Effect of low Vitamin D on volumetric bone mineral density, bone microarchitecture, and stiffness in primary hyperparathyroidism

Abstract

Context: Patients with 25-hydroxyvitamin D deficiency (25OHD <20 ng/ml) and primary hyperparathyroidism (PHPT) have more severe disease reflected by higher serum PTH levels compared to those with vitamin D levels in the insufficient (20-29 ng/ml) or replete range (<30 ng/ml). Objective: To study the effect of low vitaminDin PHPT on volumetric bone mineral density (vBMD), bone microarchitecture, and bone strength. Design, Setting, and Participants: This is a cross-sectional analysis of 99 PHPT patients with and without 25OHD insufficiency and deficiency from a university hospital. Outcome Measures: Bone microarchitecture and strength were assessed with high-resolution peripheral quantitative computed tomography (HRpQCT), microfinite element analysis, and individual trabecula segmentation. Results: In this cohort, 25OHD levels were deficient in 18.1%, insufficient in 35.4% and replete in 46.5%. Those with lower 25OHD levels had higher PTH (P <20 vs 20-29 vs<30 ng/ml) in any HRpQCT, microfinite element analysis, or individual trabecula segmentation indices. Because few participants had 25OHD below 20 ng/ml, we also compared those with 25OHD below 30 vs at least 30 ng/ml and found only a trend toward lower adjusted corticalvBMD(3.1%, P