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Hypovitaminosis D and secondary hyperparathyroidism in resident physicians of a general hospital in southern Brazil

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Abstract

Objectives: To evaluate the prevalence of hypovitaminosis D and secondary hyperparathyroidism in resident physicians of a general hospital in southern Brazil and identify associated factors. Design: Crosssectional study. Population: Resident physicians of Hospital de Clinicas de Porto Alegre, Porto Alegre, southern Brazil. Participants: Seventythree subjects age 26.4± 1.9. Measurements: Serum PTH, 25- hydroxyvitamin D [25(OH)D], total calcium, phosphorus, magnesium, creatinine, and alkaline phosphatase were measured. In addition calcium, creatinine, and magnesium were measured in urine. Fractional excretion of calcium and magnesium were calculated. Calcium intake was estimated by a food intake questionnaire. Results: Mean serum levels of 25(OH)D were 17.9± 8.0 ng/ml and 57.4% presented 25(OH)D below 20 ng/ml. Secondary hyperparathyroidism, defined as serum PTH ≥ 48 pg/ml and normal or low serum calcium, was identified in 39.7% of the individuals. Mean serum levels of magnesium were higher (p=0.02) and the fractional excretion of calcium was lower (p<0.001) in individuals with secondary hyperparathyroidism. Serum PTH levels were positively correlated with body mass index (r=0.33 and p=0.006) and serum magnesium levels (r=0.33 and p=0.02) and negatively correlated with serum 25(OH)D levels (r=− 0.33 and p=0.008), estimated calcium intake (r=− 0.25 and p=0.04), and fractional excretion of calcium (r=− 0.34 and p=0.009). Conclusion: Vitamin D deficiency and secondary hyperparathyroidism was very common in resident physicians. Therefore, measures to prevent this situation should be recommended.

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References

  1. Holick MF. Vitamin D deficiency. N Engl J Med 2007, 357: 266–81.

    Article  PubMed  CAS  Google Scholar 

  2. Saleh F, Jorde R, Sundsfjord J, Haug E, Figenschau Y. Causes of secondary hyperparathyroidism in a healthy population: the Tromsø study. J Bone Miner Metab 2006, 24: 58–64.

    Article  PubMed  Google Scholar 

  3. Patel S, Hyer S, Barron J. Glomerular filtration rate is a major determinant of the relationship between 25-hydroxyvitamin D and parathyroid hormone. Calcif Tissue Int 2007, 80: 221–6.

    Article  PubMed  CAS  Google Scholar 

  4. Vieth R, Ladak Y, Walfish PG. Age-related changes in the 25-hydroxyvitamin D versus parathyroid hormone relationship suggest a different reason why older adults require more vitamin D. J Clin Endocrinol Metab 2003, 88: 185–91.

    Article  PubMed  CAS  Google Scholar 

  5. Stein MS, Flicker L, Scherer SC, et al. Relationships with serum parathyroid hormone in old institutionalized subjects. Clin Endocrinol (Oxf) 2001, 54: 583–92.

    Article  CAS  Google Scholar 

  6. Lips P. Vitamin D status and nutrition in Europe and Asia. J Steroid Biochem Mol Biol 2007, 103: 620–5.

    Article  PubMed  CAS  Google Scholar 

  7. Tangpricha V, Pearce EN, Chen TC, Holick MF. Vitamin D insufficiency among free-living healthy young adults. Am J Med 2002, 112: 659–62.

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  8. Cohen JJ. Resident hours: reform is at hand. Am Fam Physician 2002, 66: 1398–400.

    PubMed  Google Scholar 

  9. Thomas NK. Resident burnout. JAMA 2004, 292: 2880–9.

    Article  PubMed  CAS  Google Scholar 

  10. Cohen JJ. Heeding the plea to deal with resident stress. Ann Intern Med 2002, 136: 394–5.

    Article  PubMed  Google Scholar 

  11. Astner S, Anderson RR. Skin phototypes 2003. J Invest Dermatol 2004, 122: xxx–xxxi.

    Article  PubMed  CAS  Google Scholar 

  12. Premaor MO, Alves GV, Crossetti LB, Furlanetto TW. Hyperparathyroidism secondary to hypovitaminosis D in hypoalbuminemic is less intense than in normoalbuminemic patients: a prevalence study in medical inpatients in southern Brazil. Endocrine 2004, 24: 47–53.

