title: Relationship between serum vitamin d status and clinical manifestations of primary hyperparathyroidism.
abstract: OBJECTIVE
  To compare vitamin D status represented by serum 25-hydroxyvitamin D (25-OHD) levels in a group of patients with primary hyperparathyroidism, stratified by clinical manifestations.
  
  
  METHODS
  We studied 22 patients (18 women and 4 men) with primary hyperparathyroidism--5 patients with severe osteitis fibrosa cystica, 10 symptomatic patients with active renal stone disease without overt bone disease, and 7 asymptomatic patients. Bone mineral density (BMD) measurements (T-scores) were done at the lumbar spine, femoral neck, and distal radius, and laboratory data for the three subgroups were analyzed.
  
  
  RESULTS
  Although considerably younger than the asymptomatic group, patients with osteitis fibrosa had significantly lower mean serum 25-OHD levels (16.7 +/- 1.1 ng/mL versus 29.9 +/- 2.9 ng/mL; P = 0.003). Moreover, patients with osteitis fibrosa had significantly lower BMD in comparison with patients who had renal stone disease as well as asymptomatic patients for all sites measured. Serum parathyroid hormone levels were significantly higher in patients with osteitis fibrosa than in asymptomatic patients (1,352.8 +/- 297.2 pg/mL versus 145.0 +/- 43.7 pg/mL; P<0.02) as well as in comparison with patients who had renal stone disease (P<0.02). Patients with osteitis fibrosa had urinary N-telopeptide levels that were significantly higher than those in asymptomatic patients (501.5 +/- 201.7 versus 51.3 +/- 6.4 nmol/mmol creatinine; P = 0.02) and those in patients with renal stone disease (P = 0.01).
  
  
  CONCLUSIONS
  The findings in this study demonstrate that vitamin D deficiency or insufficiency may contribute to disease severity in primary hyperparathyroidism.
authors.affiliation: Department of Medicine, Endocrine Unit, Agamenon Magalhães Hospital, Secretary of Health/University of Pernambuco, Recife, Brazil.
authors.forename: Francisco
authors.initials: F
authors.lastname: Bandeira
authors.forename: Gustavo
authors.initials: G
authors.lastname: Caldas
authors.forename: Eduardo
authors.initials: E
authors.lastname: Freese
authors.forename: Luiz
authors.initials: L
authors.lastname: Griz
authors.forename: Manuel
authors.initials: M
authors.lastname: Faria
authors.forename: Cristina
authors.initials: C
authors.lastname: Bandeira
mesh_terms: D000328:Adult; D000368:Aged; D015519:Bone Density; D002112:Calcifediol / Q000097:blood*; D003094:Collagen / Q000652:urine; D024042:Collagen Type I; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications* / Q000473:pathology / Q000503:physiopathology*; D007669:Kidney Calculi / Q000150:complications; D008297:Male; D008875:Middle Aged; D010002:Osteitis Fibrosa Cystica / Q000150:complications; D010281:Parathyroid Hormone / Q000097:blood; D010455:Peptides / Q000652:urine
chemical_list: D024042:Collagen Type I; D010281:Parathyroid Hormone; D010455:Peptides; C052929:collagen type I trimeric cross-linked peptide; D003094:Collagen; D002112:Calcifediol