title: Hyperparathyroidism secondary to hypovitaminosis D in hypoalbuminemic is less intense than in normoalbuminemic patients: a prevalence study in medical inpatients in southern Brazil.
abstract: 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.
authors.affiliation: 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.
authors.forename: Melissa Orlandin
authors.initials: MO
authors.lastname: Premaor
authors.forename: Gustavo Vasconcelos
authors.initials: GV
authors.lastname: Alves
authors.forename: Ligia Beatriz
authors.initials: LB
authors.lastname: Crossetti
authors.forename: Tania Weber
authors.initials: TW
authors.lastname: Furlanetto
mesh_terms: 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
chemical_list: D000418:Albumins; D010281:Parathyroid Hormone; D014807:Vitamin D; D010758:Phosphorus; D002118:Calcium