Tags

Type your tag names separated by a space and hit enter

Effect of concomitant vitamin D deficiency or insufficiency on lumbar spine volumetric bone mineral density and trabecular bone score in primary hyperparathyroidism.
Osteoporos Int 2016; 27(10):3063-71OI

Abstract

Lower vitamin D and higher parathyroid hormone (PTH) levels are associated with higher volumetric BMD and bone strength at the lumbar spine as measured by central quantitative computed tomography in primary hyperparathyroidism (PHPT), but there are no differences in bone microarchitecture as measured by trabecular bone score (TBS).

INTRODUCTION

The purpose of this study was to evaluate the association between 25-hydroxyvitamin D (25OHD) and volumetric bone mineral density (vBMD) and the TBS at the lumbar spine (LS) in PHPT.

METHODS

This is a cross-sectional analysis of PHPT patients with and without low 25OHD. We measured vBMD with quantitative computed tomography (cQCT) and TBS by dual-energy X-ray absorptiometry (DXA) at the LS in 52 and 88 participants, respectively.

RESULTS

In the cQCT cohort, those with lower vitamin D (<20 vs. 20-29 vs. ≥30 ng/ml) tended to be younger (p = 0.05), were less likely to use vitamin D supplementation (p < 0.01), and had better renal function (p = 0.03). Those with 25OHD <20 ng/ml had 80 and 126 % higher serum PTH levels respectively vs. those with 25OHD 20-29 ng/ml (p = 0.002) and 25OHD ≥30 ng/ml (p < 0.0001). Covariate-adjusted integral and trabecular vBMD were higher in those with 25OHD 20-29 vs. those with 25OHD ≥30 ng/ml, but those with 25OHD <20 did not differ. Because there were few participants with 25OHD deficiency, we also compared those with vitamin D <30 vs. ≥30 ng/ml. Covariate-adjusted integral and trabecular vBMD were 23 and 30 % higher respectively (both p < 0.05) in those with vitamin D <30 vs. ≥30 ng/ml. TBS was in the partially degraded range but did not differ by vitamin D status.

CONCLUSION

In mild PHPT, lower 25OHD is associated with higher PTH, but vitamin D deficiency and insufficiency using current clinical thresholds did not adversely affect lumbar spine skeletal health in PHPT. Further work is needed to determine if higher vBMD in those with lower vitamin D is due to an anabolic effect of PTH.

Authors+Show Affiliations

Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA. mad2037@columbia.edu.Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA.Department of Surgery, Columbia University College of Physicians and Surgeons, New York, NY, USA.Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.Center of Bone Diseases, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland.Department of Radiology and Biomedical Imaging, University of California at San Francisco, San Francisco, CA, USA.Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27198233

Citation

Walker, M D., et al. "Effect of Concomitant Vitamin D Deficiency or Insufficiency On Lumbar Spine Volumetric Bone Mineral Density and Trabecular Bone Score 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. 27, no. 10, 2016, pp. 3063-71.
Walker MD, Saeed I, Lee JA, et al. Effect of concomitant vitamin D deficiency or insufficiency on lumbar spine volumetric bone mineral density and trabecular bone score in primary hyperparathyroidism. Osteoporos Int. 2016;27(10):3063-71.
Walker, M. D., Saeed, I., Lee, J. A., Zhang, C., Hans, D., Lang, T., & Silverberg, S. J. (2016). Effect of concomitant vitamin D deficiency or insufficiency on lumbar spine volumetric bone mineral density and trabecular bone score 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, 27(10), pp. 3063-71. doi:10.1007/s00198-016-3637-0.
Walker MD, et al. Effect of Concomitant Vitamin D Deficiency or Insufficiency On Lumbar Spine Volumetric Bone Mineral Density and Trabecular Bone Score in Primary Hyperparathyroidism. Osteoporos Int. 2016;27(10):3063-71. PubMed PMID: 27198233.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of concomitant vitamin D deficiency or insufficiency on lumbar spine volumetric bone mineral density and trabecular bone score in primary hyperparathyroidism. AU - Walker,M D, AU - Saeed,I, AU - Lee,J A, AU - Zhang,C, AU - Hans,D, AU - Lang,T, AU - Silverberg,S J, Y1 - 2016/05/19/ PY - 2016/03/28/received PY - 2016/05/12/accepted PY - 2016/5/21/entrez PY - 2016/5/21/pubmed PY - 2018/4/11/medline KW - Central quantitative computed tomography KW - Primary hyperparathyroidism KW - Trabecular bone score KW - Vitamin D deficiency KW - Volumetric bone density SP - 3063 EP - 71 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 - 27 IS - 10 N2 - UNLABELLED: Lower vitamin D and higher parathyroid hormone (PTH) levels are associated with higher volumetric BMD and bone strength at the lumbar spine as measured by central quantitative computed tomography in primary hyperparathyroidism (PHPT), but there are no differences in bone microarchitecture as measured by trabecular bone score (TBS). INTRODUCTION: The purpose of this study was to evaluate the association between 25-hydroxyvitamin D (25OHD) and volumetric bone mineral density (vBMD) and the TBS at the lumbar spine (LS) in PHPT. METHODS: This is a cross-sectional analysis of PHPT patients with and without low 25OHD. We measured vBMD with quantitative computed tomography (cQCT) and TBS by dual-energy X-ray absorptiometry (DXA) at the LS in 52 and 88 participants, respectively. RESULTS: In the cQCT cohort, those with lower vitamin D (<20 vs. 20-29 vs. ≥30 ng/ml) tended to be younger (p = 0.05), were less likely to use vitamin D supplementation (p < 0.01), and had better renal function (p = 0.03). Those with 25OHD <20 ng/ml had 80 and 126 % higher serum PTH levels respectively vs. those with 25OHD 20-29 ng/ml (p = 0.002) and 25OHD ≥30 ng/ml (p < 0.0001). Covariate-adjusted integral and trabecular vBMD were higher in those with 25OHD 20-29 vs. those with 25OHD ≥30 ng/ml, but those with 25OHD <20 did not differ. Because there were few participants with 25OHD deficiency, we also compared those with vitamin D <30 vs. ≥30 ng/ml. Covariate-adjusted integral and trabecular vBMD were 23 and 30 % higher respectively (both p < 0.05) in those with vitamin D <30 vs. ≥30 ng/ml. TBS was in the partially degraded range but did not differ by vitamin D status. CONCLUSION: In mild PHPT, lower 25OHD is associated with higher PTH, but vitamin D deficiency and insufficiency using current clinical thresholds did not adversely affect lumbar spine skeletal health in PHPT. Further work is needed to determine if higher vBMD in those with lower vitamin D is due to an anabolic effect of PTH. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/27198233/Effect_of_concomitant_vitamin_D_deficiency_or_insufficiency_on_lumbar_spine_volumetric_bone_mineral_density_and_trabecular_bone_score_in_primary_hyperparathyroidism_ L2 - https://dx.doi.org/10.1007/s00198-016-3637-0 DB - PRIME DP - Unbound Medicine ER -