Hyperparathyroidism secondary to hypovitaminosis D in hypoalbuminemic is less intense than in normoalbuminemic patients: a prevalence study in medical inpatients in southern Brazil.
Hypovitaminosis D has been reported in tropical countries, but this hormone has seldom been studied in Brazil. Our purpose was to study the prevalence of hypovitaminosis D in patients hospitalized in internal medicine wards in Southern Brazil. Possible associated factors were studied. We studied 81 adult patients in early spring. Mean serum 25(OH)D was 12 +/- 8.57 ng/mL; hypovitaminosis D was severe (< 10 ng/mL) in 27 (33.3%) patients, and moderate (> or = 10 ng/mL and < 20 ng/mL) in 36 (44.5%) patients. Clinical evaluation did not yield any data associated with hypovitaminosis D. Serum 25(OH)D levels of up to 20 ng/mL were associated with decreased mean serum total calcium (p = 0.001), ionized calcium (p = 0.01), and phosphorus (p = 0.044) levels, and increased mean serum PTH level (p = 0.001). In a multiple regression model, serum PTH level was independently affected by serum total calcium (p = 0.01), phosphorus (p = 0.009), and albumin (p = 0.009) levels. Hypovitaminosis D patients had lower mean serum albumin levels (p = 0.004), and serum 25(OH)D levels were directly correlated to serum albumin levels (p < 0.0001). Albumin influenced independently PTH response to hypovitaminosis D; normoalbuminemic hypovitaminosis D patients had higher mean serum PTH than hypoalbuminemic patients.


CONCLUSIONS
Hypovitaminosis D prevalence was very high in medical inpatients in Southern Brazil, in early spring. Nevertheless, secondary hyperparathyroidism was less intense in hypoalbuminemic hypovitaminosis D patients suggesting that in these patients free serum 25(OH)D was closer to normal.
Premaor
Melissa Orlandin
MO
Division of Internal Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, Rua Ramiro Barcellos 2350/700, 90035-003--Porto Alegre, RS, Brazil.
Alves
Gustavo Vasconcelos
GV
Crossetti
Ligia Beatriz
LB
Furlanetto
Tania Weber
TW
D000418:Albumins / Q000032:analysis; D001938:Brazil / Q000453:epidemiology; D002118:Calcium / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D034141:Hypoalbuminemia / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D008163:Luminescent Measurements; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010758:Phosphorus / Q000097:blood; D015995:Prevalence; D011863:Radioimmunoassay; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000453:epidemiology
D000418:Albumins; D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; D002118:Calcium