Assessment of Vitamin D Status in Primary Hyperparathyroidism Patients: A Retrospective Study

Primary hyperparathyroidism (PHPT), a condition that manifests in various clinical forms, is a significant health concern. Normocalcemic primary hyperparathyroidism (NPHPT) is characterized by normal calcemia despite elevated parathyroid hormone (PTH) levels. Vitamin D deficiency can contribute to t...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-07, Vol.16 (7), p.e64988
Main Authors: Kolcsar, Melinda, Szabó, László, Dénes, Orsolya Mária, Gáll, Zsolt
Format: Article
Language:English
Subjects:
Asymptomatic
Bisphosphonates
Bone density
Bones
Chi-square test
Diuretics
Endocrinology/Diabetes/Metabolism
Females
Fractures
Hypercalcemia
Hyperplasia
Kidney diseases
Kidney stones
Males
Metabolism
Metabolites
Standard scores
Statistical analysis
Tumors
Vitamin D
Vitamin deficiency
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Summary:Primary hyperparathyroidism (PHPT), a condition that manifests in various clinical forms, is a significant health concern. Normocalcemic primary hyperparathyroidism (NPHPT) is characterized by normal calcemia despite elevated parathyroid hormone (PTH) levels. Vitamin D deficiency can contribute to the clinical spectrum and complexity of NPHPT. Low vitamin D levels can elevate PTH, making it difficult to distinguish between NPHPT and secondary hyperparathyroidism. Additionally, it might mask hypercalcemia, leading to an underestimation of the disease severity. Our study aims to shed light on these complexities by investigating normocalcemic and hypercalcemic PHPT patient's clinical, hormonal, and biochemical patterns, including their vitamin D status.    Materials: In this retrospective study, we enrolled 60 PHPT patients with autonomous parathyroid function confirmed using a combination of ultrasonography, radionuclide scan, and parathyroid function index calculation. We evaluated the albumin-corrected calcemia, calciuria, PTH, 25(OH)D level, serum phosphate, bone mineral density, and major clinical symptoms (fracture, nephrolithiasis). A comparative analysis and a correlation study were performed between normo- and hypercalcemic and vitamin D-deficient and vitamin D-non-deficient groups.  The median age was 62 years, 51.66% (31/60) being normocalcemic and 46.66% (29/60) presenting a deficient 25(OH)D level. In the group with 25(OH)D below 20 ng/mL, we observed a reduced level of albumin-corrected calcemia, without a significant increase of PTH compared to the adequate 25(OH)D level group. The frequency of the NPHPT and the risk of fracture were significantly higher in the deficient 25(OH)D group (20/60, 33.33% and 8/60, 13.33%) than in the adequate one (11/60, 18.33% and 1/60, 1.66%) with OR=4.7 (p
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.64988