Endocrine Abstracts

Vitamin D insufficiency is common in the Irish population. Patients with primary hyperparathyroidism (PHPT) and co-existing vitamin D insufficiency have higher PTH levels, increased bone turnover and increased risk of postoperative hypocalcaemia. The 3rd International Workshop on PHPT recommended measurement of serum 25-OH Vitamin D in all patients with PHPT, and treatment where required to maintain 25-OH Vitamin D >50 nmol/l. Our study aimed to assess vitamin D status in patients with PHPT referred to our tertiary referral centre.

Using the biochemistry database, 58 patients with PHPT were identified over a 1 year period (October 2007 to September 2008). Fifty-two (90%) were female with mean age of 62 years. Forty-three were seen by Endocrinology services with 15 referred directly to surgical outpatients by General Practitioners and other specialties. Twenty-two of those seen by Endocrinology (51%) had their vitamin D status assessed. Six were vitamin D deficient (25-OH Vitamin D <25 nmol/l) with the remaining 16 vitamin D insufficient (25-OH Vitamin D <50 nmol/l). Equal numbers were deficient/insufficient in spring/summer and autumn/winter, so no significant seasonal variation was noted. None of the 15 patients referred directly to surgeons had their vitamin D status assessed. Those with vitamin D deficiency had higher mean parathyroid hormone (PTH) and alkaline phosphatase levels than those with vitamin D insufficiency.

In conclusion, over half of the patients with PHPT in our cohort did not have vitamin D status assessed as is now recommended. None of the 22 patients whose vitamin D status was assessed were vitamin D sufficient indicating high levels of vitamin D insufficiency in our PHPT cohort.