Abstract
Background
Endocrine regulation of bone metabolisms is the focus of the “Skeletal Endocrinology” series of meetings.
Aims
To report on the outcome of the discussion on the role of vitamin D/PTH axis in endocrine osteopathies held during the 10th Skeletal Endocrinology Meeting which took place in Stresa (Italy) in March 2023.
Outcomes
Vitamin D/PTH axis has relevant influence on several outcomes in the general population and in patients affected by endocrinopathies such as hypoparathyroidism and secreting pituitary adenomas.
Conclusions
Assessing the status of the vitamin D/PTH axis and using vitamin D and PTH as therapeutic agents is mandatory in several endocrine-related bone metabolic conditions.
Similar content being viewed by others
References
E. Canalis, J.P. Bilezikian, A. Angeli, A. Giustina, Perspectives on glucocorticoid-induced osteoporosis. Bone 34(4), 593–598 (2004). https://doi.org/10.1016/j.bone.2003.11.026
G. Mazziotti, J.P. Bilezikian, E. Canalis, D. Cocchi, A. Giustina, New understanding and treatments for osteoporosis. Endocrine 41(1), 58–69 (2012). https://doi.org/10.1007/s12020-011-9570-2
R. Bouillon, C. Marcocci, G. Carmeliet et al. Skeletal and extraskeletal actions of vitamin D: Current evidence and outstanding questions. Endocr. Rev. 40(4), 1109–1151 (2019). https://doi.org/10.1210/er.2018-00126
A. Giustina, R. Bouillon, N. Binkley et al. Controversies in vitamin D: A statement from the third international conference. JBMR 4(12), e10417 (2020). https://doi.org/10.1002/jbm4.10417
A. Giustina, M. Lazaretti-Castro, A.R. Martineau, R.S. Mason, C.J. Rosen, I. Schoenmakers, A view on vitamin D: a pleiotropic factor?. Nat. Rev. Endocrinol. 20(Jan 4), 202–208 (2024). https://doi.org/10.1038/s41574-023-00942-0
A. Cui, P. Xiao, Y. Ma et al. Prevalence, trend, and predictor analyses of vitamin D deficiency in the US population, 2001-2018. Front Nutr. 9, 965376 (2022). https://doi.org/10.3389/fnut.2022.965376
P.R. Ebeling, R.A. Adler, G. Jones, et al. MANAGEMENT OF ENDOCRINE DISEASE: Therapeutics of Vitamin D. Eur. J. Endocrinol. 179(Oct 5), R239–R259 (2018). https://doi.org/10.1530/EJE-18-0151
C.T. Sempos, A.C. Heijboer, D.D. Bikle, et al. Vitamin D assays and the definition of hypovitaminosis D: results from the First International Conference on Controversies in Vitamin D. Br. J. Clin. Pharm. 84(Oct 10), 2194–2207 (2018). https://doi.org/10.1111/bcp.13652
M.M. Mendes, A.P.O. Gomes, M.M. Araújo, A.S.G. Coelho, K.M.B. Carvalho, P.B. Botelho, Prevalence of vitamin D deficiency in South America: a systematic review and meta-analysis. Nutr. Rev. 81(10), 1290–1309 (2023). https://doi.org/10.1093/nutrit/nuad010
A. Giustina, R. Bouillon, B. Dawson-Hughes et al. Vitamin D in the older population: a consensus statement. Endocrine 79(1), 31–44 (2023). https://doi.org/10.1007/s12020-022-03208-3
L. di Filippo, R. De Lorenzo, A. Giustina, P. Rovere-Querini, C. Conte, Vitamin D in osteosarcopenic Obesity. Nutrients 14(9), 1816 (2022). https://doi.org/10.3390/nu14091816
A. Giustina, L. di Filippo, A. Allora et al. Vitamin D and malabsorptive gastrointestinal conditions: A bidirectional relationship? Rev. Endocr. Metab. Disord. 24(2), 121–138 (2023). https://doi.org/10.1007/s11154-023-09792-7
A. Giustina, L. di Filippo, A. Facciorusso et al. Vitamin D status and supplementation before and after Bariatric Surgery: Recommendations based on a systematic review and meta-analysis. Rev. Endocr. Metab. Disord. 24, 1011–1029 (2023). https://doi.org/10.1007/s11154-023-09831-3
M.D. Walker, S.J. Silverberg, Primary hyperparathyroidism. Nat. Rev. Endocrinol. 14(2), 115–125 (2018). https://doi.org/10.1038/nrendo.2017.104
J.C. Fleet, Vitamin D-mediated regulation of intestinal calcium absorption. Nutrients 14(16), 3351 (2022). https://doi.org/10.3390/nu14163351
Z. Xiang, M. Wang, C. Miao, D. Jin, H. Wang, Mechanism of calcitriol regulating parathyroid cells in secondary hyperparathyroidism. Front Pharm. 13, 1020858 (2022). https://doi.org/10.3389/fphar.2022.1020858
J.P. Bilezikian, A.M. Formenti, R.A. Adler et al. Vitamin D: Dosing, levels, form, and route of administration: Does one approach fit all? Rev. Endocr. Metab. Disord. 22(4), 1201–1218 (2021). https://doi.org/10.1007/s11154-021-09693-7
