Total and free vitamin D metabolites in patients with primary hyperparathyroidism

Meng, Lingqiong; Su, Chi; Shapses, Sue; Wang, X

doi:10.1007/s40618-021-01633-1

Cited by 8 publications

(5 citation statements)

References 33 publications

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“…Two other VitD metabolite ratios have been proposed in the literature: 1,25(OH) 2 D/25(OH)D (32) and 24,25(OH) 2 D/25(OH)D (24, 30, 31, 33, 34). Our mathematical model predicts that the 25(OH)D/1,25(OH) 2 D ratio [i.e., the reciprocal of the 1,25(OH) 2 D/25(OH)D ratio proposed in the literature (32)] is a near-linear function of 25(OH)D levels (Fig. 5A); the graph of the 24,25(OH) 2 D/25(OH)D ratio versus 25(OH)D is predicted to be a sigmoid curve (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Tang et al (11) previously suggested that the 1,25(OH)2D/24,25(OH)2D ratio provides a more relevant index for assessment of VitD status compared to measuring total levels of 25(OH)D in serum or plasma. In this study, we calculated and assessed three VitD metabolite ratios (12)(13)(14)(15) among which we concluded that 1,25(OH)2D/24,25(OH)2D and 25(OH)D/1,25(OH)2D ratios may provide the most clinically relevant information regarding VitD status.…”

Section: Introductionmentioning

confidence: 99%

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Critical Role for 24-Hydroxylation in Homeostatic Regulation of Vitamin D Metabolism

Yazdi

Streeten

Whitlatch

et al. 2023

Preprint

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The body has evolved effective homeostatic mechanisms to maintain free levels of Ca+2 and 1,25-dihydroxyvitamin D [1,25(OH)2D] within narrow physiological ranges. The literature documents critical contributions of PTH to this homeostatic regulation. We developed a mechanistic mathematical model documenting an important contribution from homeostatic regulation of 24-hydroxylase activity. Data on vitamin D (VitD) metabolite levels were obtained from a clinical trial conducted in healthy participants with baseline total 25-hydroxyvitamin D [25(OH)D] levels ≤20 ng/mL. The trial was designed as a crossover trial in which participants were studied before and after receiving VitD3 supplementation (≥4-6 weeks) to achieve total 25(OH)D levels >30 ng/mL. VitD3 supplementation significantly increased mean levels of 25(OH)D by 2.7-fold and 24,25-dihydroxyvitamin D [24,25(OH)2D] by 4.3-fold. In contrast, mean levels of PTH, FGF23, and 1,25(OH)2D did not change in response to VitD3 supplementation. Mathematical modeling suggested that 24-hydroxylase activity was maximal for 25(OH)D levels ≥50 ng/mL and achieved a minimum (~90% suppression) when 25(OH)D levels were <10-20 ng/mL. Suppression of 24-hydroxylase is triggered by mild-moderate VitD deficiency and is predicted to sustain physiological levels of 1,25(OH)2D by suppressing metabolic clearance of 1,25(OH)2D. VitD metabolite ratios [e.g., 1,25(OH)2D/24,25(OH)2D] provide useful indices demonstrating that the body has triggered homeostatic regulation to compensate for limited availability of VitD. Thus, suppression of 24-hydroxylase activity provides a first line of defense protecting against VitD deficiency. In severe VitD deficiency, when this first line of defense has been maximally deployed, the body triggers secondary hyperparathyroidism, thereby providing a second line of defense.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Critical Role for 24-Hydroxylation in Homeostatic Regulation of Vitamin D Metabolism

Yazdi

Streeten

Whitlatch

et al. 2023

Preprint

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“…Patients in studies are typically symptomatic, but there are also asymptomatic patients [ 6 , 7 , 23 ]. Vitamin D deficiency has been found in PHPT patients in previous studies, and vitamin D deficiency causes low serum calcium levels [ 24 , 25 ]. Patients may be asymptomatic as a result of this.…”

