"96","author":"Holick","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"619","DOI":"10.3945\/ajcn.111.019539","article-title":"Serum 25-hydroxyvitamin D is a reliable indicator of vitamin D status","volume":"94","author":"Heaney","year":"2011","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1093\/ajcn\/84.3.602","article-title":"Optimal vitamin D status and serum parathyroid hormone concentrations in African American women","volume":"84","author":"Aloia","year":"2006","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_7","unstructured":"Ross, A.C., Taylor, C.L., Yaktine, A.L., and Del Valle, H.B. (2021, August 22). Committee to review dietary reference intakes for vitamin D and calcium, Overvew of Calcium. Dietary Reference Intakes for Calcium and Vitamin D, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK56060\/."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2283","DOI":"10.1007\/s00198-011-1877-6","article-title":"Defining physiologically \u201cnormal\u201d vitamin D in African Americans","volume":"23","author":"Wright","year":"2012","journal-title":"Osteoporos. Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1097\/01.ogx.0000418531.13405.69","article-title":"IOM Committee Members respond to endocrine society vitamin D guideline","volume":"67","author":"Rosen","year":"2012","journal-title":"Obstet. Gynecol. Surv."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1177\/0009922811425954","article-title":"Serum 25(OH)-vitamin D level in children: Is there a need to change the reference range based on 2011 Institute of Medicine report?","volume":"52","author":"Srivastava","year":"2013","journal-title":"Clin. Pediatr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1038\/pr.2013.139","article-title":"Relationship between serum 25-hydroxyvitamin D and parathyroid hormone in the search for a biochemical definition of vitamin D deficiency in children","volume":"74","author":"Atapattu","year":"2013","journal-title":"Pediatr. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1210\/jc.2010-1886","article-title":"Relationship between vitamin D, parathyroid hormone, and bone health","volume":"96","author":"Sai","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.bone.2010.05.002","article-title":"Age but not gender modulates the relationship between PTH and vitamin D","volume":"47","author":"Arabi","year":"2010","journal-title":"Bone"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.berh.2009.09.005","article-title":"Vitamin D: What is an adequate vitamin D level and how much supplementation is necessary?","volume":"23","year":"2009","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2016","DOI":"10.1016\/j.jksus.2020.02.002","article-title":"Vitamin D Status and its correlation with Parathyroid Hormone level among population in Riyadh, Saudi Arabia","volume":"32","author":"Aljohani","year":"2020","journal-title":"J. King Saud. Univ. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1038\/sj.ki.5000020","article-title":"Effect of manipulating serum phosphorus with phosphate binder on circulating PTH and FGF23 in renal failure rats","volume":"69","author":"Nagano","year":"2006","journal-title":"Kidney Int."},{"key":"ref_17","unstructured":"Yang, S.B., and Hu, G.Q. (2020). Research and Design of Medical Science, People\u2019s Medical Publishing House."},{"key":"ref_18","first-page":"599","article-title":"Sample size estimation in clinical research: (2) observational study","volume":"48","author":"Wan","year":"2007","journal-title":"J. Tradit. Chin. Med."},{"key":"ref_19","first-page":"368","article-title":"Study of serum vitamin D levels for women of childbearing age from rural areas in China Health and Nutrition Survey 2010\u20132012","volume":"46","author":"Liu","year":"2017","journal-title":"J. Hyg. Res."},{"key":"ref_20","first-page":"112","article-title":"The vitamin D nutritional status in Chinese urban women of childbearing age from 2010\u20132012","volume":"51","author":"Lu","year":"2017","journal-title":"Chin. J. Prev. Med."},{"key":"ref_21","unstructured":"National Health Commission of China (2015). Report on Nutrition and Chronic Diseases of Chinese Residents, People\u2019s Medical Publishing House."},{"key":"ref_22","unstructured":"China CDC (2015). Workbook of China Adult Chronic Disease and Nutrition Surveillance, unpublished work."},{"key":"ref_23","unstructured":"China Central Meteorological Administration (1979). Climate Atlas of the People\u2019s Republic of China, Sinomap Press."},{"key":"ref_24","unstructured":"Yang, Y.X., and Ge, K.Y. (2019). Encyclopedia of Nutrition Science, People\u2019s Medical Publishing House. [2nd ed.]."},{"key":"ref_25","unstructured":"Crawley, M.J. (2013). The R Book, John Wiley & Sons, Ltd. Publication. [2nd ed.]."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1007\/s00198-016-3754-9","article-title":"Cut-points for associations between vitamin D status and multiple musculoskeletal outcomes in middle-aged women","volume":"28","author":"Wu","year":"2017","journal-title":"Osteoporos. Int."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1080\/01621459.1988.10478639","article-title":"Locally weighted regression: An approach to regression analysis by local fitting","volume":"83","author":"Cleveland","year":"1988","journal-title":"J. Am. Stat. Assoc."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Fong, Y., Huang, Y., Gilbert, P.B., and Permar, S.R. (2017). chngpt: Threshold regression model estimation and inference. BMC Bioinform., 18.","DOI":"10.1186\/s12859-017-1863-x"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.annepidem.2007.12.001","article-title":"Vitamin D status: Measurement, interpretation and Clinical application","volume":"19","author":"Holick","year":"2009","journal-title":"Ann. Epidemiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1007\/s00198-010-1383-2","article-title":"Racial differences in the relationship between vitamin D, bone mineral density, and parathyroid hormone in the National Health and Nutrition Examination Survey","volume":"22","author":"Farwell","year":"2011","journal-title":"Osteoporos. Int."