L. di Filippo, F.M. Ulivieri, R. Nuti, A. Giustina, Use of vitamin D with anti-osteoporotic drugs: are available clinical trials telling us the whole story? Endocrine 83, 342–348 (2023). https://doi.org/10.1007/s12020-023-03551-z
E. Jodar, C. Campusano, R.T. de Jongh, M.F. Holick, Calcifediol: a review of its pharmacological characteristics and clinical use in correcting vitamin D deficiency. Eur. J. Nutr. 62(4), 1579–1597 (2023). https://doi.org/10.1007/s00394-023-03103-1
R. Bouillon, D. Manousaki, C. Rosen, K. Trajanoska, F. Rivadeneira, J.B. Richards, The health effects of vitamin D supplementation: evidence from human studies. Nat. Rev. Endocrinol. 18(2), 96–110 (2022). https://doi.org/10.1038/s41574-021-00593-z
J.P. Sutherland, A. Zhou, E. Hyppönen, Vitamin D deficiency increases mortality risk in the UK biobank : A nonlinear Mendelian randomization study. Ann. Intern Med 175(11), 1552–1559 (2022). https://doi.org/10.7326/M21-3324
A.G. Pittas, T. Kawahara, R. Jorde et al. Vitamin D and risk for type 2 diabetes in people with prediabetes : A systematic review and meta-analysis of individual participant data from 3 randomized clinical trials. Ann. Intern Med 176(3), 355–363 (2023). https://doi.org/10.7326/M22-3018
J.P. Bilezikian, N. Binkley, H.F. De Luca et al. Consensus and controversial aspects of vitamin D and COVID-19. J. Clin. Endocrinol. Metab. 108(5), 1034–1042 (2023). https://doi.org/10.1210/clinem/dgac719
M. Puig-Domingo, M. Marazuela, B.O. Yildiz, A. Giustina, COVID-19 and endocrine and metabolic diseases. An updated statement from the European Society of Endocrinology. Endocrine 72, 301–316 (2021). https://doi.org/10.1007/s12020-021-02734-w
L. di Filippo, S. Frara, M. Doga, A. Giustina, The osteo-metabolic phenotype of COVID-19: an update. Endocrine 78(2), 247–254 (2022). https://doi.org/10.1007/s12020-022-03135-3
L. di Filippo, M. Uygur, M. Locatelli, F. Nannipieri, S. Frara, A. Giustina, Low vitamin D levels predict outcomes of COVID-19 in patients with both severe and non-severe disease at hospitalization. Endocrine 80(3), 669–683 (2023). https://doi.org/10.1007/s12020-023-03331-9
L. di Filippo, S. Frara, F. Nannipieri et al. Low vitamin D levels are associated with Long COVID syndrome in COVID-19 survivors. J. Clin. Endocrinol. Metab. 108, dgad207 (2023). https://doi.org/10.1210/clinem/dgad207
L. di Filippo, S. Frara, U. Terenzi et al. Lack of vitamin D predicts impaired long-term immune response to COVID-19 vaccination. Endocrine 82, 536–541 (2023). https://doi.org/10.1007/s12020-023-03481-w
A. Giustina, Vitamin D at the crossroad of prediabetes, sarcopenia, and risk of falls. Lancet Healthy Longev. Published online February 29, 2024 https://doi.org/10.1016/S2666-7568(24)00032-1
J. Hahn, N.R. Cook, E.K. Alexander et al. Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial. BMJ 376, e066452 (2022). https://doi.org/10.1136/bmj-2021-066452
K. H. Costenbader, N. R. Cook, I. Lee et al. Vitamin D and Marine n-3 Fatty Acids for Autoimmune Disease Prevention: Outcomes Two Years After Completion of a Double-Blind, Placebo-Controlled Trial. Arthritis Rheumatol. 2024 https://doi.org/10.1002/art.42811
J.P. Bilezikian, Hypoparathyroidism. J. Clin. Endocrinol. Metab. 105(6), 1722–1736 (2020). https://doi.org/10.1210/clinem/dgaa113
A.A. Khan, G. Guyatt, D.S. Ali et al. Management of Hypoparathyroidism. J. Bone Min. Res 37(12), 2663–2677 (2022). https://doi.org/10.1002/jbmr.4716
S. K. Hans, S. N. Levine, Hypoparathyroidism. In: StatPearls [Internet]. (Treasure Island (FL): StatPearls Publishing, 2022)
B.C. Silva, J.P. Bilezikian, Skeletal abnormalities in hypoparathyroidism and in primary hyperparathyroidism. Rev. Endocr. Metab. Disord. 22(4), 789–802 (2021). https://doi.org/10.1007/s11154-020-09614-0
A.M. Formenti, F. Tecilazich, R. Giubbini, A. Giustina, Risk of vertebral fractures in hypoparathyroidism. Rev. Endocr. Metab. Disord. 20(3), 295–302 (2019). https://doi.org/10.1007/s11154-019-09507-x
