Vitamin D Deficiency in Cushing’s Disease: Before and After Its Supplementation

Abstract

Background: The primary objective of the study was to assess serum 25-hydroxyvitamin D [25(OH)D] values in patients with Cushing’s disease (CD), compared to controls. The secondary objective was to assess the response to a load of 150,000 U of cholecalciferol. Methods: In 50 patients with active CD and 48 controls, we evaluated the anthropometric and biochemical parameters, including insulin sensitivity estimation by the homeostatic model of insulin resistance, Matsuda Index and oral disposition index at baseline and in patients with CD also after 6 weeks of cholecalciferol supplementation. Results: At baseline, patients with CD showed a higher frequency of hypovitaminosis deficiency (p = 0.001) and lower serum 25(OH)D (p < 0.001) than the controls. Six weeks after cholecalciferol treatment, patients with CD had increased serum calcium (p = 0.017), 25(OH)D (p < 0.001), ISI-Matsuda (p = 0.035), oral disposition index (p = 0.045) and decreased serum PTH (p = 0.004) and total cholesterol (p = 0.017) values than at baseline. Multivariate analysis showed that mean urinary free cortisol (mUFC) was independently negatively correlated with serum 25(OH)D in CD. Conclusions: Serum 25(OH)D levels are lower in patients with CD compared to the controls. Vitamin D deficiency is correlated with mUFC and values of mUFC > 240 nmol/24 h are associated with hypovitaminosis D. Cholecalciferol supplementation had a positive impact on insulin sensitivity and lipids.

Cholecalciferol Use Is Associated With a Decreased Risk of Incident Morphometric Vertebral Fractures in Acromegaly

“…It is also worth mentioning that in our treated group desirable V25OH-D values were obtained using similar doses with respect to those recommended for the general osteoporotic population, in line with the recommended daily intake of about 1000 IU per day ( 30 ). Moreover, serum V25OH-D levels were significantly lower in patients with active disease at follow-up, confirming that active acromegaly may represent a state of relative “VD resistance,” as already reported for Cushing disease ( 46 , 47 ).…”

The Interrelated Multifactorial Actions of Cortisol and Klotho: Potential Implications in the Pathogenesis of Parkinson’s Disease

“…Vitamin D is now suggested to be a biomarker of healthy aging with a strong association between low levels and higher all-cause mortality with large and significant effect sizes in multiple studies [ 179 ]. Cortisol has an antagonist relationship with vitamin D. Higher cortisol levels correlate with lower vitamin D levels [ 180 ]. Several studies also suggest that vitamin D may regulate the HPA axis.…”

Vitamin D and adrenal gland: Myth or reality? A systematic review

“…An even more recent study by Gurnotta et al conducted on patients with CD is of considerable interest (17). The objectives of the study were to: 1. evaluate serum 25-OH-vitamin D in CD patients, compared to controls; 2. evaluate the response to a dose of 150,000 UI of cholecalciferol in patients with CD.…”

“…An even more recent study by Gurnotta et al. conducted on patients with CD is of considerable interest ( 17 ). The objectives of the study were to: 1 .…”

“…In conclusion, serum levels of 25 (OH) D were lower in patients with CD than in controls. Vitamin D deficiency is correlated with mUFC and mUFC values>240 nmol/24 h are associated with hypovitaminosis D. The supplementation of cholecalciferol had a positive impact on insulin sensitivity and lipids ( 17 ).…”