Vitamin D revisited: Individualized Vitamin D normal values according to PTH levels; incidence and treatment of Normocalcemic Hyperparathyroidism in children

Familial metaphysial dysostosis has been described as it occurred among 18 members of a family in seven generations. The roentgenologic changes were very similar to those seen in vitamin D resistant rickets. No biochemical defect could be detected. Studies of renal function with special reference to tubular reabsorption of phosphorus gave normal values. The treatment of choice is osteotomy, after epiphysial closure has occurred, to correct the pronounced bowing of the legs. Administration of vitamin D in high doses has no effect on the course of this disease.

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Vitamin D: Current Challenges between the Laboratory and Clinical Practice

Nutrients ◽

10.3390/nu13061758 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1758

Author(s):

Ludmila Máčová ◽

Marie Bičíková

Keyword(s):

Vitamin D ◽

Normal Values ◽

External Quality Assessment ◽

Healthy Population ◽

External Quality ◽

Clinical Laboratories ◽

Routine Measurement ◽

Growing Body ◽

High Degree ◽

Significant Interference

Vitamin D is a micronutrient with pleiotropic effects in humans. Due to sedentary lifestyles and increasing time spent indoors, a growing body of research is revealing that vitamin D deficiency is a global problem. Despite the routine measurement of vitamin D in clinical laboratories and many years of efforts, methods of vitamin D analysis have yet to be standardized and are burdened with significant difficulties. This review summarizes several key analytical and clinical challenges that accompany the current methods for measuring vitamin D. According to an external quality assessment, methods and laboratories still produce a high degree of variability. Structurally similar metabolites are a source of significant interference. Furthermore, there is still no consensus on the normal values of vitamin D in a healthy population. These and other problems discussed herein can be a source of inconsistency in the results of research studies.

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Vitamin D and mineral metabolism after childbirth with the use of preventive doses of cholecalciferol

Journal of obstetrics and women s diseases ◽

10.17816/jowd68545-53 ◽

2019 ◽

Vol 68 (5) ◽

pp. 45-53

Author(s):

Tatyana V. Novikova ◽

Irina E. Zazerskaya ◽

Lyubov V. Kuznetsova ◽

Ekaterina S. Shelepova ◽

Elena L. Khazova

Keyword(s):

Vitamin D ◽

Calcium Carbonate ◽

Blood Serum ◽

Vitamin D Deficiency ◽

Normal Values ◽

Vitamin D Insufficiency ◽

Phosphorus Metabolism ◽

Group I ◽

Calcium Phosphorus ◽

Pth Level

Hypothesis/aims of study. According to the literature, the prevalence of vitamin D deficiency and its deficiency in pregnant women reaches 6080%, which is a significant factor in reducing bone mineral density (BMD), osteopenia, and the risk of fractures after childbirth. Hormone-mediated changes in calcium-phosphorus metabolism during lactation are an independent factor in the reduction of BMD. Therefore, the study of the relationship between vitamin D deficiency and insufficiency after childbirth and the possibility of correction is relevant. The aim of this study was to evaluate the effect of prophylactic doses of cholecalciferol and calcium carbonate over time on calcium-phosphorus metabolism indicators after childbirth. Study design, materials and methods. A randomized controlled trial was conducted based on V.A. Almazov National Medical Research Center, Saint Petersburg. 64 puerperas, who lived in St. Petersburg from 2013 to 2014, were surveyed on the 35th day after childbirth. The age of women ranged from 20 to 35 years. Blood serum levels of calcium, phosphorus, magnesium, 25-hydroxycalciferol (25(OH)D), and parathyroid hormone (PTH) were determined for all the puerpera. Using the blind envelope method, the postpartum women were randomized into groups: group I received cholecalciferol 400 IU and calcium carbonate 1000 mg after delivery for 6 months; group II received cholecalciferol 900 IU and calcium carbonate 1000 mg after delivery for 6 months. Blood sampling was performed over time to assess the levels of 25(OH)D, PTH, calcium, phosphorus, and magnesium. Results. In group I after childbirth, the initial level of 25(OH)D in the blood serum was 22.46 4.35 ng/ml, which corresponds to vitamin D insufficiency. An increase in 25(OH)D level by 3.56 ng/ml was observed after 3 months from the start of taking cholecalciferol 400 IU. After 6 months, the level of 25(OH)D reached normal values in 20% of women (p = 0.0001). In group II after childbirth, the initial level of 25(OH)D in the blood serum was 20.64 5.37 ng/ml, which corresponds to vitamin D insufficiency. An increase in 25(OH)D level by 7.60 ng/ml was observed after 3 months from the start of taking cholecalciferol 900 IU. After 6 months, the level of 25(OH)D reached normal values in 56% of women, while the average level of 25(OH)D in these women corresponded to its normally low values. The levels of PTH, calcium, phosphorus, and magnesium remained within the reference values in both groups; however, there was an increase in PTH concentration 6 months after delivery, which may indicate that the cholecalciferol dose is insufficient to stabilize PTH. Conclusion. Vitamin D deficiency and insufficiency occurred in 80-97 % of those examined after delivery. The use of prophylactic doses of cholecalciferol has a positive effect on calcium-phosphorus metabolism; however, they are not sufficient to stabilize PTH level. The cholecalciferol dose of 400 IU is insufficient to normalize the level of 25(OH)D within 6 months of administration. The cholecalciferol dose of 900 IU leads to normally low values of 25(OH)D in 56 % of women after 6 months of administration, but this does not stabilize PTH level either.