R. Pal, S.K. Bhadada, S. Mukherjee, M. Banerjee, A. Kumar, Fracture risk in hypoparathyroidism: a systematic review and meta-analysis. Osteoporos. Int 32(11), 2145–2153 (2021). https://doi.org/10.1007/s00198-021-05966-8
C. Cipriani, S. Minisola, J.P. Bilezikian et al. Vertebral fracture assessment in postmenopausal women with postsurgical hypoparathyroidism. J. Clin. Endocrinol. Metab. 106(5), 1303–1311 (2021). https://doi.org/10.1210/clinem/dgab076
E.O. Gosmanova, P. Houillier, L. Rejnmark, C. Marelli, J.P. Bilezikian, Renal complications in patients with chronic hypoparathyroidism on conventional therapy: a systematic literature review : Renal disease in chronic hypoparathyroidism. Rev. Endocr. Metab. Disord. 22(2), 297–316 (2021). https://doi.org/10.1007/s11154-020-09613-1
E.O. Gosmanova, K. Chen, L. Rejnmark et al. Risk of chronic kidney disease and estimated glomerular filtration rate decline in patients with chronic hypoparathyroidism: A retrospective cohort study. Adv. Ther. 38(4), 1876–1888 (2021). https://doi.org/10.1007/s12325-021-01658-1
M. Ketteler, K. Chen, E.O. Gosmanova et al. Risk of nephrolithiasis and nephrocalcinosis in patients with chronic hypoparathyroidism: A retrospective cohort study. Adv. Ther. 38(4), 1946–1957 (2021). https://doi.org/10.1007/s12325-021-01649-2
I. Levy, C. Licht, A. Daneman, E. Sochett, J. Harrington, The impact of hypoparathyroidism treatment on the kidney in children: Long-term retrospective follow-up study. J. Clin. Endocrinol. Metab. 100(11), 4106–4113 (2015). https://doi.org/10.1210/jc.2015-2257
D.M. Mitchell, S. Regan, M.R. Cooley et al. Long-term follow-up of patients with hypoparathyroidism. J. Clin. Endocrinol. Metab. 97(12), 4507–4514 (2012). https://doi.org/10.1210/jc.2012-1808
E.O. Gosmanova, O. Ayodele, K. Chen et al. Association of calcium and phosphate levels with incident chronic kidney disease in patients with hypoparathyroidism: A Retrospective case-control study. Int J. Endocrinol. 2022, 6078881 (2022). https://doi.org/10.1155/2022/6078881
K.S. Chen, E.O. Gosmanova, G.C. Curhan et al. Five-year estimated glomerular filtration rate in patients with hypoparathyroidism treated with and without rhPTH(1-84). J. Clin. Endocrinol. Metab. 105(10), e3557–e3565 (2020). https://doi.org/10.1210/clinem/dgaa490
L. Rejnmark, O. Ayodele, A. Lax, F. Mu, E. Swallow, E.O. Gosmanova, The risk of chronic kidney disease development in adult patients with chronic hypoparathyroidism treated with rhPTH(1-84): A retrospective cohort study. Clin. Endocrinol. (Oxf.) 98(4), 496–504 (2023). https://doi.org/10.1111/cen.14813
O. Ayodele, L. Rejnmark, F. Mu et al. Five-year estimated glomerular filtration rate in adults with chronic hypoparathyroidism treated with rhPTH(1-84): A retrospective cohort study. Adv. Ther. 39(11), 5013–5024 (2022). https://doi.org/10.1007/s12325-022-02292-1
F. Tecilazich, A.M. Formenti, S. Frara, R. Giubbini, A. Giustina, Treatment of hypoparathyroidism. Best. Pr. Res Clin. Endocrinol. Metab. 32(6), 955–964 (2018). https://doi.org/10.1016/j.beem.2018.12.002
L. Yao, J. Li, M. Li et al. Parathyroid hormone therapy for managing chronic hypoparathyroidism: A systematic review and meta-analysis. J. Bone Min. Res 37(12), 2654–2662 (2022). https://doi.org/10.1002/jbmr.4676
A.A. Khan, J.P. Bilezikian, M.L. Brandi, B.L. Clarke, J.J. Potts, M. Mannstadt, The Second international workshop on the evaluation and management of hypoparathyroidism. J. Bone Min. Res 37(12), 2566–2567 (2022). https://doi.org/10.1002/jbmr.4671
L. Yao, X. Hui, M. Li et al. Complications, symptoms, presurgical predictors in patients with chronic hypoparathyroidism: A systematic review. J. Bone Min. Res 37(12), 2642–2653 (2022). https://doi.org/10.1002/jbmr.4673
S. Van Uum, M. Shrayyef, I. M’Hiri et al. Initial assessment and monitoring of patients with chronic hypoparathyroidism: A systematic current practice survey. J. Bone Min. Res 37(12), 2630–2641 (2022). https://doi.org/10.1002/jbmr.4698
A.A. Khan, J.P. Bilezikian, M.L. Brandi et al. Evaluation and management of hypoparathyroidism summary statement and guidelines from the second international workshop. J. Bone Min. Res 37(12), 2568–2585 (2022). https://doi.org/10.1002/jbmr.4691
