Differences in the Clinical Presentation and Biochemical Profile of the Patients with Primary Hyperparathyroidism with regard to their Serum Vitamin D Levels: a Single-center Experience

Amal Dev D; Apoorva Suran; Aasim N Maldar; Phulrenu H Chauhan; Murad Lala; N F Shah; Milind V Kirtane; Manoj Chadha

doi:10.1007/s13193-022-01676-7

Differences in the Clinical Presentation and Biochemical Profile of the Patients with Primary Hyperparathyroidism with regard to their Serum Vitamin D Levels: a Single-center Experience

Indian J Surg Oncol. 2023 Jun;14(2):301-307. doi: 10.1007/s13193-022-01676-7. Epub 2022 Oct 29.

Authors

Amal Dev D¹, Apoorva Suran¹, Aasim N Maldar¹, Phulrenu H Chauhan¹, Murad Lala², N F Shah¹, Milind V Kirtane³, Manoj Chadha¹

Affiliations

¹ Department of Endocrinology, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, 400016 India.
² Department of Onco-Surgery, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, 400016 India.
³ Department of ENT, P. D. Hinduja Hospital and Medical Research Centre, Mumbai, 400016 India.

PMID: 37324304
PMCID: PMC10267019 (available on 2024-06-01)
DOI: 10.1007/s13193-022-01676-7

Abstract

The association between vitamin D deficiency and primary hyperparathyroidism (PHPT) is common and has clear implications. Vitamin D deficiency is commonly seen in PHPT population and exacerbates its severity with skeletal and metabolic effects. Retrospective data collection and review were done in patients who underwent surgery for PHPT at a tertiary care hospital in India between January 2011 and December 2020. A total of 150 subjects were included in the study and were divided into group 1 (vitamin D < 20 ng/ml, deficient), group 2 (vitamin D 21-29 ng/ml, insufficient), and group 3 (vitamin D > 30 ng/ml, sufficient). There was no difference in the duration of symptoms or the symptomatology between the three groups. Mean pre-operative serum calcium and serum phosphorous levels were also comparable in all the three groups. Mean pre-operative parathyroid hormone (PTH) levels in the three groups were 703 ± 996 vs 343.6 ± 396 vs 343.6 ± 396 pg/ml, respectively (P = 0.009). There was a statistically significant difference in group 1 vs groups 2 and 3 in their mean weight of the parathyroid gland (P = 0.018) and high alkaline phosphatase (ALP) levels (P = 0.047). Post-operative symptomatic hypocalcemia was observed in 17.3% of patients. Post-operative hungry bone syndrome occurred in 4 patients, all in group 1. PHPT in patients with low serum vitamin D was associated with higher serum PTH levels, increased frequency of high serum ALP levels, and higher weight of the excised gland, with no difference in the serum calcium and phosphorous.

Keywords: 25-Hydroxy vitamin D; Hypercalcemia; Parathyroid adenoma; Primary hyperparathyroidism; Vitamin D.

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