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Impact of vitamin D deficiency on the clinical and biochemical phenotype in women with sporadic primary hyperparathyroidism

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Abstract

The purpose of the study was to evaluate the relationship between serum 25(OH)D and the clinical phenotype in 215 consecutive Italian Caucasian women with sporadic primary hyperparathyroidism (PHPT) not taking vitamin D supplements. The study was performed at a single Italian tertiary center. PHPT-related manifestations, serum 25(OH)D, and other parameters of calcium metabolism and bone mineral density (BMD) by DXA were recorded. Serum 25(OH)D was negatively correlated with age (r = −0.18; P = 0.006), BMI (r = −0.20; P = 0.002), PTH (r = −0.21; P = 0.001), bone-specific alkaline phosphatase (BSAP) (r = −0.27; P < 0.001), and eGFR (r = −0.22; P = 0.01), and positively with serum creatinine and 1/3 distal radius BMD (R-BMD; r = 0.17; P = 0.015). In a multivariate regression analysis, serum 25(OH)D remained significantly correlated with age (r = −0.18; P = 0.005), BMI (r = −0.23; P = 0.049), serum PTH (r = −0.01; P = 0.023), BSAP (r = −0.01; P = 0.023) and eGFR (r = −0.09; P = 0.001), but not with R-BMD. Serum 25(OHD) was higher in patients with nephrolithiasis than in those without nephrolithiasis (18.5 ± 8.8 vs. 15.6 ± 8.0 ng/ml; P = 0.029), whereas no difference was found between fractured and unfractured patients (16.8 ± 9.3 vs. 16.0 ± 7.7; P = 0.663). There was a statistically significant inverse correlation between vitamin D status [defined by quartiles of measured values as well as commonly accepted cutoffs of serum 25(OH)D] and severity of the disease, as reflected by higher PTH and BSAP, but not by meeting the latest guidelines for parathyroidectomy. In conclusion, a low vitamin D status is associated with some features reflecting a more severe biochemical and clinical phenotype of PHPT in Italian women not taking vitamin D supplements.

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Acknowledgments

The authors thank Drs. Chiara Banti and Federica Saponaro for their work collecting some clinical data used in this study.

Authors’ contributions

Giuseppe Viccica contributed in design, acquisition of data, data analysis, and interpretation. Filomena Cetani contributed in acquisition of data and manuscript revision. Edda Vignali contributed in acquisition of data and manuscript revision. Mario Miccoli contributed in analysis of data and manuscript revision. Claudio Marcocci contributed in design, interpretation of data and manuscript drafting.

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This study did not receive any specific grant or fellowship from any funding agency in the public, commercial or not-for-profit sector.

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Correspondence to Claudio Marcocci.

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Viccica, G., Cetani, F., Vignali, E. et al. Impact of vitamin D deficiency on the clinical and biochemical phenotype in women with sporadic primary hyperparathyroidism. Endocrine 55, 256–265 (2017). https://doi.org/10.1007/s12020-016-0931-8

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