title: Health-related quality of life after successful surgery for primary hyperparathyroidism: no additive effect from vitamin D supplementation: results of a double-blind randomized study.
abstract: OBJECTIVE
  Vitamin D insufficiency is common in primary hyperparathyroidism (pHPT). Patients with pHPT frequently have a reduced health-related quality of life (HRQoL). Our objectives were to evaluate whether HRQoL in pHPT is associated with vitamin D insufficiency and whether vitamin D supplementation after parathyroidectomy (PTX) could improve HRQoL.
  
  
  METHODS
  A randomized, double-blind study (ClinicalTrials.gov identifier: NCT00982722).
  
  
  METHODS
  The study included 150 pHPT patients randomized, 6 weeks after PTX, to daily treatment with either cholecalciferol 1600 IU and calcium carbonate 1000 mg (D+) or calcium carbonate alone (D-). HRQoL was estimated with SF-36 before and after PTX and after 12 months of study medication.
  
  
  RESULTS
  Three-quarters (77%) of the pHPT patients had vitamin D insufficiency, defined as 25OHD <50 nmol/l. The pHPT patients scored lower than a reference population in all domains of SF-36. A total of 135 patients completed the entire study period. Improvements in nearly all domains were registered at the follow-up 6 weeks after PTX. At the end of the study medication period, the D+ group had a significantly higher median serum (s-) 25OHD concentration (76 (65; 93) (lower; upper interquartile ranges) vs 48 (40; 62) nmol/l, P<0.001) and a lower plasma (p-) parathyroid hormone concentration (40 (34; 52) vs 49 (38; 66) ng/l, P=0.01) than the D- group. The improvements in HRQoL remained unchanged at the follow-up 1 year after PTX. Postoperative vitamin D supplementation had no obvious effect on HRQoL.
  
  
  CONCLUSIONS
  PTX resulted in significant improvements in HRQoL. Despite a high prevalence of vitamin D insufficiency, 1 year of postoperative vitamin D supplementation had no obvious beneficial effect on HRQoL.
authors.affiliation: Department of Breast and Endocrine SurgeryKarolinska University Hospital, P9:03, SE-171 76 Stockholm, Sweden.
authors.forename: Viveca
authors.initials: V
authors.lastname: Åberg
authors.affiliation: Department of Breast and Endocrine SurgeryKarolinska University Hospital, P9:03, SE-171 76 Stockholm, Sweden.
authors.forename: Sophie
authors.initials: S
authors.lastname: Norenstedt
authors.affiliation: Department of Breast and Endocrine SurgeryKarolinska University Hospital, P9:03, SE-171 76 Stockholm, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Zedenius
authors.affiliation: Department of Breast and Endocrine SurgeryKarolinska University Hospital, P9:03, SE-171 76 Stockholm, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Sääf
authors.affiliation: Department of Breast and Endocrine SurgeryKarolinska University Hospital, P9:03, SE-171 76 Stockholm, Sweden.
authors.forename: Jörgen
authors.initials: J
authors.lastname: Nordenström
authors.affiliation: Department of Breast and Endocrine SurgeryKarolinska University Hospital, P9:03, SE-171 76 Stockholm, Sweden.
authors.forename: Ylva
authors.initials: Y
authors.lastname: Pernow
authors.affiliation: Department of Breast and Endocrine SurgeryKarolinska University Hospital, P9:03, SE-171 76 Stockholm, Sweden inga-lena.nilsson@ki.se.
authors.forename: Inga-Lena
authors.initials: IL
authors.lastname: Nilsson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D006306:Health Surveys / Q000379:methods; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011788:Quality of Life; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage*
chemical_list: D014807:Vitamin D