Bone mineral density increases with vitamin D repletion in patients with coexistent vitamin D insufficiency and primary hyperparathyroidism

Two hundred and twenty-nine consecutive subjects, 202 women and 27 men, referred for evaluation of osteoporosis or low bone mineral density (BMD) had serum measurements of immunoreactive PTH (iPTH) and 25-hydroxyvitamin D (25OHD) performed. Fifteen individuals (mean age +/- SE, 75+/-2.4 yr) had depr...

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Published in:The journal of clinical endocrinology and metabolism 2000-10, Vol.85 (10), p.3541-3543
Main Authors: KANTOROVICH, Vitaly, GACAD, Mercedes A, SEEGER, Leanne L, ADAMS, John S
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Bone Density - drug effects
Calcifediol - blood
Endocrinopathies
Female
Humans
Hyperparathyroidism - complications
Hyperparathyroidism - drug therapy
Male
Medical sciences
Metabolic diseases
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Other nutritional diseases (malnutrition, nutritional and vitamin deficiencies...)
Parathyroid Hormone - blood
Parathyroid Hormone - deficiency
Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases)
Vitamin D - blood
Vitamin D - therapeutic use
Vitamin D Deficiency - complications
Vitamin D Deficiency - drug therapy
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Summary:Two hundred and twenty-nine consecutive subjects, 202 women and 27 men, referred for evaluation of osteoporosis or low bone mineral density (BMD) had serum measurements of immunoreactive PTH (iPTH) and 25-hydroxyvitamin D (25OHD) performed. Fifteen individuals (mean age +/- SE, 75+/-2.4 yr) had depressed serum 25OHD (65 pg/mL) iPTH levels. After successful treatment of vitamin D insufficiency in all subjects, iPTH remained inappropriately high or frankly elevated in 5, describing a 2.2% prevalence rate of coexistent primary hyperparathyroidism and vitamin D insufficiency in our population. Despite persistent primary hyperparathyroidism, normalization of serum 25OHD levels in these 5 subjects increased their BMD at an annual rate of 6.3% and 8.2% in spine and hip, respectively. Our results suggest that coexistent vitamin D insufficiency can obscure the diagnosis of primary hyperparathyroidism and, when treated effectively, can result in substantial short-terms gains in BMD despite persistence of the inappropriate production of PTH.
ISSN:0021-972X
1945-7197
DOI:10.1210/jc.85.10.3541