L. Yao, G. Guyatt, Z. Ye et al. Methodology for the guidelines on evaluation and management of hypoparathyroidism and primary hyperparathyroidism. J. Bone Min. Res 37(11), 2404–2410 (2022). https://doi.org/10.1002/jbmr.4687
A.M. Formenti, F. Tecilazich, S. Frara, R. Giubbini, H. De Luca, A. Giustina, Body mass index predicts resistance to active vitamin D in patients with hypoparathyroidism. Endocrine 66(3), 699–700 (2019). https://doi.org/10.1007/s12020-019-02105-6
A.A. Khan, C.A. Koch, S. Van Uum et al. Standards of care for hypoparathyroidism in adults: A Canadian and International Consensus. Eur. J. Endocrinol. 180(3), P1–P22 (2019). https://doi.org/10.1530/EJE-18-0609
N.B. Watts, J.P. Bilezikian, H.G. Bone et al. Long-term safety and efficacy of recombinant human parathyroid hormone (1-84) in adults with chronic hypoparathyroidism. J. Endocr. Soc. 7(5), bvad043 (2023). https://doi.org/10.1210/jendso/bvad043
S. Agarwal, D.J. McMahon, J. Chen et al. The clinical and skeletal effects of long-term therapy of hypoparathyroidism with rhPTH(1-84). J. Bone Min. Res 38(4), 480–492 (2023). https://doi.org/10.1002/jbmr.4780
A.A. Khan, L. Rejnmark, M. Rubin et al. PaTH forward: A randomized, double-blind, placebo-controlled phase 2 trial of TransCon PTH in adult hypoparathyroidism. J. Clin. Endocrinol. Metab. 107(1), e372–e385 (2022). https://doi.org/10.1210/clinem/dgab577
A.A. Khan, M.R. Rubin, P. Schwarz et al. Efficacy and safety of parathyroid hormone replacement with TransCon PTH in hypoparathyroidism: 26-week results from the phase 3 PaTHway Trial. J. Bone Min. Res 38(1), 14–25 (2023). https://doi.org/10.1002/jbmr.4726
H. Noda, M. Okazaki, E. Joyashiki et al. Optimization of PTH/PTHrP hybrid peptides to derive a long-acting PTH analog (LA-PTH). JBMR 4(7), e10367 (2020). https://doi.org/10.1002/jbm4.10367
R. Bi, Y. Fan, K. Lauter et al. Diphtheria Toxin- and GFP-based mouse models of acquired hypoparathyroidism and treatment with a long-acting parathyroid hormone analog. J. Bone Min. Res 31(5), 975–984 (2016). https://doi.org/10.1002/jbmr.2769
M. Shimizu, E. Joyashiki, H. Noda et al. Pharmacodynamic actions of a long-acting PTH analog (LA-PTH) in thyroparathyroidectomized (TPTX) rats and normal monkeys. J. Bone Min. Res 31(7), 1405–1412 (2016). https://doi.org/10.1002/jbmr.2811
P. Kamenicky, I. Takacs, E. Mezosi et al. OR23-04 treatment of chronic hypoparathyroidism with eneboparatide (AZP-3601), a novel PTH 1 receptor agonist: Results from a phase 2 trial. J. Endocr. Soc. 7(Issue Supplement_1), (2023). https://doi.org/10.1210/jendso/bvad114.562
F.M. Hannan, M.A. Nesbit, C. Zhang et al. Identification of 70 calcium-sensing receptor mutations in hyper- and hypo-calcaemic patients: evidence for clustering of extracellular domain mutations at calcium-binding sites. Hum. Mol. Genet. 2012;21(12):2768-2778 https://doi.org/10.1093/hmg/dds105
A.M. Hofer, E.M. Brown, Extracellular calcium sensing and signalling. Nat. Rev. Mol. Cell Biol. 4(7), 530–538 (2003). https://doi.org/10.1038/nrm1154
K.L. Roszko, R.D. Bi, M. Mannstadt, Autosomal dominant hypocalcemia (hypoparathyroidism) types 1 and 2. Front Physiol. 7, 458 (2016). https://doi.org/10.3389/fphys.2016.00458
K.K. Winer, B. Zhang, J.A. Shrader et al. Synthetic human parathyroid hormone 1-34 replacement therapy: A randomized crossover trial comparing pump versus injections in the treatment of chronic hypoparathyroidism. J. Clin. Endocrinol. Metab. 97, 391–399 (2012). https://doi.org/10.1210/jc.2011-1908
R.I. Gafni, L.C. Guthrie, M.H. Kelly et al. Transient increased calcium and calcitriol requirements after discontinuation of human synthetic parathyroid hormone 1-34 (hPTH 1-34) replacement therapy in hypoparathyroidism. J. Bone Min. Res 30(11), 2112–2118 (2015). https://doi.org/10.1002/jbmr.2555
M. Mannstadt, B.L. Clarke, T. Vokes et al. Efficacy and safety of recombinant human parathyroid hormone (1-84) in hypoparathyroidism (REPLACE): a double-blind, placebo-controlled, randomised, phase 3 study. Lancet Diabetes Endocrinol. 1(4), 275–283 (2013). https://doi.org/10.1016/S2213-8587(13)70106-2
