RESUMEN
AIM: Epidemiological studies suggest that vitamin D deficiency is common in patients with primary hyperparathyroidism (PHPT). They have higher levels of serum parathyroid hormone (PTH) and markers of bone turnover and fractures are more frequent than vitamin D-replete patients. However, there are concerns that Vitamin D repletion might exacerbate pre-existent hypercalcaemia. Therefore, we aimed to determine if vitamin D replacement improved biochemical indices of calcium metabolism without worsening underlying hypercalcaemia. SUBJECTS AND METHODS: This is a prospective, observational study based on routine clinical practice, set up in a secondary care centre. 45 consecutive patients with mild biochemical hypercalcaemia due to PHPT and hypovitaminosis D were enrolled. The mean age of the cohort was 61 years (range 25-85 years), predominately Asian (32 patients) and female (41 patients). They received 20,000 IU of oral cholecalciferol, once a week, for 3 months. Calcium, phosphate, alkaline phosphatase and PTH were measured at baseline, 4, 8 and 12 weeks following treatment. Vitamin D levels were obtained at baseline and at 12 weeks, after they completed their treatment. RESULTS: Vitamin D levels normalised at week 12 (mean ± SD, 18.8 ± 9.4 versus 76 ± 20 nmol/L, p = 0.0001) and PTH levels improved following treatment completion (21.2 ± 10 versus 16.2 ± 6 pmol/L, p = 0.026). There was no significant increase in serum calcium levels during vitamin D supplementation. CONCLUSIONS: High doses of oral cholecalciferol normalised vitamin D levels without worsening underlying hypercalcaemia in individuals with PHPT.
Asunto(s)
Colecalciferol/uso terapéutico , Suplementos Dietéticos , Hiperparatiroidismo Primario/complicaciones , Deficiencia de Vitamina D/dietoterapia , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Calcifediol/sangre , Calcio/sangre , Colecalciferol/efectos adversos , Estudios de Cohortes , Suplementos Dietéticos/efectos adversos , Femenino , Humanos , Hipercalcemia/inducido químicamente , Hipercalcemia/etiología , Hiperparatiroidismo Primario/fisiopatología , Masculino , Persona de Mediana Edad , Hormona Paratiroidea/sangre , Centros de Atención Secundaria , Índice de Severidad de la Enfermedad , Reino Unido , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/complicacionesRESUMEN
Vitamin/mineral supplements were administered to institutionalized mentally retarded adults in a double-blind study over a 7-month period. No changes were observed in IQ nor in adaptive behavior, i.e., independent living skills within the institution. This was a replication with adults of a previous study of children that had obtained positive results. Possible reasons for the different findings were discussed.