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Low vitamin D levels have become less common in primary hyperparathyroidism

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Abstract

Summary

We compared temporal trends in serum 25-hydroxyvitamin D and parathyroid hormone (PTH) in two primary hyperparathyroidism (PHPT) cohorts recruited 20 years apart. The prevalence of 25-hydroxyvitamin D levels <20 and <30 ng/mL declined by 30–50 %, respectively, and was accompanied by lower PTH. In the older cohort, higher PTH may be due to lower 25-hydroxyvitamin D.

Introduction

Vitamin D deficiency may exacerbate PHPT. Whether there have been temporal trends in 25-hydroxyvitamin D (25OHD) levels in PHPT is unclear. The prevalence of low vitamin D levels (25OHD <20 and <30 ng/mL) and associated biochemical and bone mineral density (BMD) profiles were assessed in two PHPT cohorts recruited over 20 years apart.

Methods

This is a cross-sectional comparison of serum 25OHD levels, calciotropic hormones, and BMD between two PHPT cohorts recruited at the same hospital: the “old” (N = 103) and “new” (N = 100) cohorts were enrolled between 1984 and 1991 and between 2010 and 2014, respectively.

Results

Mean 25OHD levels were 26 % higher in the new cohort (23 ± 10 vs. 29 ± 10 ng/mL, p < 0.0001). Levels of 25OHD <20 and <30 ng/mL declined from 46 and 82 %, respectively, to 19 and 54 % (both p < 0.0001). Supplemental vitamin D use was common in the new (64 %) but not the old cohort (0 %). The new cohort demonstrated 33 % lower serum PTH levels (p < 0.0001). Neither serum nor urine calcium differed. BMD was higher in the new cohort at all skeletal sites (all p < 0.001).

Conclusion

With the rise in vitamin D supplementation over the last two decades, low 25OHD levels are no longer common in PHPT patients in the New York area. Those with 25OHD <20 and <30 ng/mL have declined by over 50 and 30 %, respectively. The lower mean PTH levels in the new cohort are most likely accounted for by higher vitamin D intake. Whether improved vitamin D status also underlies the relatively higher BMD in the more vitamin D replete cohort of PHPT patients is unknown.

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Funding sources

This work was supported by NIH grants R01 DK084986, K24 DK074457, R01 32333, as well as the Joseph Weintraub Family Foundation.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, PH 8 West – 864, New York, NY, 10032, USA

    M. D. Walker, E. Cong, A. Kepley, C. Zhang, D. J. McMahon, J. P. Bilezikian & S. J. Silverberg

  2. Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA

    J. A. Lee

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  1. M. D. Walker
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  2. E. Cong
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  3. J. A. Lee
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  6. D. J. McMahon
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  7. J. P. Bilezikian
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  8. S. J. Silverberg
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Correspondence to M. D. Walker.

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Walker, M.D., Cong, E., Lee, J.A. et al. Low vitamin D levels have become less common in primary hyperparathyroidism. Osteoporos Int 26, 2837–2843 (2015). https://doi.org/10.1007/s00198-015-3199-6

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  • DOI: https://doi.org/10.1007/s00198-015-3199-6

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