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Low vitamin D levels have become less common in primary hyperparathyroidism.
Osteoporos Int 2015; 26(12):2837-43OI

Abstract

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+Show Affiliations

Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH 8 West - 864, New York, NY, 10032, USA. mad2037@columbia.edu.Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH 8 West - 864, New York, NY, 10032, USA.Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA.Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH 8 West - 864, New York, NY, 10032, USA.Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH 8 West - 864, New York, NY, 10032, USA.Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH 8 West - 864, New York, NY, 10032, USA.Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH 8 West - 864, New York, NY, 10032, USA.Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH 8 West - 864, New York, NY, 10032, USA.

Pub Type(s)

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

Language

eng

PubMed ID

26084258

Citation

Walker, M D., et al. "Low Vitamin D Levels Have Become Less Common in Primary Hyperparathyroidism." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 26, no. 12, 2015, pp. 2837-43.
Walker MD, Cong E, Lee JA, et al. Low vitamin D levels have become less common in primary hyperparathyroidism. Osteoporos Int. 2015;26(12):2837-43.
Walker, M. D., Cong, E., Lee, J. A., Kepley, A., Zhang, C., McMahon, D. J., ... Silverberg, S. J. (2015). Low vitamin D levels have become less common in primary hyperparathyroidism. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 26(12), pp. 2837-43. doi:10.1007/s00198-015-3199-6.
Walker MD, et al. Low Vitamin D Levels Have Become Less Common in Primary Hyperparathyroidism. Osteoporos Int. 2015;26(12):2837-43. PubMed PMID: 26084258.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low vitamin D levels have become less common in primary hyperparathyroidism. AU - Walker,M D, AU - Cong,E, AU - Lee,J A, AU - Kepley,A, AU - Zhang,C, AU - McMahon,D J, AU - Bilezikian,J P, AU - Silverberg,S J, Y1 - 2015/06/18/ PY - 2015/03/11/received PY - 2015/06/03/accepted PY - 2015/6/19/entrez PY - 2015/6/19/pubmed PY - 2016/9/16/medline KW - Prevalence KW - Primary hyperparathyroidism KW - Vitamin D deficiency SP - 2837 EP - 43 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 26 IS - 12 N2 - 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. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/26084258/Low_vitamin_D_levels_have_become_less_common_in_primary_hyperparathyroidism_ L2 - https://dx.doi.org/10.1007/s00198-015-3199-6 DB - PRIME DP - Unbound Medicine ER -