Short-Term Outcomes of Parathyroidectomy in Patients With or Without 25-Hydroxy Vitamin D Insufficiency

The Impact of Vitamin D Status on Preoperative Ultrasound Findings and Parathyroidectomy Outcomes in Patients With Primary Hyperparathyroidism

“…As vitamin D deficiency is a stimulus for parathyroid hyperplasia and parathyroid tumour weight is the most reliable indicator of parathyroid cell mass, our patients who were vitamin D deficient or insufficient had the largest mean gland weight both in SGD and MGD and vitamin D sufficient patients had the smallest size glands. These findings echo with results from previous work by other authors [9,13,19]. We also noticed an inverse association between serum 25(OH)D3 levels and gland weight after resection especially in SGD which would be relevant in the management of PHPT as this would strongly add to the growing body of evidence whether vitamin D deficiency or insufficiency should be corrected routinely to reduce adenoma weight and disease severity before undertaking parathyroidectomy.…”

“…An altered vitamin D status is perhaps the most significant confounding factor found relating to patients with PHPT. Low levels of Vitamin D have been often linked to higher levels of PTH and larger size of parathyroid adenoma [9,13], hence one would speculate that patients with impaired vitamin D status will have an aggressive phenotype of PHPT and the likelihood of pre-surgical localization would be higher due to chronic gland stimulation. In contradiction to this speculation, our study shows that presence of vitamin D insufficiency or deficiency does not affect the biochemical severity of disease at presentation.…”

“…Amongst all available non-invasive techniques, ultrasonography and nuclear scintigraphy are the most commonly used modalities. Several studies have explored the correlation of pre-operative vitamin D status with predictive accuracy for localization and post-operative adenoma weight and biochemical parameters using the technetium (99 mTc) sestamibi scan in PHPT but the evidence of similar correlations using the ultrasound scan (USS) is very scarce and conflicting [10][11][12][13][14]. USS is inexpensive and widely available and has a sensitivity of 76-79% in identifying single adenoma's which drops to 35% in patients with MGD [15,16].…”

Effect of 25 (OH) D replacements in patients with primary hyperparathyroidism (PHPT) and coexistent vitamin D deficiency on serum 25(OH) D, calcium and PTH levels: a meta‐analysis and review of literature

“…The bone histomorphometry study by Stein and colleagues has shown that low levels of 25(OH) D in patients with PHPT are associated with higher concentrations of PTH and greater catabolic effects in cortical bone . In addition, studies have also shown that vitamin D deficiency has been associated with a higher risk of developing postoperative hypocalcaemia, hungry bone syndrome and persistent postoperative elevated serum PTH levels and increased cardiovascular mortality …”

Biochemical effects of calcifediol supplementation in mild, asymptomatic, hyperparathyroidism with concomitant vitamin D deficiency

“…The pathophysiological mechanisms responsible for the low serum 25(OH)D level in PHPT are not completely clarified. The data obtained from several studies suggest that vitamin D status might influence the clinical and biological expression of PHTP [1,2,[4][5][6][7][8][9][10][11][12][13][14][15] and even recovery after surgical treatment [11,16,17], although some authors have not found such an association [18,19].…”