Comparison of the Effect of Secondary Hyperparathyroidism Due to Vitamin D Deficiency on Bone with the Healthy Control Group

Year 2023, , 134 - 140, 30.08.2023

Hakan Demir , Cem Cihan , Emre Gönüllü , Recayi Capoglu , Merve Yiğit , Bahaeddin Umur Aka , Ahmet Tarık Harmantepe

https://doi.org/10.34084/bshr.1324716

Abstract

Aim: In healthy individuals, to demonstrate that adequate vitamin D status protects against osteoporosis by improving bone mineral density and reducing the risk of fractures.
Material and method: Fifty patients with high parathyroid hormone secondary to low vitamin D level and 50 patients with normal parathyroid hormones were included in the study as the control group.
Results: Of the 50 patients with secondary hyperparathyroidism due to vitamin D deficiency included in the study, 45 (90%) were female and 5 (10%) were male. In the control group with normal parathyroid hormone, 44 (88%) were female and 6% (12%) were male. The median age in the hyperparathyroid group was 70.5 (66-73) and in the parathyroid hormone normal group it was 71 (69-73). This median mean age was significant (p 0.004).
In the group with secondary hyperparathyroidism; The median PTH value was 99.5 (66-205.9) and 49.8 (27-61.5) in the control group, with a significant difference (p < 0.001). While 25-Hydroxy Vitamin D level was 10.73 (4.64-34.1) in the group with normal parathyroid hormone level, it was 18.63 (6.21-65.1). This created a significant difference in both groups (p < 0.001). According to the results of bone densitometry in the hyperparathyroidic and control groups. no significant difference was found between bone mineral density (BMD). 0.92 (0.66 – 1134), 0.93 (0.75 – 1293), (p0.095).
However, for the femur, the results in T and Z scores were significant (p 0.027- p 0.027), whereas for the supine (spine), no significant difference was observed between the T and Z scores (p 0.358- p 0.265).
Conclusion: . Especially when the vitamin D level falls below 10 ng/mL, PTH begins to respond. Beyond these observations, a normal serum 25(OH)D concentration is particularly important in preventing femur fractures, but its significance for vertebral fractures is unclear.

Keywords

Vitamin D, secondary hyperparathyroidism, osteoporosis

D Vitamini Eksikliğine Bağlı Sekonder Hiperparatiroidizm’in Kemik Üzerine Etkisinin Sağlıklı Kontrol Grubu ile Karşılaştırılması

Abstract

Giriş: Sağlıklı bireylerde yeterli D vitamini durumunun, kemik mineral yoğunluğunu iyileştirerek ve kırık riskini azaltarak, osteoporoza karşı koruduğunu göstermektir.
Gereç ve Yöntem :D vitamin seviyesi düşüklüğüne sekonder, paratiroid hormonu yüksek 50 hasta ile paratiroid hormonları normal olan, 50 hasta kontrol grubu olarak çalışmaya dahil edildi.
Bulgular: Çalışmaya dahil edilen D vitamin eksikliğine bağlı sekonder hiperparatiroidizm’li 50 hastanın,45’i (90%) kadın, 5’i(10%) erkekti. Paratiroid hormonu normal olan kontrol grubunda ise, 44’ü(88%) kadın,6’sı(12%) erkekti Hiperparatiroidik grupta median yaş ortalaması 70.5(66-73), paratiroid hormonu normal grupta ise 71(69-73) idi. Bu median yaş ortalaması anlamlıydı (p 0.004).
Sekonder hiperparatirodizmli grupta; PTH median değeri 99.5 (66-205.9),kontrol grubunda ise 49.8 (27-61.5) olup anlamlı fark gözlendi(p < 0.001). 25-Hydroxy Vitamin D seviyesi 10.73 (4.64-34.1)iken, paratiroid hormon seviyesi normal olan grupta 18.63 (6.21-65.1) idi. Bu da her iki grupta anlamlı fark oluşturdu(p < 0.001). Hiperparatiroidik ve kontrol grubunda çekilen kemik dansitometresi sonuçlarına göre. kemik mineral yoğunluğu(BMD) arasında anlamlı fark saptanmadı. 0.92 (0.66 – 1134), 0.93 (0.75 – 1293),(p0.095).
Buna rağmen femur için, T ve Z scorlarındaki sonuç anlamlı iken (p 0.027- p 0.027),supin(omurga),için T ve Z scorları arasında anlamlı fark gözlenmedi( p 0.358- p 0.265).
Sonuç: . Özellikle D vitamin seviyesi 10 ng/mL’nin altına indiğinde PTH cevap vermeye başlamaktadır. Bu gözlemlerin ötesinde, serum 25(OH)D konsantrasyonunun normal seviyede olması özellikle femur kırıklarından korumada önemli iken, vertebra kırıkları için önemi belirsizdir.

Keywords

D vitamini, sekonder hiperparatiroidizm, osteoporoz

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