B. Dong, I. Endo, Y. Ohnishi et al. Calcilytic ameliorates abnormalities of mutant calcium-sensing receptor (CaSR) knock-in mice mimicking autosomal dominant hypocalcemia (ADH). J. Bone Min. Res 30(11), 1980–1993 (2015). https://doi.org/10.1002/jbmr.2551
F.M. Hannan, G.V. Walls, V.N. Babinsky et al. The calcilytic agent NPS 2143 rectifies hypocalcemia in a mouse model with an activating calcium-sensing receptor (CaSR) Mutation: Relevance to autosomal dominant hypocalcemia type 1 (ADH1). Endocrinology 156(9), 3114–3121 (2015). https://doi.org/10.1210/en.2015-1269
M.S. Roberts, R.I. Gafni, B. Brillante et al. Treatment of autosomal dominant hypocalcemia type 1 with the calcilytic NPSP795 (SHP635). J. Bone Min. Res 34(9), 1609–1618 (2019). https://doi.org/10.1002/jbmr.3747
M. Collins, I. Hartley, S. Adler et al. Encaleret (CLTX-305) normalized mineral homeostasis parameters in patients with autosomal dominant hypocalcemia type 1: Results over 12 months in a phase 2 study (NCT04581629). Endocrine Abstracts. 90 RC8.4 (2023). https://doi.org/10.1530/endoabs.90.RC8.4
G. Mazziotti, S. Frara, A. Giustina, Pituitary diseases and bone. Endocr Rev. 39(4), 440–488 (2018). https://doi.org/10.1210/er.2018-00005
G. Mazziotti, T. Porcelli, M. Mormando et al. Vertebral fractures in males with prolactinoma. Endocrine 39(3), 288–293 (2011). https://doi.org/10.1007/s12020-011-9462-5
G. Mazziotti, T. Mancini, M. Mormando et al. High prevalence of radiological vertebral fractures in women with prolactin-secreting pituitary adenomas. Pituitary 14(4), 299–306 (2011). https://doi.org/10.1007/s11102-011-0293-4
L. di Filippo, M. Doga, E. Resmini, A. Giustina, Hyperprolactinemia and bone. Pituitary 23(3), 314–321 (2020). https://doi.org/10.1007/s11102-020-01041-3
G. Mazziotti, T. Porcelli, I. Patelli, P.P. Vescovi, A. Giustina, Serum TSH values and risk of vertebral fractures in euthyroid post-menopausal women with low bone mineral density. Bone 46(3), 747–751 (2010). https://doi.org/10.1016/j.bone.2009.10.031
S. Frara, M. Losa, M. Doga et al. High prevalence of radiological vertebral fractures in patients with TSH-secreting pituitary adenoma. J. Endocr. Soc 2(9), 1089–1099 (2018). https://doi.org/10.1210/js.2018-00091
S. Melmed, U.B. Kaiser, M.B. Lopes et al. Clinical Biology of the Pituitary Adenoma. Endocr. Rev. 43(6), 1003–1037 (2022). https://doi.org/10.1210/endrev/bnac010
S. Frara, A. Allora, L. di Filippo et al. Osteopathy in mild adrenal Cushing’s syndrome and Cushing disease. Best. Pr. Res Clin. Endocrinol. Metab. 35(2), 101515 (2021). https://doi.org/10.1016/j.beem.2021.101515
M. Fleseriu, R. Auchus, I. Bancos et al. Consensus on diagnosis and management of Cushing’s disease: a guideline update. Lancet Diabetes Endocrinol. 9(12), 847–875 (2021). https://doi.org/10.1016/S2213-8587(21)00235-7
A. Giustina, W.B. Wehrenberg, The role of glucocorticoids in the regulation of Growth Hormone secretion: mechanisms and clinical significance. Trends Endocrinol. Metab. 3(Oct 8), 306–311 (1992). https://doi.org/10.1016/1043-2760(92)90142-n
A. Giustina, A.R. Bussi, C. Jacobello, W.B. Wehrenberg, Effects of recombinant human growth hormone (GH) on bone and intermediary metabolism in patients receiving chronic glucocorticoid treatment with suppressed endogenous GH response to GH releasing hormone. J Clin Endocrinol Metab. 80(1), 122–129 (1995). https://doi.org/10.1210/jcem.80.1.7829600
G. Mazziotti, A.M. Formenti, S. Frara et al. MANAGEMENT OF ENDOCRINE DISEASE: Risk of overtreatment in patients with adrenal insufficiency: current and emerging aspects. Eur. J. Endocrinol. 177(5), R231–R248 (2017). https://doi.org/10.1530/EJE-17-0154
G. Mazziotti, A.M. Formenti, R.A. Adler et al. Glucocorticoid-induced osteoporosis: pathophysiological role of GH/IGF-I and PTH/VITAMIN D axes, treatment options and guidelines. Endocrine 54(3), 603–611 (2016). https://doi.org/10.1007/s12020-016-1146-8
Z.E. Davidson, K.Z. Walker, H. Truby, Clinical review: Do glucocorticosteroids alter vitamin D status? A systematic review with meta-analyses of observational studies. J. Clin. Endocrinol. Metab. 97(3), 738–744 (2012). https://doi.org/10.1210/jc.2011-2757
