Associations of serum 25-hydroxyvitamin D with circulating PTH, phosphate and calcium in patients with primary hyperparathyroidism

作者：Jayasena Channa N; Modi Manish; Palazzo Fausto; De Silva Akila; Donaldson Mandy; Meeran Karim; Dhillo Waljit S^*

来源：Clinical Endocrinology, 2013, 78(6): 838-843.

DOI：10.1111/cen.12062

Background Despite NIH clinical recommendations, many clinicians are reluctant to replace vitamin D in patients with hypercalcaemia with primary hyperparathyroidism (PHP) due to concerns over aggravating hypercalcaemia. Furthermore, the optimum level of vitamin D replacement in PHP remains unclear. Methods We performed a large retrospective study to determine whether a relationship exists between serum 25-hydroxyvitamin D levels, calcium and other important biochemical markers in patients with PHP. Serum, plasma and urinary biochemical measurements were collected from 251 patients with hypercalcaemia diagnosed with PHP. Results When examining overall mean circulating levels during clinical follow-up, serum 25-hydroxyvitamin D correlated highly significantly with plasma parathyroid hormone (PTH) (r=0 center dot 23, P=0 center dot 0003) and serum phosphate (r=0 center dot 16, P=0 center dot 0119). No significant relationship was observed between serum calcium and 25-hydroxyvitamin D (r=0 center dot 002, P=0 center dot 98). Mean plasma PTH during clinical follow-up was 51% lower in patients with serum 25-hydroxyvitamin D>60nm when compared with patients who had 25-hydroxyvitamin D<20nm (P<0 center dot 01). Conclusions Patients with PHP who have 25-hydroxyvitamin D levels>60nm have significantly reduced PTH hypersecretion when compared with patients with deficient vitamin D levels, without exhibiting worse hypercalcaemia.

• 出版日期2013-6