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Salman MA, Rabiee A, Salman A, Youssef A, E-D Shaaban H, Ftohy TE, Maurice KK, Balamoun H. Role of Vitamin D Supplements in Prevention of Hungry Bone Syndrome after Successful Parathyroidectomy for Primary Hyperparathyroidism: A Prospective Study. Scand J Surg 2020; 110:329-334. [PMID: 33019891 DOI: 10.1177/1457496920962601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We postulated that the preoperative correction of vitamin D levels can significantly reduce the incidence of hunger bone syndrome among patients undergoing parathyroidectomy for primary hyperparathyroidism. METHODS We performed a prospective, randomized, open-label study on 102 patients with primary hyperparathyroidism and coexisting vitamin D deficiency who were scheduled to undergo parathyroidectomy. Patients were divided into the following two groups: group I which included 52 patients who did not receive preoperative vitamin D supplementation; and group II which included 50 patients who received cholecalciferol 1000-2000 IU daily or 50000 IU weekly until they achieve vitamin D levels >20 ng/mL (group IIa = 25 patients) or vitamin D levels >30 ng/mL (group IIb = 25 patients). RESULTS The incidence of hunger bone syndrome in group IIb was lower than group I and group IIa (8% versus 16% versus 23%, respectively); however, this difference did not reach the level of statistical significance (p = 0.22). Patients with hunger bone syndrome were significantly younger and had higher serum phosphorus, alkaline phosphatase, magnesium, and bone mineral density at baseline than patients without hunger bone syndrome. On the other hand, patients with hunger bone syndrome had significantly lower 25-hydroxyvitamin D at baseline than patients without hunger bone syndrome (p = 0.001). The ROC curve showed that the baseline level of serum 25-hydroxyvitamin D was not an independent discriminator of hunger bone syndrome (area under curve = 0.21 (95% CI: 0.06-0.34); p = 0.011). CONCLUSION Preoperative course of vitamin D supplements has no preventive role on the postoperative incidence of hunger bone syndrome among patients with primary hyperparathyroidism and coexisting vitamin D deficiency undergoing parathyroidectomy.
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Affiliation(s)
- M A Salman
- General Surgery Department, Kasralainy School of Medicine, Cairo University, Cairo, Egypt
| | - A Rabiee
- Internal Medicine Department, Kasralainy School of Medicine, Cairo University, Cairo, Egypt
| | - A Salman
- Internal Medicine Department, Kasralainy School of Medicine, Cairo University, Cairo, Egypt
| | - A Youssef
- Internal Medicine Department, Kasralainy School of Medicine, Cairo University, Cairo, Egypt
| | - H E-D Shaaban
- National Hepatology and Tropical Medicine Research Institute, Gastroenterology and Hepatology, Cairo, Egypt
| | - T E Ftohy
- Head and Neck Surgery, Sohag University, Sohag, Egypt
| | - K K Maurice
- General Surgery Department, Kasralainy School of Medicine, Cairo University, Cairo, Egypt
| | - H Balamoun
- General Surgery Department, Kasralainy School of Medicine, Cairo University, Cairo, Egypt
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Muscogiuri G, Mitri J, Mathieu C, Badenhoop K, Tamer G, Orio F, Mezza T, Vieth R, Colao A, Pittas A. Mechanisms in endocrinology: vitamin D as a potential contributor in endocrine health and disease. Eur J Endocrinol 2014; 171:R101-10. [PMID: 24872497 DOI: 10.1530/eje-14-0158] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE It has been suggested that vitamin D may play a role in the pathogenesis of several endocrine diseases, such as hyperparathyroidism, type 1 diabetes (T1DM), type 2 diabetes (T2DM), autoimmune thyroid diseases, Addison's disease and polycystic ovary syndrome (PCOS). In this review, we debate the role of vitamin D in the pathogenesis of endocrine diseases. METHODS Narrative overview of the literature synthesizing the current evidence retrieved from searches of computerized databases, hand searches and authoritative texts. RESULTS Evidence from basic science supports a role for vitamin D in many endocrine conditions. In humans, inverse relationships have been reported not only between blood 25-hydroxyvitamin D and parathyroid hormone concentrations but also with risk of T1DM, T2DM, and PCOS. There is less evidence for an association with Addison's disease or autoimmune thyroid disease. Vitamin D supplementation may have a role for prevention of T2DM, but the available evidence is not consistent. CONCLUSIONS Although observational studies support a potential role of vitamin D in endocrine disease, high quality evidence from clinical trials does not exist to establish a place for vitamin D supplementation in optimizing endocrine health. Ongoing randomized controlled trials are expected to provide insights into the efficacy and safety of vitamin D in the management of endocrine disease.
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Affiliation(s)
- Giovanna Muscogiuri
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Joanna Mitri
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Chantal Mathieu
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Klaus Badenhoop
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Gonca Tamer
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Francesco Orio
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, CanadaDepartment of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Teresa Mezza
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Reinhold Vieth
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, CanadaDepartment of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Annamaria Colao
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
| | - Anastassios Pittas
- Department of Clinical Medicine and SurgeryUniversity 'Federico II' Naples, Via Sergio Pansini, 5-80131 Napoli, ItalyDivision of EndocrinologyDiabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts, USADepartment of EndocrinologyUZ Gasthuisberg, 3000 Leuven, BelgiumDivision Endocrinology and DiabetologyDepartment of Medicine 1, University Hospital of the Goethe-University Frankfurt, Frankfurt am Main, GermanyDivision of Endocrinology and MetabolismDepartment of Internal Medicine, Goztepe Training and Research Hospital, Medeniyet University, Istanbul, TurkeyEndocrinologyUniversity 'Parthenope' Naples, Naples, ItalyEndocrinology of Fertile AgeUniversity Hospital 'S. Giovanni di Dio e Ruggi d'Aragona' Salerno, ItalyEndocrinology and Metabolic DiseasesUniversità Cattolica del Sacro Cuore, Rome, ItalyDepartments of Nutritional SciencesLaboratory Medicine and PathobiologyUniversity of Toronto, Toronto, Ontario, Canada
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