Vitamin D deficiency and parathyroid hormone levels following renal transplantation in children

Objective To quantify how frequently intraoperative parathyroid hormone levels increase during thyroid surgery and to explore a possible relationship between secondary hyperparathyroidism due to vitamin D deficiency and elevation in intraoperative parathyroid hormone. Study Design Case series with chart review. Setting Tertiary academic center. Subjects and Methods A total of 428 consecutive patients undergoing completion and total thyroidectomy by the senior author over a 7-year period were included for analysis. All patients had baseline and postexcision intraoperative parathyroid hormone levels as well as vitamin D levels from the same laboratory. Institute of Medicine criteria were employed for vitamin D stratification (>30, normal; 20-29.9, insufficient; <20, deficient) . Other data analyzed include sex, age, neck dissection status, and parathyroid autotransplantation. Results A total of 118 patients (27.6%) had an intraoperative parathyroid hormone elevation above baseline. Patients with vitamin D deficiency were significantly more likely to experience hormone elevation ( P = .04). When parathyroid hormone rose, it did so by a mean 32.1 pg/mL. Patients with vitamin D deficiency demonstrated significantly larger hormone increases ( P = .03). Conclusion Elevation in intraoperative parathyroid hormone levels above baseline after completion and total thyroidectomy occurs in over one-fourth of cases and is significantly associated with vitamin D deficiency. This study is the first to report this observation. We hypothesize that vitamin D deficiency in these patients may create a subclinical secondary hyperparathyroidism that leads to intraoperative parathyroid hormone elevation when the glands are manipulated. Additional studies will be needed to explore this physiologic mechanism and its clinical significance.

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SERUM PARATHYROID HORMONE LEVELS IN ACQUIRED VITAMIN D DEFICIENCY OF INFANCY

PEDIATRICS ◽

10.1542/peds.49.6.837 ◽

1972 ◽

Vol 49 (6) ◽

pp. 837-840

Author(s):

Claude Arnaud ◽

Francis Glorieux ◽

Charles R. Scriver

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Deficiency Syndrome ◽

Renal Abnormality ◽

Hormone Levels ◽

Renal Tubular Reabsorption ◽

Advanced Stages ◽

Renal Tubular ◽

Immunoreactive Parathyroid Hormone

The later stages of the vitamin D deficiency syndrome during infancy are associated with impaired renal tubular reabsorption of amino acids, phosphate, and other metabolites. Secondary hyperparathyroidism has been implicated as the cause of the renal abnormality. Serum immunoreactive parathyroid hormone levels are elevated in infants with vitamin D deficiency (60 to 238 µl Eq/ml; normal < 40 µl q/ml). The highest levels were found in the more advanced stages of vitamin D deficiency.

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Screening for Vitamin D Deficiency in Black Americans: Comparison of Total, Free, Bioavailable 25 Hydroxy Vitamin D Levels with Parathyroid Hormone Levels and Bone Mineral Density

The journal of nutrition health & aging ◽

10.1007/s12603-018-1080-y ◽

2018 ◽

Vol 22 (9) ◽

pp. 1045-1050 ◽

Cited By ~ 2

Author(s):

Alexis McKee ◽

S. M. Lima Ribeiro ◽

T. K. Malmstrom ◽

H. M. Perry ◽

D. K. Miller ◽

...

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Bone Mineral ◽

Black Americans ◽

Mineral Density ◽

Hormone Levels ◽

Vitamin D Levels ◽

25 Hydroxy Vitamin D

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Preventive Effects of Low Parathyroid Hormone Levels on Hip Fracture in Patients with Vitamin D Deficiency

Journal of Bone Metabolism ◽

10.11005/jbm.2019.26.2.89 ◽

2019 ◽

Vol 26 (2) ◽

pp. 89 ◽

Cited By ~ 2

Author(s):

Seong-Eun Byun ◽

Soonchul Lee ◽

Ji Wan Kim ◽

Yong-Chan Ha ◽

Chul-Ho Kim ◽

...

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Hip Fracture ◽

Vitamin D Deficiency ◽

Hormone Levels ◽

Preventive Effects

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Clinical evaluation of two parathyroid hormone assays in the context of vitamin D supply in chronic kidney disease

Orvosi Hetilap ◽

10.1556/oh.2013.29784 ◽

2013 ◽

Vol 154 (51) ◽

pp. 2025-2036

Author(s):

László Kovács ◽

Éva Virágh ◽

Dóra Balogh ◽

Bernadette Kálmán ◽

Zoltán Lőcsei ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Vitamin D ◽

Renal Failure ◽

Peritoneal Dialysis ◽

Parathyroid Hormone ◽

Chronic Renal Failure ◽

Vitamin D Deficiency ◽

Intact Parathyroid Hormone ◽

Hormone Levels ◽

The Difference

Introduction: Parathyroid hormone levels provide important information in chronic renal failure. Aim: To compare parathyroid hormone levels measured by two assays in correlation with vitamin D supply. Method: Parathyroid hormone and 25-hydroxi-vitamin-D were determined in 104 patients (31 patients with chronic renal failure without renal replacement therapy, 36 patients treated with peritoneal dialysis and 37 patients treated with hemodialysis). Results: Good correlation was found between results of the two parathyroid hormone methods, but the intact parathyroid hormone levels were higher than the biointact values. 87% and 13% of the patients had vitamin-D deficiency and insufficiency, respectively. The frequency of serious vitamin-D deficiency was higher in the peritoneal dialysis than in the hemodialysis group. Intact parathyroid hormone levels were different in dialysed patients having vitamin-D-deficiency and insufficiency, and the difference was higher for the biointact than intact values. Negative correlation was detected between biointact parathyroid hormone and 25-hydroxivitamin-D in the hemodialysis group. Conclusions: Biointact parathyroid hormone levels better reflect the vitamin D supply and bone metabolism than intact levels, especially in hemodialysed patients. Orv. Hetil., 2013, 154(51), 2025–2036.