A.L. Skversky, J. Kumar, M.K. Abramowitz, F.J. Kaskel, M.L. Melamed, Association of glucocorticoid use and low 25-hydroxyvitamin D levels: results from the National Health and Nutrition Examination Survey (NHANES): 2001-2006. J. Clin. Endocrinol. Metab. 96(12), 3838–3845 (2011). https://doi.org/10.1210/jc.2011-1600
A.A. Hidalgo, D.L. Trump, C.S. Johnson, Glucocorticoid regulation of the vitamin D receptor. J. Steroid Biochem Mol. Biol. 121(1-2), 372–375 (2010). https://doi.org/10.1016/j.jsbmb.2010.03.081
A.A. Hidalgo, K.K. Deeb, J.W. Pike, C.S. Johnson, D.L. Trump, Dexamethasone enhances 1alpha,25-dihydroxyvitamin D3 effects by increasing vitamin D receptor transcription. J. Biol. Chem. 286(42), 36228–36237 (2011). https://doi.org/10.1074/jbc.M111.244061
M.J. Favus, D.V. Kimberg, G.N. Millar, E. Gershon, Effects of cortisone administration on the metabolism and localization of 25-hydroxycholecalciferol in the rat. J. Clin. Invest 52(6), 1328–1335 (1973). https://doi.org/10.1172/JCI107304
V. Guarnotta, F. Di Gaudio, C. Giordano, Vitamin D deficiency in Cushing’s disease: Before and after its supplementation. Nutrients 14(5), 973 (2022). https://doi.org/10.3390/nu14050973
E. Paz-Pacheco, G.E. Fuleihan, M.S. LeBoff, Intact parathyroid hormone levels are not elevated in glucocorticoid-treated subjects. J. Bone Min. Res 10(11), 1713–1718 (1995). https://doi.org/10.1002/jbmr.5650101114
S. Bonadonna, A. Burattin, M. Nuzzo et al. Chronic glucocorticoid treatment alters spontaneous pulsatile parathyroid hormone secretory dynamics in human subjects. Eur. J. Endocrinol. 152(2), 199–205 (2005). https://doi.org/10.1530/eje.1.01841
T. Mancini, G. Mazziotti, M. Doga et al. Vertebral fractures in males with type 2 diabetes treated with rosiglitazone. Bone 45(4), 784–788 (2009). https://doi.org/10.1016/j.bone.2009.06.006
G. Mazziotti, A. Delgado, F. Maffezzoni, A. Formenti, A. Giustina, Skeletal fragility in endogenous hypercortisolism. Front Horm. Res 46, 66–73 (2016). https://doi.org/10.1159/000443866
M. Doga, G. Mazziotti, S. Bonadonna et al. Prevention and treatment of glucocorticoid-induced osteoporosis. J. Endocrinol. Invest 31(7 Suppl), 53–58 (2008)
G. Mazziotti, A. Giustina, Glucocorticoids and the regulation of growth hormone secretion. Nat. Rev. Endocrinol. 9(5), 265–276 (2013). https://doi.org/10.1038/nrendo.2013.5
A.M. Formenti, F. Maffezzoni, M. Doga, G. Mazziotti, A. Giustina, Growth hormone deficiency in treated acromegaly and active Cushing’s syndrome. Best. Pr. Res Clin. Endocrinol. Metab. 31(1), 79–90 (2017). https://doi.org/10.1016/j.beem.2017.03.002
G. Mazziotti, M. Doga, S. Frara et al. Incidence of morphometric vertebral fractures in adult patients with growth hormone deficiency. Endocrine 52(1), 103–110 (2016). https://doi.org/10.1007/s12020-015-0738-z
R. Zerlotin, A. Oranger, P. Pignataro et al. Irisin and secondary osteoporosis in humans. Int J. Mol. Sci. 23(2), 690 (2022). https://doi.org/10.3390/ijms23020690
V. Guarnotta, A. Prinzi, M. Pitrone, G. Pizzolanti, C. Giordano, Circulating irisin levels as a marker of osteosarcopenic-obesity in Cushing’s disease. Diabetes Metab. Syndr. Obes. 13, 1565–1574 (2020). https://doi.org/10.2147/DMSO.S249090
A. Bosman, A.W. van den Beld, R.A. Feelders, M.C. Zillikens, Cortisol and phosphate homeostasis: cushing’s syndrome is associated with reversible hypophosphatemia. Front Endocrinol. (Lausanne) 12, 733793 (2021). https://doi.org/10.3389/fendo.2021.733793
M.M. Uygur, S. Frara, L. di Filippo, A. Giustina, New tools for bone health assessment in secreting pituitary adenomas. Trends Endocrinol. Metab. 34(4), 231–242 (2023). https://doi.org/10.1016/j.tem.2023.01.006
T. Apaydın, D.G. Yavuz, Assessment of non-traumatic vertebral fractures in Cushing’s syndrome patients. J. Endocrinol. Invest 44(8), 1767–1773 (2021). https://doi.org/10.1007/s40618-020-01496-y
G. Zavatta, V. Vicennati, P. Altieri et al. Mild autonomous cortisol secretion in adrenal incidentalomas and risk of fragility fractures: A large cross-sectional study. Eur. J. Endocrinol. 188(4), 343–352 (2023). https://doi.org/10.1093/ejendo/lvad038
