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Levels of bioavailable, and free forms of 25(OH)D after supplementation with vitamin D3 in primary hyperparathyroidism

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Abstract

The 25 hydroxyvitamin D [25(OH)D] is the major metabolite for ascertaining vitamin D status, which circulates bound to a specific carrier (vitamin D-binding protein - VDBP). A portion that circulates unbound vary according to the VDBP genotype. This study evaluates the behavior of different forms of 25(OH)D, before and after supplementation with 14,000 IU of vitamin D3, weekly for 12 weeks, in individuals with primary hyperparathyroidism and controls. Fifty-six patients with active primary hyperparathyroidism (PHPT) and 64 paired controls (CTRL), not taking vitamin D3 for the last three months, were enrolled. The genetic isotypes of VDBP were determined to calculate bioavailable and free 25(OH)D. A p < 0.05 was considered significant. There were no statistical differences in free, bioavailable, and total 25(OH)D levels between PHPT and CTRL groups at baseline. The distribution of VDBP haplotypes 1s/1s, 1f/1f, 1s/1f, 2/2, 1s/2, and 1f/2 was similar between groups. After supplementation, all three forms of 25(OH)D proportionally increased within each group, although the percentage increment was lower in the PHPT group (p < 0.05). Total 25(OH)D is better correlated with PTH in the PHPT group than bioavailable and free 25(OH)D (r = −0.41; p < 0.05). The concentrations of total, free, and bioavailable 25(OH)D were similar in both PHPT and CTRL groups, and all forms increased proportionally after supplementation, although this increment percentage was higher in the CTRL group, with a subsequent reduction of PTH and AP. Total 25(OH)D correlated better with PTH than other forms, suggesting no advantages in measuring free or bioavailable 25(OH)D in these situations.

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Authors and Affiliations

  1. Department of Medicine, Endocrinology Unit, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil

    Lívia Marcela dos Santos, Monique Nakayama Ohe, Sthefanie Giovanna Pallone, Isabela Ohki Nacaguma, Ilda Sizue Kunii, Renata Elen Costa da Silva, Sergio Setsuo Maeda, José Gilberto Henriques Vieira & Marise Lazaretti-Castro

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Correspondence to Lívia Marcela dos Santos.

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The authors declare no competing interest. Our article analyzes the usefulness of free 25(OH)D in individuals with primary hyperparathyroidism before and after supplementation with cholecalciferol. There are few studies in the literature on this topic, in addition we can contribute to clinical practice by verifying whether free 25(OH)D is necessary to evaluate the patient with primary hyperparathyroidism.

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dos Santos, L.M., Ohe, M.N., Pallone, S.G. et al. Levels of bioavailable, and free forms of 25(OH)D after supplementation with vitamin D3 in primary hyperparathyroidism. Endocrine 80, 183–190 (2023). https://doi.org/10.1007/s12020-022-03265-8

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