Low vitamin D levels have become less common in primary hyperparathyroidism.

Abstract

UNLABELLED:

We compared temporal trends in serum 25-hydroxyvitamin D and parathyroid hormone (PTH) in two primary hyperparathyroidism (PHPT) cohorts recruited 20 years apart. The prevalence of 25-hydroxyvitamin D levels <20 and <30 ng/mL declined by 30-50 %, respectively, and was accompanied by lower PTH. In the older cohort, higher PTH may be due to lower 25-hydroxyvitamin D.

INTRODUCTION:

Vitamin D deficiency may exacerbate PHPT. Whether there have been temporal trends in 25-hydroxyvitamin D (25OHD) levels in PHPT is unclear. The prevalence of low vitamin D levels (25OHD <20 and <30 ng/mL) and associated biochemical and bone mineral density (BMD) profiles were assessed in two PHPT cohorts recruited over 20 years apart.

METHODS:

This is a cross-sectional comparison of serum 25OHD levels, calciotropic hormones, and BMD between two PHPT cohorts recruited at the same hospital: the "old" (N = 103) and "new" (N = 100) cohorts were enrolled between 1984 and 1991 and between 2010 and 2014, respectively.

RESULTS:

Mean 25OHD levels were 26 % higher in the new cohort (23 ± 10 vs. 29 ± 10 ng/mL, p < 0.0001). Levels of 25OHD <20 and <30 ng/mL declined from 46 and 82 %, respectively, to 19 and 54 % (both p < 0.0001). Supplemental vitamin D use was common in the new (64 %) but not the old cohort (0 %). The new cohort demonstrated 33 % lower serum PTH levels (p < 0.0001). Neither serum nor urine calcium differed. BMD was higher in the new cohort at all skeletal sites (all p < 0.001).

CONCLUSION:

With the rise in vitamin D supplementation over the last two decades, low 25OHD levels are no longer common in PHPT patients in the New York area. Those with 25OHD <20 and <30 ng/mL have declined by over 50 and 30 %, respectively. The lower mean PTH levels in the new cohort are most likely accounted for by higher vitamin D intake. Whether improved vitamin D status also underlies the relatively higher BMD in the more vitamin D replete cohort of PHPT patients is unknown.

• Authors: M D Walker, E Cong, J A Lee, A Kepley, C Zhang, D J McMahon, J P Bilezikian, S J Silverberg
• Journal: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA (Osteoporos Int) Vol. 26 Issue 12 Pg. 2837-43 (Dec 2015) ISSN: 1433-2965 [Electronic] England
• PMID: 26084258 (Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Parathyroid Hormone
• Vitamin D
• 25-hydroxyvitamin D

Topics

• Adult
• Aged
• Bone Density (physiology)
• Cross-Sectional Studies
• Drug Utilization (trends)
• Female
• Humans
• Hyperparathyroidism, Primary (blood, complications, epidemiology, physiopathology)
• Male
• Middle Aged
• New York (epidemiology)
• Parathyroid Hormone (blood)
• Vitamin D (analogs & derivatives, blood, therapeutic use)
• Vitamin D Deficiency (blood, epidemiology, etiology, physiopathology)