A. Radecka, A. Lubkowska, The significance of dual-energy X-ray absorptiometry (DXA) examination in cushing’s syndrome-A systematic review. Diagnostics (Basel) 13(9), 1576 (2023). https://doi.org/10.3390/diagnostics13091576
A. Nowakowska-Płaza, J. Wroński, I. Sudoł-Szopińska, P. Głuszko, Clinical utility of trabecular bone score (TBS) in fracture risk assessment of patients with rheumatic diseases treated with glucocorticoids. Horm. Metab. Res 53(8), 499–503 (2021). https://doi.org/10.1055/a-1528-7261
K.A. Lee, J. Kim, H.J. Kim, H.S. Kim, Discriminative ability of trabecular bone score over bone mineral density for vertebral and fragility fracture in patients treated with long-term and low-dose glucocorticoid. Int J. Rheum. Dis. 24(8), 1053–1060 (2021). https://doi.org/10.1111/1756-185X.14164
F. Ferraù, S. Giovinazzo, Y. Alessi et al. Trabecular bone score, bone marrow fat and vertebral fractures in cushing syndrome. Endocrine 80(2), 441–447 (2023). https://doi.org/10.1007/s12020-023-03318-6
H. Boro, V. Mannar, R. Malhotra et al. Trabecular bone score and bone mineral density as indices of skeletal fragility in endogenous Cushing’s syndrome. Clin. Endocrinol. (Oxf.) 99(3), 253–261 (2023). https://doi.org/10.1111/cen.14944
S. Frara, L. di Filippo, M. Doga, P. Loli, F.F. Casanueva, A. Giustina, Novel approaches to bone comorbidity in Cushing’s disease: An update. Pituitary 25(5), 754–759 (2022). https://doi.org/10.1007/s11102-022-01252-w
J. Deng, Z. Silver, E. Huang et al. Pharmacological prevention of fractures in patients undergoing glucocorticoid therapies: A systematic review and network meta-analysis. Rheumatol. (Oxf.) 60(2), 649–657 (2021). https://doi.org/10.1093/rheumatology/keaa228
L. Jiang, J. Dong, J. Wei, L. Liu, Comparison of denosumab and oral bisphosphonates for the treatment of glucocorticoid-induced osteoporosis: a systematic review and meta-analysis. BMC Musculoskelet. Disord. 23(1), 1027 (2022). https://doi.org/10.1186/s12891-022-05997-0
S.Y. Tamechika, S.I. Ohmura, S. Maeda, T. Naniwa, Efficacy of denosumab on bisphosphonate-treated osteoporosis and osteopenia in systemic rheumatic disease patients receiving glucocorticoids. J. Bone Min. Metab. 41(2), 203–211 (2023). https://doi.org/10.1007/s00774-022-01393-9
Z.M. Liu, M. Zhang, Y. Zong et al. The efficiency and safety of alendronate versus teriparatide for treatment glucocorticoid-induced osteoporosis: A meta-analysis and systematic review of randomized controlled trials. PLoS One 17(5), e0267706 (2022). https://doi.org/10.1371/journal.pone.0267706
B. Dong, Y. Zhou, J. Wang et al. Comparison of bisphosphonates versus teriparatide in therapy of the glucocorticoid-induced osteoporosis (GIOP): A meta-analysis of randomized controlled trials. Horm. Metab. Res 55(4), 236–244 (2023). https://doi.org/10.1055/a-2015-1747
A. Giustina, G. Mazziotti, E. Canalis, Growth hormone, insulin-like growth factors, and the skeleton. Endocr. Rev. 29(5), 535–559 (2008). https://doi.org/10.1210/er.2007-0036
A. Giustina, Acromegaly and Vertebral Fractures: Facts and Questions. Trends Endocrinol. Metab. 31(4), 274–275 (2020). https://doi.org/10.1016/j.tem.2020.01.011
A. Giustina, Acromegaly and Bone: An Update. Endocrinol Metab (Seoul). 38(6), 655–666 (2023). https://doi.org/10.3803/EnM.2023.601
H. Kwon, K.D. Han, B.S. Kim et al. Acromegaly and the long-term fracture risk of the vertebra and hip: a national cohort study. Osteoporos. Int 34(9), 1591–1600 (2023). https://doi.org/10.1007/s00198-023-06800-z
M.C. Sorohan, C. Poiana, Vertebral fractures in acromegaly: A systematic review. J. Clin. Med 12(1), 164 (2022). https://doi.org/10.3390/jcm12010164
C. Ribeiro de Moura, S. Campos Lopes, A.M. Monteiro, Determinants of skeletal fragility in acromegaly: A systematic review and meta-analysis. Pituitary 25(6), 780–794 (2022). https://doi.org/10.1007/s11102-022-01256-6
S. Chiloiro, A. Giampietro, I. Gagliardi et al. Impact of the diagnostic delay of acromegaly on bone health: data from a real life and long term follow-up experience. Pituitary 25(6), 831–841 (2022). https://doi.org/10.1007/s11102-022-01266-4
