Endocrine Abstracts

Background: The study aimed to evaluate quality-of-life (QoL) aspects and impact of vitamin D deficiency in primary hyperparathyroidism (pHPT).

Method: 150 consecutive patients (119 women) with pHPT (mean age 60±11 years; BMI 27±5 kg/m²; ionized calcium 1.44±0.08 mmol/l; PTH 130±69 ng/l) were included. Six weeks postoperatively, the pHPT patients were reexamined and randomized (double-blind) to daily substitution with calcium carbonate (1g), with or without cholecalciferol (1600 IE). Self-estimation questionnaires (SF-36) were completed at baseline and repeatedly during follow-up. A gender- and age-matched reference group (n=459) was randomly selected from the Swedish SF-36 norm database.

Results: Vitamin D deficiency, defined as 25-hydroxyvitamin D < 50 nmol/l, was present preoperatively in 59% of the patients. The 25-hydroxyvitamin D level increased postoperatively (mean 49±18 vs 52±17 nmol/L, P=0.019). The calcium level normalized after parathyroidectomy in all patients, while the PTH level decreased but was not normalized in 45% of the cases. Compared to the reference population baseline, the patients scored significantly lower on all eight domains of the SF-36. Postoperatively, patients improved significantly but reached the level of the reference population in only two domains: GH (general health perceptions) and BP (bodily pain). No correlation was found between the SF-36 scores and the calcium, PTH or vitamin D levels at baseline. The baseline scores were inversely correlated to body mass index (BMI; r=−0.226–r=−0.386; P<0.01). The study will be deblinded on January 15 2012 and further follow-up data will be presented.

Conclusions: Patients with pHPT had worse QoL scores than the reference population on all eight domains of the SF-36. The outcome after parathyroid surgery was not predictable from preoperative calcium, PTH- or vitamin D status. The effects of vitamin D supplementation are yet to be evaluated.