Endocrine Abstracts

Introduction: Low levels of vitamin D are commonly seen in patients with primary hyperparathyroidism (PHP). The aim of this study was to determine the vitamin D status and to evaluate its relation with primary hyperparathyroidism severity.

Patients and Methods: This is a retrospective descriptive study including 48 patients with primary hyperparathyroidism followed-up in the Endocrinology-Diabetology and Nutrition Department of the University Hospital Center of Mohammed-VI-Oujda in Morocco. Clinical, biochemical, and densitometric presentation, were compared among patients with vitamin D insufficiency (group 1) and deficiency (group 2).

Results: The mean age of our patients was 55.60 ±11.4 years, with a clear female predominance (77% of cases). The average vitamin D level was 12.06±7.4 ng/ml, 18 cases (37.5%) had vitamin D insufficiency, and 29 cases (60.4%) had vitamin D deficiency, while only one case (2%) had normal level of vitamin D. The discovery of primary hyperparathyroidism was mainly by an incidental finding of hypercalcemia in these patients. Bone densitometry indicated osteoporosis, osteopenia, and was normal in 53.12%, 28.12% and 18.75% of cases respectively. Ten percent of patients had renal failure, and 35.6% had urolithiasis as complications. We observed that patients who had vitamin D deficiency had higher levels of serum calcium (134.06 ±25.60 vs 118.57±21.31), and PTH 1-84 (468.05±536 vs 362.04±432.9) comparatively to those who had vitamin D insufficiency. Also, urolithiasis was twice as common in those with vitamin D deficiency. Post-operative severe hypocalcemia was only seen in those who had vitamin D deficiency before surgery. Therefore, no difference in clinical presentation and severity, in bone mineral density, and the prevalence of renal failure were noted between the two groups.

Conclusion: Vitamin D deficiency worsens the profile of hyperparathyroidism. For this reason, a systematic preoperative screening is necessary in order to prevent its complications.