G. Mazziotti, P. Marzullo, M. Doga, G. Aimaretti, A. Giustina, Growth hormone deficiency in treated acromegaly. Trends Endocrinol. Metab. 26(1), 11–21 (2015). https://doi.org/10.1016/j.tem.2014.10.005
S. Frara, M. Melin Uygur, L. di Filippo et al. High prevalence of vertebral fractures associated with preoperative GH levels in patients with recent diagnosis of acromegaly. J. Clin. Endocrinol. Metab. 107(7), e2843–e2850 (2022). https://doi.org/10.1210/clinem/dgac183
P. Ameri, A. Giusti, M. Boschetti, G. Murialdo, F. Minuto, D. Ferone, Interactions between vitamin D and IGF-I: from physiology to clinical practice. Clin. Endocrinol. (Oxf.) 79(4), 457–463 (2013). https://doi.org/10.1111/cen.12268
J. Halupczok-Żyła, A. Jawiarczyk-Przybyłowska, M. Bolanowski, Patients with active acromegaly are at high risk of 25(OH)D deficiency. Front Endocrinol. (Lausanne) 6, 89 (2015). https://doi.org/10.3389/fendo.2015.00089
A.A. Povaliaeva, V.P. Bogdanov, A.Y. Zhukov et al. Characterization of vitamin D metabolism in active acromegaly in the setting of bolus (150,000 IU) cholecalciferol treatment. Endocrine 76(2), 407–418 (2022). https://doi.org/10.1007/s12020-022-02994-0
A.E. Altinova, C. Ozkan, M. Akturk et al. Vitamin D-binding protein and free vitamin D concentrations in acromegaly. Endocrine 52(2), 374–379 (2016). https://doi.org/10.1007/s12020-015-0789-1
G. Mazziotti, F. Maffezzoni, A. Giustina, Vitamin D-binding protein: one more piece in the puzzle of acromegalic osteopathy? Endocrine 52(2), 183–186 (2016). https://doi.org/10.1007/s12020-016-0890-0
G. Mazziotti, V. Cimino, E. De Menis et al. Active acromegaly enhances spontaneous parathyroid hormone pulsatility. Metabolism 55(6), 736–740 (2006). https://doi.org/10.1016/j.metabol.2006.01.009
F. Bioletto, M. Barale, N. Prencipe et al. Trabecular bone score as an index of bone fragility in patients with acromegaly: A systematic review and meta-analysis. Neuroendocrinology 113(4), 395–405 (2023). https://doi.org/10.1159/000528199
I. Ságová, M. Mokáň, I. Tonhajzerová, M. Rončáková, P. Vaňuga, Age, body composition parameters and glycaemic control contribute to trabecular bone score deterioration in acromegaly more than disease activity. Front Endocrinol. (Lausanne) 14, 1197725 (2023). https://doi.org/10.3389/fendo.2023.1197725
A.P. Kuker, S. Agarwal, E. Shane et al. Persistent deficits in bone quality in treated acromegaly: evidence from assessments of microstructure. J. Endocr. Soc. 7(10), bvad121 (2023). https://doi.org/10.1210/jendso/bvad121
S. Chiloiro, A. Giampietro, S. Frara et al. Effects of Pegvisomant and Pasireotide LAR on Vertebral Fractures in Acromegaly Resistant to First-generation SRLs. J. Clin. Endocrinol. Metab. 105(3), dgz054 (2020). https://doi.org/10.1210/clinem/dgz054
S. Chiloiro, G. Mazziotti, A. Giampietro et al. Effects of pegvisomant and somatostatin receptor ligands on incidence of vertebral fractures in patients with acromegaly. Pituitary 21(3), 302–308 (2018). https://doi.org/10.1007/s11102-018-0873-7
S. Chiloiro, S. Frara, I. Gagliardi et al. Cholecalciferol use is associated with a decreased risk of incident morphometric vertebral fractures in acromegaly. J. Clin. Endocrinol. Metab. 109, e58–e68 (2023). https://doi.org/10.1210/clinem/dgad493
Acknowledgements
The research activities of Luigi di Filippo are partially supported by Glucocorticoid induced Osteoporosis Skeletal Endocrinology Group (GIOSEG).
Author information
Authors and Affiliations
Contributions
Author Contributions: All authors contributed to the manuscript conception and design. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
A.G. is consultant for Abiogen Pharma S.p.A. and Takeda and received research grant to Institution from Takeda. L.di.F. received research grants to Institution from Abiogen Pharma S.p.A. J.P.B. is consultant for Abiogen Pharma S.p.A. U.T. and E.C. have no conflict of interests to declare.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
di Filippo, L., Bilezikian, J.P., Canalis, E. et al. New insights into the vitamin D/PTH axis in endocrine-driven metabolic bone diseases. Endocrine (2024). https://doi.org/10.1007/s12020-024-03784-6
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s12020-024-03784-6