Effect on bone density of postoperative calcium and vitamin-D supplementation in patients with primary hyperparathyroidism: A retrospective study
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- Nordenström, E., Westerdahl, J. & Bergenfelz, A. Langenbecks Arch Surg (2009) 394: 461. doi:10.1007/s00423-008-0350-2
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Primary hyperparathyroidism (pHPT) is associated with decreased bone density and increased fracture risk. A significant number of pHPT patients have low calcium intake and suffer from vitamin deficiency. Thus, we adopted a policy of postoperative supplements with calcium and vitamin D after parathyroid surgery. In this study, we investigated if this policy enhanced the postoperative increase in bone density.
Forty-two consecutive patients (83% female) were studied. The first 21 patients received no supplements, whereas the following 21 patients received 1,000 g calcium and 800 IU hydroxy D-vitamin daily (Ca–D group) for 1 year postoperatively. The patients were monitored with bone density and biochemistry pre- and at 1 year postoperatively.
Preoperatively, the patients without vitamin D supplementation (non-Ca–D group) did neither differ in biochemistry, clinical features, nor in bone density from patients in Ca–D group. Postoperatively, there was a tendency that patients in Ca–D group increased their bone density, at all sites measured, in a greater extent than patients that did not receive calcium and vitamin D supplementation.
In conclusion, based on our results, it is difficult to give a recommendation of vitamin D supplementation in routine use following surgery for primary hyperparathyroidism. Based on the present data, a calculation of sample size for a future randomized controlled trial is presented.