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Normocalcemic Hyperparathyroidism: Study of its Prevalence and Natural History

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa084 ◽

2020 ◽

Vol 105 (4) ◽

pp. e1171-e1186 ◽

Cited By ~ 5

Author(s):

Marian Schini ◽

Richard M Jacques ◽

Eleanor Oakes ◽

Nicola F A Peel ◽

Jennifer S Walsh ◽

...

Keyword(s):

Vitamin D ◽

Natural History ◽

Outcome Measures ◽

Serum Calcium ◽

Density Measurement ◽

Control Group ◽

Mineral Density ◽

History Of ◽

Using Data ◽

Normocalcemic Hyperparathyroidism

Abstract Context Normocalcemic hyperparathyroidism (NPHPT) is characterized by persistently normal calcium levels and elevated parathyroid hormone (PTH) values, after excluding other causes of secondary hyperparathyroidism. The prevalence of the disease varies greatly and the data on the natural history of this disease are sparse and inconclusive. Objectives The objectives of this study are to describe the prevalence of NPHPT and its natural history in a referral population and to compare the variability of serum calcium with a group of patients with primary hyperparathyroidism (PHPT). Design A retrospective study was conducted over 5 years. Setting The setting for this study was a metabolic bone referral center. Patients A total of 6280 patients were referred for a bone mineral density measurement (BMD). Main Outcome Measures The prevalence and natural history of NPHPT and variability of calcium were the main outcome measures. Results We identified NPHPT patients using data from the day of the BMD measurement. We excluded patients with low estimated glomerular filtration rate (eGFR) or vitamin D, or with no measurements available. Based on the evaluation of their medical files, we identified 11 patients with NPHPT (prevalence 0.18%). Only 4 patients had consistent normocalcemia throughout their follow-up, with only 2 also having consistently high PTH. None had consistently normal eGFR or vitamin D. Intermittent hypercalcemia was present in 7 of the 11 NPHPT patients. The mean adjusted calcium was found to be significantly lower in the NPHPT group compared with the PHPT group but higher than the control group. PTH was similar for NPHPT and PHPT. These 2 groups had similar variability in serum calcium. Conclusions NPHPT patients often have episodes of hypercalcemia. We believe that NPHPT is a mild form of PHPT.

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Prevalence of vitamin D deficiency in children with lower respiratory tract infection

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20191043 ◽

2019 ◽

Vol 6 (3) ◽

pp. 1041

Author(s):

Chandrashekhara . ◽

Srinivasu Pampana

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Normal Values ◽

Early Recognition ◽

Economic Status ◽

P Value ◽

Cross Sectional ◽

Socio Economic Status ◽

Vitamin D Supplements ◽

D Values

Background: Vitamin D has a role in lung growth, preserving lung function, and preventing pulmonary infection.Methods: Hospital based cross sectional prospective study was done for a period of one year from January 2017 to December 2017, at the AJ Institute of Medical Sciences, Mangalore. A total of 69 patients were admitted with LRTI during the duration of 1 year, which includes pneumonia and bronchiolitis. Out of 69 patients admitted with LRTI, 10 were excluded from the study as they were not fulfilled the criteria.Results: A total 59 children were enrolled in the study with LRTI, out of which 50 (84.7%) were vitamin D deficiency 6 (10.1%) were insufficiency and only 3 (5.08%) had normal vitamin D values, which was statistically highly significant with p value <0.05. Vitamin D deficiency is more common in less than 1 year and also in male child. Vitamin D deficiency is also common among preterm babies who were not on Vitamin D supplements, exclusively breast fed babies and among lower socio economic status especially in class 4. Authors found that 13 (22.03%) members were having a history of previous LRTI out of which 11 (84.6%), 2 (15.3%) had Vitamin D deficiency and insufficiency respectively. Among study group, 16 (27.11%) were diagnosed to have bronchiolitis, out of which 10 (62.5%), 4 (25%), 2 (12.5%) patients were found to have Vitamin D deficiency, insufficiency and normal values respectively. Children who diagnosed as pneumonia were 43 (72.88%), out of them 40 (93%), 2 (4.6%), 1 (2.3%) were having deficiency, insufficiency and normal values of Vitamin D respectively.Conclusions: Vitamin D deficiency is common in children with LRTI especially among exclusively breastfed, born preterm and children from lower socio economic status. Early recognition and treatment of Vitamin D deficiency can prevent morbidity associated with rickets and possibly frequent LRTI.

