Search tips
Search criteria 


Logo of jcinvestThe Journal of Clinical Investigation
J Clin Invest. 1985 July; 76(1): 370–373.
PMCID: PMC423785

Evidence for alteration of the vitamin D-endocrine system in obese subjects.


Serum immunoreactive parathyroid hormone (PTH) is increased in obese as compared with nonobese subjects and declines with weight loss. To determine whether alteration of the vitamin D-endocrine system occurs in obesity and whether ensuing secondary hyperparathyroidism is associated with a reduction in urinary calcium, a study was performed in 12 obese white individuals, five men and seven women, and 14 nonobese white subjects, eight men and six women, ranging in age from 20 to 35 yr. Body weight averaged 106 +/- 6 kg in the obese and 68 +/- 2 kg in the nonobese subjects (P less than 0.01). Each of them were hospitalized on a metabolic ward and were given a constant daily diet containing 400 mg of calcium and 900 mg of phosphorus. Whereas mean serum calcium, serum ionized calcium, and serum phosphorus were the same in the two groups, mean serum immunoreactive PTH (518 +/- 48 vs. 243 +/- 33 pg/ml, P less than 0.001), mean serum 1,25-dihydroxyvitamin D [1,25(OH)2D] (37 +/- 2 vs. 29 +/- 2, P less than 0.01), and mean serum Gla protein (33 +/- 2 vs. 24 +/- 2 ng/ml, P less than 0.02) were significantly higher, and mean serum 25-hydroxyvitamin D (25-OHD) (8 +/- 1 vs. 20 +/- 2 ng/ml, P less than 0.001) was significantly lower in the obese than in the nonobese men and women. Mean urinary phosphorus was the same in the two groups, whereas mean urinary calcium (115 +/- 10 vs. 166 +/- 13 mg/d, P less than 0.01) was significantly lower, and mean urinary cyclic AMP (3.18 +/- 0.43 vs. 1.84 +/- 0.25 nM/dl GF, P less than 0.01) and creatinine clearance (216 +/- 13 vs. 173 +/- 6 liter/d, P less than 0.01) were significantly higher in the obese than in the nonobese individuals. There was a significant positive correlation between percentage of ideal body weight and urinary cyclic AMP (r = 0.524, P less than 0.01) and between percentage of ideal body weight and serum immunoreactive PTH (r = 0.717, P less than 0.01) in the two groups. The results provide evidence that alteration of the vitamin D-endocrine system in obese subjects is characterized by secondary hyperparathyroidism which is associated with enhanced renal tubular reabsorption of calcium and increased circulating 1,25(OH)2D. The reduction of serum 25-OHD in them is attributed to feedback inhibition of hepatic synthesis of the precursor by the increased serum 1,25(OH)2D.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (634K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Baginski ES, Marie SS, Clark WL, Zak B. Direct microdetermination of serum calcium. Clin Chim Acta. 1973 Jun 14;46(1):49–54. [PubMed]
  • Bartels H, Böhmer M. Eine Mikromethode zur Kreatininbestimmung. Clin Chim Acta. 1971 Mar;32(1):81–85. [PubMed]
  • Dorantes LM, Arnaud SB, Arnaud CD. Importance of the isolation of 25-hydroxyvitamin D before assay. J Lab Clin Med. 1978 May;91(5):791–796. [PubMed]
  • Reinhardt TA, Horst RL, Orf JW, Hollis BW. A microassay for 1,25-dihydroxyvitamin D not requiring high performance liquid chromatography: application to clinical studies. J Clin Endocrinol Metab. 1984 Jan;58(1):91–98. [PubMed]
  • Wiske PS, Epstein S, Bell NH, Queener SF, Edmondson J, Johnston CC., Jr Increases in immunoreactive parathyroid hormone with age. N Engl J Med. 1979 Jun 21;300(25):1419–1421. [PubMed]
  • Epstein S, Poser J, McClintock R, Johnston CC, Jr, Bryce G, Hui S. Differences in serum bone GLA protein with age and sex. Lancet. 1984 Feb 11;1(8372):307–310. [PubMed]
  • Gilman AG. A protein binding assay for adenosine 3':5'-cyclic monophosphate. Proc Natl Acad Sci U S A. 1970 Sep;67(1):305–312. [PubMed]
  • Broadus AE, Mahaffey JE, Bartter FC, Neer RM. Nephrogenous cyclic adenosine monophosphate as a parathyroid function test. J Clin Invest. 1977 Oct;60(4):771–783. [PMC free article] [PubMed]
  • TROTTER M, BROMAN GE, PETERSON RR. Densites of bones of white and Negro skeletons. J Bone Joint Surg Am. 1960 Jan;42-A:50–58. [PubMed]
  • Cohn SH, Abesamis C, Yasumura S, Aloia JF, Zanzi I, Ellis KJ. Comparative skeletal mass and radial bone mineral content in black and white women. Metabolism. 1977 Feb;26(2):171–178. [PubMed]
  • Garn SM, Sandusky ST, Nagy JM, McCann MB. Advanced skeletal development in low-income Negro children. J Pediatr. 1972 Jun;80(6):965–969. [PubMed]
  • Owen GM, Lubin AH. Anthropometric differences between black and white preschool children. Am J Dis Child. 1973 Aug;126(2):168–169. [PubMed]
  • Garn SM, Clark DC, Trowbridge FL. Tendency toward greater stature in American black children. Am J Dis Child. 1973 Aug;126(2):164–166. [PubMed]
  • Garn SM, Clark DC. Nutrition, growth, development, and maturation: findings from the ten-state nutrition survey of 1968-1970. Pediatrics. 1975 Aug;56(2):306–319. [PubMed]
  • Price PA, Parthemore JG, Deftos LJ. New biochemical marker for bone metabolism. Measurement by radioimmunoassay of bone GLA protein in the plasma of normal subjects and patients with bone disease. J Clin Invest. 1980 Nov;66(5):878–883. [PMC free article] [PubMed]
  • Frumar AM, Meldrum DR, Geola F, Shamonki IM, Tataryn IV, Deftos LJ, Judd HL. Relationship of fasting urinary calcium to circulating estrogen and body weight in postmenopausal women. J Clin Endocrinol Metab. 1980 Jan;50(1):70–75. [PubMed]
  • Dalén N, Hallberg D, Lamke B. Bone mass in obese subjects. Acta Med Scand. 1975 May;197(5):353–355. [PubMed]
  • Teitelbaum SL, Halverson JD, Bates M, Wise L, Haddad JG. Abnormalities of circulating 25-OH vitamin D after jejunal-lleal bypass for obesity: evidence of an adaptive response. Ann Intern Med. 1977 Mar;86(3):289–293. [PubMed]
  • Rickers H, Christiansen C, Balslev I, Rødbro P. Impairment of vitamin D metabolism and bone mineral content after intestinal bypass for obesity. A longitudinal study. Scand J Gastroenterol. 1984 Mar;19(2):184–189. [PubMed]
  • Bell NH, Shaw S, Turner RT. Evidence that 1,25-dihydroxyvitamin D3 inhibits the hepatic production of 25-hydroxyvitamin D in man. J Clin Invest. 1984 Oct;74(4):1540–1544. [PMC free article] [PubMed]
  • Clemens TL, Adams JS, Henderson SL, Holick MF. Increased skin pigment reduces the capacity of skin to synthesise vitamin D3. Lancet. 1982 Jan 9;1(8263):74–76. [PubMed]

Articles from The Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation