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Effect on bone density of postoperative calcium and vitamin-D supplementation in patients with primary hyperparathyroidism: A retrospective study

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Abstract

Background

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.

Patients/Methods

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.

Results

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.

Conclusion

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.

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Authors and Affiliations

  1. Department of Surgery, Lund University Hospital, 221-85, Lund, Sweden

    Erik Nordenström, Johan Westerdahl & Anders Bergenfelz

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  1. Erik Nordenström
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  2. Johan Westerdahl
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  3. Anders Bergenfelz
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Correspondence to Erik Nordenström.

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Nordenström, E., Westerdahl, J. & Bergenfelz, A. Effect on bone density of postoperative calcium and vitamin-D supplementation in patients with primary hyperparathyroidism: A retrospective study. Langenbecks Arch Surg 394, 461–467 (2009). https://doi.org/10.1007/s00423-008-0350-2

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  • DOI: https://doi.org/10.1007/s00423-008-0350-2

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