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Vitamin D deficiency influences histomorphometric features of bone in primary hyperparathyroidism.
Bone 2011; 48(3):557-61BONE

Abstract

INTRODUCTION

Vitamin D deficiency is common in patients with primary hyperparathyroidism (PHPT). The presence of low levels of vitamin D may affect the skeletal consequences of PHPT.

METHODS

In this cross-sectional study, transiliac crest bone biopsies were performed after double tetracycline labeling in patients with mild PHPT and analyzed according to serum levels of 25 hydroxyvitamin D (25OHD).

RESULTS

We studied 30 patients with mild PHPT (age 53 ± 11 years; 67% women; calcium 11.1 ± 1.0 mg/dl; PTH 149 ± 129 pg/ml). Serum 25OHD levels were low in the majority of subjects (mean 21 ± 11 ng/ml) and inversely associated with PTH (r = -0.69; p < 0.01). 25OHD levels were directly associated with cortical width (Ct.Wi; r = 0.46, p < 0.03) and trabecular separation (Tb.Sp; r = 0.41; p < 0.04), but inversely associated with cancellous bone volume (BV/TV; r = -0.39, p < 0.04). Subjects with 25OHD levels < 20 ng/ml (n = 14) and ≥ 20 ng/ml (n = 16) were compared. Groups did not differ by age, sex, menopausal status, serum calcium, creatinine, or 1,25(OH)₂D. PTH was 1.8-fold higher in subjects with 25OHD < 20 (265 ± 166 pg/ml vs. 95 ± 50 pg/ml; p < 0.01). On histomorphometric analysis, those with low 25OHD had lower Ct.Wi (541 ± 167 μm vs. 712 ± 200 μm; p < 0.03). Conversely, measures of trabecular microarchitecture were better in those with lower 25OHD, with higher BV/TV (26.1 ± 6.1% vs. 20.4 ± 6.4%; p < 0.03), greater trabecular number (Tb.N: 2.0 ± 0.4 mm⁻¹ vs. 1.8 ± 0.4 mm⁻¹; p < 0.04) and lower Tb.Sp (371 ± 90 μm vs. 472 ± 137 μm; p < 0.04). There were no differences between the groups in bone remodeling indices.

CONCLUSIONS

Low levels of 25OHD in patients with PHPT are associated with higher concentrations of PTH, greater catabolic effects in cortical bone and greater anabolic effects in trabecular bone.

Authors+Show Affiliations

College of Physicians and Surgeons, Columbia University, New York, NY, USA. es2029@columbia.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20950725

Citation

Stein, Emily M., et al. "Vitamin D Deficiency Influences Histomorphometric Features of Bone in Primary Hyperparathyroidism." Bone, vol. 48, no. 3, 2011, pp. 557-61.
Stein EM, Dempster DW, Udesky J, et al. Vitamin D deficiency influences histomorphometric features of bone in primary hyperparathyroidism. Bone. 2011;48(3):557-61.
Stein, E. M., Dempster, D. W., Udesky, J., Zhou, H., Bilezikian, J. P., Shane, E., & Silverberg, S. J. (2011). Vitamin D deficiency influences histomorphometric features of bone in primary hyperparathyroidism. Bone, 48(3), pp. 557-61. doi:10.1016/j.bone.2010.10.004.
Stein EM, et al. Vitamin D Deficiency Influences Histomorphometric Features of Bone in Primary Hyperparathyroidism. Bone. 2011 Mar 1;48(3):557-61. PubMed PMID: 20950725.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin D deficiency influences histomorphometric features of bone in primary hyperparathyroidism. AU - Stein,Emily M, AU - Dempster,David W, AU - Udesky,Julia, AU - Zhou,Hua, AU - Bilezikian,John P, AU - Shane,Elizabeth, AU - Silverberg,Shonni J, Y1 - 2010/10/13/ PY - 2010/03/12/received PY - 2010/10/01/revised PY - 2010/10/05/accepted PY - 2010/10/19/entrez PY - 2010/10/19/pubmed PY - 2011/5/24/medline SP - 557 EP - 61 JF - Bone JO - Bone VL - 48 IS - 3 N2 - INTRODUCTION: Vitamin D deficiency is common in patients with primary hyperparathyroidism (PHPT). The presence of low levels of vitamin D may affect the skeletal consequences of PHPT. METHODS: In this cross-sectional study, transiliac crest bone biopsies were performed after double tetracycline labeling in patients with mild PHPT and analyzed according to serum levels of 25 hydroxyvitamin D (25OHD). RESULTS: We studied 30 patients with mild PHPT (age 53 ± 11 years; 67% women; calcium 11.1 ± 1.0 mg/dl; PTH 149 ± 129 pg/ml). Serum 25OHD levels were low in the majority of subjects (mean 21 ± 11 ng/ml) and inversely associated with PTH (r = -0.69; p < 0.01). 25OHD levels were directly associated with cortical width (Ct.Wi; r = 0.46, p < 0.03) and trabecular separation (Tb.Sp; r = 0.41; p < 0.04), but inversely associated with cancellous bone volume (BV/TV; r = -0.39, p < 0.04). Subjects with 25OHD levels < 20 ng/ml (n = 14) and ≥ 20 ng/ml (n = 16) were compared. Groups did not differ by age, sex, menopausal status, serum calcium, creatinine, or 1,25(OH)₂D. PTH was 1.8-fold higher in subjects with 25OHD < 20 (265 ± 166 pg/ml vs. 95 ± 50 pg/ml; p < 0.01). On histomorphometric analysis, those with low 25OHD had lower Ct.Wi (541 ± 167 μm vs. 712 ± 200 μm; p < 0.03). Conversely, measures of trabecular microarchitecture were better in those with lower 25OHD, with higher BV/TV (26.1 ± 6.1% vs. 20.4 ± 6.4%; p < 0.03), greater trabecular number (Tb.N: 2.0 ± 0.4 mm⁻¹ vs. 1.8 ± 0.4 mm⁻¹; p < 0.04) and lower Tb.Sp (371 ± 90 μm vs. 472 ± 137 μm; p < 0.04). There were no differences between the groups in bone remodeling indices. CONCLUSIONS: Low levels of 25OHD in patients with PHPT are associated with higher concentrations of PTH, greater catabolic effects in cortical bone and greater anabolic effects in trabecular bone. SN - 1873-2763 UR - https://www.unboundmedicine.com/medline/citation/20950725/Vitamin_D_deficiency_influences_histomorphometric_features_of_bone_in_primary_hyperparathyroidism_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S8756-3282(10)01708-4 DB - PRIME DP - Unbound Medicine ER -