Health-related quality of life after successful surgery for primary hyperparathyroidism: no additive effect from vitamin D supplementation: results of a double-blind randomized study.

Abstract

OBJECTIVE:

Vitamin D insufficiency is common in primary hyperparathyroidism (pHPT). Patients with pHPT frequently have a reduced health-related quality of life (HRQoL). Our objectives were to evaluate whether HRQoL in pHPT is associated with vitamin D insufficiency and whether vitamin D supplementation after parathyroidectomy (PTX) could improve HRQoL.

DESIGN:

A randomized, double-blind study (ClinicalTrials.gov identifier: NCT00982722).

METHODS:

The study included 150 pHPT patients randomized, 6 weeks after PTX, to daily treatment with either cholecalciferol 1600 IU and calcium carbonate 1000 mg (D+) or calcium carbonate alone (D-). HRQoL was estimated with SF-36 before and after PTX and after 12 months of study medication.

RESULTS:

Three-quarters (77%) of the pHPT patients had vitamin D insufficiency, defined as 25OHD <50 nmol/l. The pHPT patients scored lower than a reference population in all domains of SF-36. A total of 135 patients completed the entire study period. Improvements in nearly all domains were registered at the follow-up 6 weeks after PTX. At the end of the study medication period, the D+ group had a significantly higher median serum (s-) 25OHD concentration (76 (65; 93) (lower; upper interquartile ranges) vs 48 (40; 62) nmol/l, P<0.001) and a lower plasma (p-) parathyroid hormone concentration (40 (34; 52) vs 49 (38; 66) ng/l, P=0.01) than the D- group. The improvements in HRQoL remained unchanged at the follow-up 1 year after PTX. Postoperative vitamin D supplementation had no obvious effect on HRQoL.

CONCLUSION:

PTX resulted in significant improvements in HRQoL. Despite a high prevalence of vitamin D insufficiency, 1 year of postoperative vitamin D supplementation had no obvious beneficial effect on HRQoL.

• Authors: Viveca Åberg, Sophie Norenstedt, Jan Zedenius, Maria Sääf, Jörgen Nordenström, Ylva Pernow, Inga-Lena Nilsson
• Journal: European journal of endocrinology (Eur J Endocrinol) Vol. 172 Issue 2 Pg. 181-7 (Feb 2015) ISSN: 1479-683X [Electronic] England
• PMID: 25414430 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: © 2015 The authors.

Chemical References

• Vitamin D

Topics

• Adult
• Aged
• Aged, 80 and over
• Cohort Studies
• Dietary Supplements
• Double-Blind Method
• Female
• Health Surveys (methods)
• Humans
• Hyperparathyroidism, Primary (diagnosis, drug therapy, surgery)
• Male
• Middle Aged
• Postoperative Care (methods)
• Quality of Life
• Treatment Outcome
• Vitamin D (administration & dosage)