title: Effect of 25 (OH) D replacements in patients with primary hyperparathyroidism (PHPT) and coexistent vitamin D deficiency on serum 25(OH) D, calcium and PTH levels: a meta-analysis and review of literature.
abstract: BACKGROUND
  The safety of vitamin D replacement in subjects with primary hyperparathyroidism (PHPT) and coexistent vitamin D deficiency is not well established.
  
  
  OBJECTIVE
  To evaluate the safety of vitamin D replacement in PHPT.
  
  
  METHODS
  Data were searched from Medline, EMBASE, Cochrane CENTRAL and abstracts form annual scientific meetings of various international bone and mineral societies.
  
  
  METHODS
  Studies examining the effect of preoperative vitamin D replacement in patients with PHPT and coexisting vitamin D deficiency, irrespective of year and language of the publication were included in the present meta-analysis.
  
  
  METHODS
  Data were extracted from text of the included publications or abstract of conferences.
  
  
  RESULTS
  Ten studies enrolling 340 subjects with PHPT were analysed in this meta-analysis. After vitamin D replacement, there was significant increase in 25(OH) D levels by 55·3 nmol/l (95% CI 33·3-77·3), reduction in serum parathyroid hormone levels by 3·5 pmol/l (5·8 to -1·2) without change in serum calcium (-0·08 mmol/l, -0·2 to +0·03) and urinary calcium levels (0·72 mmol/24 h, P = 0·2) compared to baseline.
  
  
  CONCLUSIONS
  Vitamin D replacement in subjects with PHPT and coexistent vitamin D deficiency increase 25 (OH) D and reduce serum PTH significantly without causing hypercalcaemia and hypercalciuria. The finding of the study needs to be confirmed by a large randomized trial in patient with PHPT and coexistent vitamin D deficiency.
authors.affiliation: Barbara Davis Center for Diabetes, University of Colorado, Denver, CO, USA.
authors.forename: Viral N
authors.initials: VN
authors.lastname: Shah
authors.forename: Chirag S
authors.initials: CS
authors.lastname: Shah
authors.forename: Sanjay K
authors.initials: SK
authors.lastname: Bhadada
authors.forename: D Sudhakar
authors.initials: DS
authors.lastname: Rao
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D002118:Calcium / Q000097:blood / Q000652:urine; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood*; D010710:Phosphates / Q000097:blood; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000097:blood*
chemical_list: D010710:Phosphates; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D000469:Alkaline Phosphatase; D002118:Calcium