Effect of concomitant vitamin D deficiency or insufficiency on lumbar spine volumetric bone mineral density and trabecular bone score in primary hyperparathyroidism.

Détails

ID Serval
serval:BIB_D44A522F12D7
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Effect of concomitant vitamin D deficiency or insufficiency on lumbar spine volumetric bone mineral density and trabecular bone score in primary hyperparathyroidism.
Périodique
Osteoporosis international
Auteur(s)
Walker M.D., Saeed I., Lee J.A., Zhang C., Hans D., Lang T., Silverberg S.J.
ISSN
1433-2965 (Electronic)
ISSN-L
0937-941X
Statut éditorial
Publié
Date de publication
10/2016
Peer-reviewed
Oui
Volume
27
Numéro
10
Pages
3063-3071
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Lower vitamin D and higher parathyroid hormone (PTH) levels are associated with higher volumetric BMD and bone strength at the lumbar spine as measured by central quantitative computed tomography in primary hyperparathyroidism (PHPT), but there are no differences in bone microarchitecture as measured by trabecular bone score (TBS).
The purpose of this study was to evaluate the association between 25-hydroxyvitamin D (25OHD) and volumetric bone mineral density (vBMD) and the TBS at the lumbar spine (LS) in PHPT.
This is a cross-sectional analysis of PHPT patients with and without low 25OHD. We measured vBMD with quantitative computed tomography (cQCT) and TBS by dual-energy X-ray absorptiometry (DXA) at the LS in 52 and 88 participants, respectively.
In the cQCT cohort, those with lower vitamin D (<20 vs. 20-29 vs. ≥30 ng/ml) tended to be younger (p = 0.05), were less likely to use vitamin D supplementation (p < 0.01), and had better renal function (p = 0.03). Those with 25OHD <20 ng/ml had 80 and 126 % higher serum PTH levels respectively vs. those with 25OHD 20-29 ng/ml (p = 0.002) and 25OHD ≥30 ng/ml (p < 0.0001). Covariate-adjusted integral and trabecular vBMD were higher in those with 25OHD 20-29 vs. those with 25OHD ≥30 ng/ml, but those with 25OHD <20 did not differ. Because there were few participants with 25OHD deficiency, we also compared those with vitamin D <30 vs. ≥30 ng/ml. Covariate-adjusted integral and trabecular vBMD were 23 and 30 % higher respectively (both p < 0.05) in those with vitamin D <30 vs. ≥30 ng/ml. TBS was in the partially degraded range but did not differ by vitamin D status.
In mild PHPT, lower 25OHD is associated with higher PTH, but vitamin D deficiency and insufficiency using current clinical thresholds did not adversely affect lumbar spine skeletal health in PHPT. Further work is needed to determine if higher vBMD in those with lower vitamin D is due to an anabolic effect of PTH.

Mots-clé
Aged, Bone Density, Cancellous Bone/pathology, Cross-Sectional Studies, Female, Humans, Hyperparathyroidism, Primary/complications, Hyperparathyroidism, Primary/physiopathology, Male, Middle Aged, Parathyroid Hormone/blood, Vitamin D/analogs & derivatives, Vitamin D/blood, Vitamin D Deficiency/complications, Vitamin D Deficiency/physiopathology, Central quantitative computed tomography, Primary hyperparathyroidism, Trabecular bone score, Vitamin D deficiency, Volumetric bone density
Pubmed
Web of science
Création de la notice
02/12/2016 10:40
Dernière modification de la notice
20/08/2019 15:54
Données d'usage