Section: Discussionmentioning

confidence: 99%

Use of Parathyroid Function Index and Wisconsin Index to Differentiate Primary Hyperparathyroidism From Secondary Hyperparathyroidism: A Case-Control Study

ÖZKAN¹,

Turhan²

2022

Cureus

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Introduction: Patients with primary hyperparathyroidism (PHPT) can be asymptomatic or have a normal calcium level (NHPT). Patients with 25(OH) vitamin D insufficiency, on the other hand, may present with a similar presentation. In regions where 25(OH) vitamin D deficiency is common, patients are usually diagnosed with secondary hyperparathyroidism (SHPT). Therefore, it is necessary to separate PHPT and NHPT from SHPT. Parathormone and calcium values are used for differentiation in the clinic. The predictive value of the newly developed parathyroid function test (PFindex), which previously had a high diagnostic value, was evaluated in this patient population in our investigation.Methods: The study comprised 163 PHPT and NHPT patients with pathological confirmation and 56 SHPT patients. The PHPT, NHPT, and SHPT properties were defined using PFindex. The diagnostic power of PFindex was investigated using a receiver operating characteristic (ROC) curve of the results assessed in three groups.Results: The PHPT group had the highest PFindex (1365.4±784.6) compared to the other two groups (NHPT: 723.5±509.4; SHPT:227.2±49.9, all p < 0.001). A PFindex threshold of 327.8 yielded 91.9% and 90.9% sensitivity and specificity rates for distinguishing PHPT and NHPT from SHPT, respectively. Conclusion: PFindex gave the outstanding diagnostic capacity to distinguish PHPT from SHPT due to our research. This straightforward tool can assist in making quick decisions about vitamin D therapy or surgery for PHPT.

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“…Several epidemiological studies suggest an association between obesity, insulin resistance, diabetes and a reduced vitamin D activity [ 38 ]. In particular, Meng et al observed lower total 25(OH)D and vitamin D binding protein levels ( p < 0.001) in patients with hyperPTH [ 39 ]. Moreover, vitamin D concentrations present an inverted correlation with obesity-related parameters as BMI and waist circumference and vitamin D may contribute to build the sarcopenic obesity phenotype[ 40 , 41 ].…”

Section: Methodsmentioning

confidence: 99%

Parathyroid diseases and metabolic syndrome

Modica¹,

Liccardi²,

Minotta³

et al. 2023

J Endocrinol Invest

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Purpose Parathyroid diseases are related to parathyroid hormone (PTH) dysregulation by parathyroid cells or alteration of PTH function. They include hyperparathyroidism (PTH excess), hypoparathyroidism (PTH deficiency) and pseudohypoparathyroidism (PTH resistance). Little is known about correlation between parathyroid diseases and metabolic syndrome (MetS). Methods An electronic-based search using PubMed was performed until October 2022 and articles were selected based on relevance of title, abstract, English language and publication in peer-reviewed journals. Results Possible association between PTH alterations and the diverse manifestation of MetS have been proposed and it could be supposed that MetS may negatively influence parathyroid diseases. Available data show significant association for hyperparathyroidism and pseudohypoparathyroidism. Conclusions This review highlights the possible implications between MetS and parathyroid diseases. Given the increasing MetS global prevalence and the higher parathyroid diseases awareness and diagnosis, it may be interesting to further explore the possible role of alterations in parathyroid homeostasis in the development of MetS components with dedicated prospective studies.

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Total and free vitamin D metabolites in patients with primary hyperparathyroidism

Cited by 8 publications

References 33 publications

Critical Role for 24-Hydroxylation in Homeostatic Regulation of Vitamin D Metabolism

Critical Role for 24-Hydroxylation in Homeostatic Regulation of Vitamin D Metabolism

Use of Parathyroid Function Index and Wisconsin Index to Differentiate Primary Hyperparathyroidism From Secondary Hyperparathyroidism: A Case-Control Study

Parathyroid diseases and metabolic syndrome

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