The combined associations we observed between vitamin D deficiency and PTH excess with at least one cardiometabolic condition (i.e., obesity, hypertension, or CKD) and their joint association with CVD risk in women without diabetes imply that the combined assessment of vitamin D and PTH may more accurately reflect the functional status of vitamin D relevant to cardiometabolic health compared with assessment of one factor alone. This evidence concerns the gene PTH and obesity due to melanocortin 4 receptor deficiency.