    Article  PubMed  CAS  Google Scholar 

  13. Souberbielle JC, Cormier C, Kindermans C, et al. Vitamin D status and redefining serum parathyroid hormone reference range in the elderly. J Clin Endocrinol Metab 2001, 86: 3086–90.

    PubMed  CAS  Google Scholar 

  14. Collier VU, McCue JD, Markus A, Smith L. Stress in medical residency: status quo after a decade of reform? Ann Intern Med 2002, 136: 384–90.

    Article  PubMed  Google Scholar 

  15. Alagöl F, Shihadeh Y, Boztepe H, et al. Sunlight exposure and vitamin D deficiency in Turkish women. J Endocrinol Invest 2000, 23: 173–7.

    Article  PubMed  Google Scholar 

  16. McKenna MJ. Differences in vitamin D status between countries in young adults and the elderly. Am J Med 1992, 93: 69–77.

    Article  PubMed  CAS  Google Scholar 

  17. Holick MF, Siris ES, Binkley N, et al. Prevalence of Vitamin D inadequacy among postmenopausal North American women receiving osteoporosis therapy. J Clin Endocrinol Metab 2005, 90: 3215–24.

    Article  PubMed  CAS  Google Scholar 

  18. Saraiva GL, Cendoroglo MS, Ramos LR, et al. Influence of ultraviolet radiation on the production of 25 hydroxyvitamin D in the elderly population in the city of Sao Paulo (23 degrees 34’S), Brazil. Osteoporos Int 2005, 16: 1649–54.

    Article  PubMed  CAS  Google Scholar 

  19. Fassi J, Russo Picasso MF, Furci A, Sorroche P, Jáuregui R, Plantalech L. Seasonal variations in 25-hydroxyvitamin D in young and elderly and populations in Buenos Aires City. Medicina (B Aires) 2003, 63: 215–20.

    CAS  Google Scholar 

  20. Fradinger EE, Zanchetta JR. Vitamin D status in women living in Buenos Aires. Medicina (B Aires) 1999, 59: 449–52.

    CAS  Google Scholar 

  21. Clements MR, Davies M, Hayes ME, et al. The role of 1,25-dihy-droxyvitamin D in the mechanism of acquired vitamin D deficiency. Clin Endocrinol (Oxf) 1992, 37: 17–27.

    Article  CAS  Google Scholar 

  22. Cross HS, Lipkin M, Kállay E. Nutrients regulate the colonic vitamin D system in mice: relevance for human colon malignancy. J Nutr 2006, 136: 561–4.

    PubMed  CAS  Google Scholar 

  23. Sahota O, Gaynor K, Harwood RH, Hosking DJ. Hypovitaminosis D and ‘functional hypoparathyroidism’-the NoNoF (Nottingham Neck of Femur) study. Age Ageing 2001, 30: 467–72.

    Article  PubMed  CAS  Google Scholar 

  24. Fatemi S, Ryzen E, Flores J, Endres DB, Rude RK. Effect of experimental human magnesium depletion on parathyroid hormone secretion and 1,25-dihydroxyvitamin D metabolism. J Clin Endocrinol Metab 1991, 73: 1067–72.

    Article  PubMed  CAS  Google Scholar 

  25. Sahota O, Mundey MK, San P, Godber IM, Hosking DJ. Vitamin D insufficiency and the blunted PTH response in established osteoporosis: the role of magnesium deficiency. Osteoporos Int 2006, 17: 1013–21.

    Article  PubMed  CAS  Google Scholar 

  26. Kamycheva E, Sundsfjord J, Jorde R. Serum parathyroid hormone level is associated with body mass index. The 5th Tromsø study. Eur J Endocrinol 2004, 151: 167–72.

    Article  CAS  Google Scholar 

  27. Karlsson SL, Indridason OS, Franzson L, Sigurdsson G. Prevalence of secondary hyperparathyroidism (SHPT) a d causal factors in adult population in Reykjavik area. Laeknabladid 2005, 91: 161–9.

    PubMed  Google Scholar 

  28. Carbone LD, Bush AJ, Barrow KD, Kang AH. The relationship of sodium intake to calcium and sodium excretion and bone mineral density of the hip in postmenopausal African-American and Caucasian women. J Bone Miner Metab 2003, 21: 415–20.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to M. Orlandin Premaor MD.

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Orlandin Premaor, M., Paludo, P., Manica, D. et al. Hypovitaminosis D and secondary hyperparathyroidism in resident physicians of a general hospital in southern Brazil. J Endocrinol Invest 31, 991–995 (2008). https://doi.org/10.1007/BF03345637

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