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Predictive Factors of Secondary Normocalcemic Hyperparathyroidism after Roux-en-Y Gastric Bypass

International Journal of Endocrinology ◽

10.1155/2018/5010287 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8

Author(s):

Claudio Casella ◽

Sarah Molfino ◽

Francesco Mittempergher ◽

Carlo Cappelli ◽

Nazario Portolani

Keyword(s):

Bariatric Surgery ◽

Vitamin D ◽

Gastric Bypass ◽

Vertical Banded Gastroplasty ◽

Elapsed Time ◽

Group 4 ◽

Group 3 ◽

Group 2 ◽

Normocalcemic Hyperparathyroidism ◽

Group 1

Objective. Aim of this study is to evaluate determinants of secondary normocalcemic hyperparathyroidism (SNHPT) persistence in patients who have undergone Roux-en-Y gastric bypass on vertical-banded gastroplasty.Methods. 226 consecutive patients submitted to bariatric surgery were prospectively enrolled and divided in two groups on the basis of preoperative presence of SNHPT. For each patient, we evaluated anthropometric and laboratory parameters. Calcium metabolism (calcemia, PTH, and 25-hydroxy vitamin D serum levels) was studied before surgery and at 6-month intervals (6, 12, and 18 months) as surgical follow-up.Results. Based on presurgical SNHPT presence or absence, we definedgroup 1—201 patients andgroup 2—25 patients, respectively. Among thegroup 1, 153 (76%) recovered from this endocrinopathy within 6 months after surgery (group 3), while the remaining 48 patients (24%) had persistent SNHPT (group 4). Comparing the anthropometric and laboratory data ofgroup 3withgroup 2, the only statistically significant factor was the elapsed time since a prior effective medically controlled diet that led to a steady and substantial weight loss. We found also a statistically significant difference (p<0.05) betweengroup 3andgroup 4in term of % of weight loss and PTH levels.Conclusions. Patients suitable for bariatric surgery must have history of at least one efficient medically controlled diet, not dating back more than 5 years before surgery. This elapsed time represent the cut-off time within which it is possible to recover from SNHPT in the first semester after Roux-en-Y gastric bypass on vertical-banded gastroplasty. The treatment of vitamin D insufficiency and the evaluation of SNHPT before bariatric surgery should be recommended. The clinical significance of preoperative SNHPT and in particular SNHPT after bariatric surgery remains undefined and further studies are required.

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Hearing-loss and calciferol deficiency

The Journal of Laryngology & Otology ◽

10.1017/s002221510010091x ◽

1986 ◽

Vol 100 (11) ◽

pp. 1245-1247 ◽

Cited By ~ 4

Author(s):

J. Irwin

Keyword(s):

Vitamin D ◽

Hearing Loss ◽

Vitamin D Deficiency ◽

Normal Values ◽

Serum Vitamin ◽

Serum Vitamin D ◽

Cochlear Hearing Loss ◽

Biochemical Abnormalities

AbstractVitamin D (calciferol) dehciency has recently been claimed to cause cochlear hearing-loss (Brookes and Morrison, 1981; Brookes, 1983, 1984). In view of the therapeutic and pathophysiological implications of this finding, a confirmatory study was undertaken in the Department of Neuro-otology at The Royal National Throat, Nose and Ear Hospital.Screening of 112 consecutive new referrals revealed 32 patients with biochemical abnormalities compatible with vitamin D deficiency. Of these, 26 agreed to serum vitamin D assay and normal values were obtained in all of these cases. This study does not support the claim that vitamin D deficiency is a cause of hearing-loss.

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Determination of Vitamin D Status in a Population of Ecuadorian Subjects

The Scientific World JOURNAL ◽

10.1155/2017/3831275 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

G. Maldonado ◽

C. Paredes ◽

R. Guerrero ◽

C. Ríos

Keyword(s):

Vitamin D ◽

Retrospective Study ◽

Uv Radiation ◽

Normal Values ◽

Initial Study ◽

Vitamin D Status ◽

The City ◽

Uv Rays

Introduction. Vitamin D is a preprohormone known to play a key role in phosphocalcic metabolism; its main source comes from the synthesis at the skin level by ultraviolet (UV) radiation.Objective. The purpose of this study was to determine the levels of vitamin D in an Ecuadorian population.Materials and Methods. Retrospective study of Ecuadorian subjects from the city of Guayaquil, who had an initial study of 25 (OH)-D serum, as the indicator of Vitamin D status, in the period of 2015-2016.Results. A total of 269 Ecuadorian subjects were analyzed, with a mean age of 54.73 ± 16.58; 85% (229) were females and 15% (41) males; mean vitamin D was 27.29 ± 10.12 ng/dl[6.41–88.74]; 70% of the population showed levels below 30 ng/dL of vitamin D, whereas only 30% (81) had normal values. 69% (185) had levels between 29 and 10 ng/dl and 1% (3) levels below 10 ng/dl. High levels of vitamin D were evidenced in the summer months in relation to the winter months.Conclusion. It is evident that, despite the location of Ecuador and the intensity of UV rays it receives throughout the year, Ecuadorian subjects have insufficient levels of vitamin D.

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