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1323 ELEVATED PARATHYROID HORMONE LEVELS IN NORMOCALCEMIC HYPERCALCIURIC PATIENTS PREDICTS VITAMIN D DEFICIENCY

The Journal of Urology ◽

10.1016/j.juro.2010.02.908 ◽

2010 ◽

Vol 183 (4S) ◽

Author(s):

Gyan Pareek ◽

Liza Aguiar ◽

Michael Lasser ◽

George Haleblian ◽

Jack Monchik

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Hormone Levels

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Biochemical changes associated with temporomandibular disorders

Journal of International Medical Research ◽

10.1177/0300060518811009 ◽

2018 ◽

Vol 47 (2) ◽

pp. 765-771 ◽

Cited By ~ 3

Author(s):

Canser Yilmaz Demir ◽

Muhammet Eren Ersoz

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Temporomandibular Disorders ◽

Group Differences ◽

Hormone Levels ◽

Vitamin D Levels ◽

Calcium Magnesium ◽

25 Oh Vitamin D ◽

The Impact

Objective To assess vitamin D, parathyroid hormone, calcitonin, calcium, phosphorus and magnesium levels in patients with versus without temporomandibular disorders (TMDs). Methods This prospective observational study included patients with TMDs and age-matched healthy controls. TMDs were diagnosed via physical and radiologic examination, and serum levels of 25 (OH) vitamin D, parathyroid hormone, calcitonin, calcium, magnesium, and phosphorus were determined. The impact of age, sex and seasonal variations in serum 25 (OH) vitamin D levels was controlled by the inclusion of age, sex and date-matched control patients. Results The study included 100 patients, comprising 50 patients with TMDs and 50 control patients. No statistically significant between-group differences were found regarding age or sex. No statistically significant between-group differences were found in terms of serum 25 (OH) vitamin D, calcitonin, calcium, magnesium or phosphorus levels. Parathyroid hormone levels were statistically significantly higher in patients with TMDs versus healthy control patients. Conclusion In patients with temporomandibular disorders, increased parathyroid hormone levels in response to vitamin D deficiency was significantly more prominent. These data suggest that, in patients with temporomandibular disorders, vitamin D deficiency should be assessed and corrected.

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Serum 25- OH Vitamin D and Parathyroid Hormone Levels in Beta Thalassemia Patients

Blood ◽

10.1182/blood.v126.23.4574.4574 ◽

2015 ◽

Vol 126 (23) ◽

pp. 4574-4574 ◽

Cited By ~ 1

Author(s):

Emine Türkkan ◽

Burcu Tufan Tas ◽

Suheyla Ocak

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Patient Group ◽

Healthy People ◽

Beta Thalassemia ◽

Control Group ◽

Hormone Levels ◽

Vitamin D Levels ◽

25 Oh Vitamin D

Abstract Introduction: The survival of the patients with thalassemia has progressively improved with advances in therapy, however, increased survival allowed for several complications of disease. Metabolism of vitamin D affected in patients with thalassemia, due to accumulation of iron in the liver as the skin. The aim of this study is to compare vitamin D and parathyroid hormone (PTH) levels between patients with thalassemia and healthy control group. Methods: In pediatric hematology clinic, 33 patients (23 male, 10 female) with beta thalassemia major and 33 age-sex matched healthy people as a control group were included. Serum 25- OH Vitamin D levels were defined as normal >30 ng/ml, insufficiency between 20-30 ng/ml and deficiency < 20 ng/ml and PTH levels as normal between 10-65 pg/ml, decreased <10 pg/ml, and increased >65 pg/ml. Results: Mean age was 23.02+8.18 years old in patient group and 23+ 8.16 in control group. %33.3 of the patients had 25-OH vitamin D insufficiency and %30.3 of had 25-OH vitamin D deficiency. In different studies, the 25-OH vitamin D deficiency found between %12-90, and insufficiency between % 24.7-69.8 of the thalassemic patients. %81.8 of the patients had normal PTH levels, %18.2 decreased and none of the patients were found increased. In literature, there were confluent results about PTH levels in thalassemic patients, some of the studies showed hypoparathyroidism, and some of hyperparathyroidism or normal levels of PTH (Vogiatzi Br J Haematol 2009, Moulas Acta Paediatrica 1997, Merchant Indian J Pediatr 2011). In our study we couldn't show hyperparathyroidism in patient group. Also we found parathyroid hormone levels were significantly lower (p<0.001), while 25-OH vitamin D levels were significantly higher (p<0.05), in patients with thalassemia than in control group. This result was interestingly showed that, normal population in our country may be low levels of vitamin D. So we need more studies about PTH and vitamin D levels of healthy people, not only thalassemic patients in our country. Disclosures No relevant conflicts of interest to declare.

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