Mosekilde L, Charles P, Lindegreen P. Determinants for serum 1,25-dihydroxycholecalciferol in primary hyperparathyroidism.
BONE AND MINERAL 1989;
5:279-90. [PMID:
2720198 DOI:
10.1016/0169-6009(89)90006-8]
[Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Serum levels of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), 25-hydroxyvitamin D3 (25(OH)D3), C-terminal immunoreactive PTH (iPTH), calcium and phosphate, and endogenous creatinine clearance (Clcr) were measured in 34 patients with primary hyperparathyroidism. Clcr ranged from 13 to 161 ml/min (mean 72). S-iPTH was elevated in 82% of the patients and correlated positively to serum calcium (r = 0.74, P less than 0.001) and inversely to Clcr (r = -0.50, P less than 0.02). S-25(OH)D3 was reduced in 28% of the patients and depended on regular multivitamin supplementation (P less than 0.005). S-1,25(OH)2D3 was increased in 26% of the patients and decreased in 9%. It was positively correlated to S-25(OH)D3 (r = 0.39, P less than 0.05) and Clcr (r = 0.42, P less than 0.02) and inversely to serum levels of calcium (r = -0.39, P less than 0.05), phosphate (r = -0.42, P less than 0.02) and iPTH (r = -0.40, P less than 0.05). Multiple regression analysis revealed a positive correlation to 25(OH)D3 when Clcr was taken into account and to Clcr when S-25(OH)D3 was taken into account. When both variables were considered no significant partial correlations were found between S-1,25(OH)2D3 and serum calcium, phosphate and PTH, respectively. It is concluded that serum levels of 25(OH)D3 and renal function are the main determinants for S-1,25(OH)2D3 in primary hyperparathyroidism.
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