Management of hypovitaminosis D in patients with primary hyperparathyroidism
| Autor: | S. Gonzalez, S. R. Peacey, N. R. Ellis, M. S. Rathi, D. Wright |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Vitamin medicine.medical_specialty Hypercalcaemia endocrine system diseases Endocrinology Diabetes and Metabolism Parathyroid hormone Severity of Illness Index Gastroenterology vitamin D deficiency Cohort Studies chemistry.chemical_compound Endocrinology Internal medicine medicine Vitamin D and neurology Humans Secondary Care Centers Aged Calcifediol Cholecalciferol Aged 80 and over Hyperparathyroidism business.industry Middle Aged Hyperparathyroidism Primary Vitamin D Deficiency medicine.disease United Kingdom chemistry Parathyroid Hormone Dietary Supplements Hypercalcemia Calcium Female business Biomarkers |
| Zdroj: | Journal of Endocrinological Investigation. 37:467-471 |
| ISSN: | 1720-8386 |
| DOI: | 10.1007/s40618-014-0056-y |
| Popis: | Epidemiological studies suggest that vitamin D deficiency is common in patients with primary hyperparathyroidism (PHPT). They have higher levels of serum parathyroid hormone (PTH) and markers of bone turnover and fractures are more frequent than vitamin D-replete patients. However, there are concerns that Vitamin D repletion might exacerbate pre-existent hypercalcaemia. Therefore, we aimed to determine if vitamin D replacement improved biochemical indices of calcium metabolism without worsening underlying hypercalcaemia. This is a prospective, observational study based on routine clinical practice, set up in a secondary care centre. 45 consecutive patients with mild biochemical hypercalcaemia due to PHPT and hypovitaminosis D were enrolled. The mean age of the cohort was 61 years (range 25–85 years), predominately Asian (32 patients) and female (41 patients). They received 20,000 IU of oral cholecalciferol, once a week, for 3 months. Calcium, phosphate, alkaline phosphatase and PTH were measured at baseline, 4, 8 and 12 weeks following treatment. Vitamin D levels were obtained at baseline and at 12 weeks, after they completed their treatment. Vitamin D levels normalised at week 12 (mean ± SD, 18.8 ± 9.4 versus 76 ± 20 nmol/L, p = 0.0001) and PTH levels improved following treatment completion (21.2 ± 10 versus 16.2 ± 6 pmol/L, p = 0.026). There was no significant increase in serum calcium levels during vitamin D supplementation. High doses of oral cholecalciferol normalised vitamin D levels without worsening underlying hypercalcaemia in individuals with PHPT. |
| Databáze: | OpenAIRE |
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