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1017\/S0007114515003189","article-title":"Determinants of parathyroid hormone response to vitamin D supplementation: A systematic review and meta-analysis of randomised controlled trials","volume":"114","author":"Moslehi","year":"2015","journal-title":"Br. J. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1007\/s00774-010-0200-5","article-title":"Vitamin D insufficiency defined by serum 25-hydroxyvitamin D and parathyroid hormone before and after oral vitamin D load in Japanese subjects","volume":"29","author":"Okazaki","year":"2011","journal-title":"J. Bone Miner. Metab."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"45","DOI":"10.3345\/kjp.2017.60.2.45","article-title":"The serum level of 25-hydroxyvitamin D for maximal suppression of parathyroid hormone in children: The relationship between 25-hydroxyvitamin D and parathyroid hormone","volume":"60","author":"Kang","year":"2017","journal-title":"Korean J. Pediatr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1017\/S0007114507844382","article-title":"Very high rates of vitamin D insufficiency in women of child-bearing age living in Beijing and Hong Kong","volume":"99","author":"Jean","year":"2008","journal-title":"Br. J. Nutr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.cca.2021.06.004","article-title":"Serum PTH range in a reference population: From an integrated approach to vitamin D prevalence impact evaluation","volume":"521","author":"Minieri","year":"2021","journal-title":"Clin. Chim. Acta"},{"key":"ref_36","first-page":"233","article-title":"Serum parathyroid hormone level in Chinese population","volume":"11","author":"Jin","year":"2018","journal-title":"Chin. J. Osteoporos. Bone Miner. Dis."},{"key":"ref_37","first-page":"2076","article-title":"Study on establishing reference interval of parathyroid hormone in normal adults","volume":"12","author":"Xie","year":"2019","journal-title":"Label. Immunoass. Clin. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.clinbiochem.2021.01.014","article-title":"Data mining: Biological and temporal factors associated with blood parathyroid hormone, vitamin D, and calcium concentrations in the Southwestern Chinese population","volume":"90","author":"Ding","year":"2021","journal-title":"Clin. Biochem."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1359\/jbmr.2004.19.2.265","article-title":"Vitamin D receptor expression in human muscle tissue decreases with age","volume":"19","author":"Borchers","year":"2004","journal-title":"J. Bone Miner. Res."},{"key":"ref_40","first-page":"1","article-title":"A letter to the editor: Vitamin D deficiency leads to elevated PTH levels and to decreased bone density","volume":"2021","author":"Gelbard","year":"2021","journal-title":"Innov. J. Med. Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"595","DOI":"10.3945\/jn.109.116681","article-title":"Three-phase model harmonizes estimates of the maximal suppression of parathyroid hormone by 25-hydroxyvitamin D in persons 65 years of age and older","volume":"140","author":"Sempos","year":"2010","journal-title":"J. Nutr."},{"key":"ref_42","unstructured":"National Health Commission of China (2021, August 22). WS\/T 677-2020 Screening Method for Vitamin D Deficiency in Population. Available online: http:\/\/down.foodmate.net\/standard\/sort\/16\/77966.html."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1210\/jc.2016-2930","article-title":"Effects of genetic and nongenetic factors on total and bioavailable 25(OH)D responses to vitamin D supplementation","volume":"102","author":"Yao","year":"2017","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1007\/s00198-015-3475-5","article-title":"Establishment of a normal reference value of parathyroid hormone in a large healthy Chinese population and evaluation of its relation to bone turnover and bone mineral density","volume":"27","author":"Li","year":"2016","journal-title":"Osteoporos. Int."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Li, M., Li, Y., Deng, W.M., Zhang, Z.L., Deng, Z.L., Hu, Y.Y., Xia, W.B., and Xu, L. (2014). Chinese bone turnover marker study: Reference ranges for C-terminal telopeptide of type I collagen and procollagen I N-terminal peptide by age and gender. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0103841"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1007\/s00198-009-1163-z","article-title":"Effects of 25-hydroxyvitamin D level and its change on parathyroid hormone in premenopausal Chinese women","volume":"21","author":"Bacon","year":"2010","journal-title":"Osteoporos. Int."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1016\/j.jsbmb.2006.12.048","article-title":"Effects of diet and exercise on plasma vitamin D (25(OH)D) levels in Vietnamese immigrant elderly in Sydney, Australia","volume":"103","author":"Brock","year":"2007","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Lombardi, G., Ziemann, E., Banfi, G., and Corbetta, S. (2020). Physical activity-dependent regulation of parathyroid hormone and calcium-phosphorous metabolism. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21155388"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/24\/13060\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:45:15Z","timestamp":1760168715000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/24\/13060"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,10]]},"references-count":48,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["ijerph182413060"],"URL":"https:\/\/doi.org\/10.3390\/ijerph182413060","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2021,12,10]]}}}