Yamashita Hiroyuki, Noguchi Shiro, Uchino Shinya, Watanabe Shin, Koike Eisuke, Murakami Tsukasa, Fujihira Takashi, Koga Yutaka, Masatsugu Toshihiro, Yamashita Hiroto
Department of Surgery, Noguchi Thyroid Clinic and Hospital Foundation, 6-33 Noguchi-Nakamachi, Beppu 874-0932, Japan.
World J Surg. 2002 Aug;26(8):937-41. doi: 10.1007/s00268-002-6622-z. Epub 2002 May 21.
The disturbance of vitamin D metabolism plays an important role in determining the clinical presentation of hyperthyroidism. We studied 72 patients (65 women, 7 men) with primary hyperparathyroidism (pHPT). Clinical presentation, biochemical indices, and bone mineral density (BMD) were compared in three patient groups classified according to their serum 25-hydroxyvitamin D (25OHD) levels: 23 patients whose 25OHD level was <25 nmol/L comprised the low group, 26 whose level was 25 to 40 nmol/L made up the intermediate group, and 23 whose level was > 40 nmol/L comprised the high group. The mean serum calcium level was 10.8 +/- 0.9 mg/dl, and the mean weight of the resected parathyroids was 684 +/- 749 mg. The mean serum 25OHD level was 36.5 +/- 16.3 nmol/L (normal 25-100 nmol/L). Levels were below normal in 23 patients (32%). No between-group differences existed for clinical presentation, biochemistry, or BMD. Only differences in mean patient age were statistically significant between groups. Vitamin D deficiency is common among Japanese patients with pHPT, but the effects of HPT on clinical, biochemical, and densitometric indices are not pronounced. Our study population was at an early stage of pHPT, so the vitamin D deficiency may not be associated with the effects of HPT.
维生素D代谢紊乱在决定甲状腺功能亢进的临床表现中起重要作用。我们研究了72例原发性甲状旁腺功能亢进症（pHPT）患者（65名女性，7名男性）。根据血清25-羟基维生素D（25OHD）水平将患者分为三组，比较了三组患者的临床表现、生化指标和骨密度（BMD）：25OHD水平<25 nmol/L的23例患者组成低水平组，25至40 nmol/L的26例患者组成中等水平组，>40 nmol/L的23例患者组成高水平组。血清钙平均水平为10.8±0.9 mg/dl，切除的甲状旁腺平均重量为684±749 mg。血清25OHD平均水平为36.5±16.3 nmol/L（正常范围25 - 100 nmol/L）。23例患者（32%）的水平低于正常。三组之间在临床表现、生化指标或骨密度方面无差异。仅组间患者平均年龄差异有统计学意义。维生素D缺乏在日本pHPT患者中很常见，但HPT对临床、生化和骨密度指标的影响并不明显。我们的研究人群处于pHPT的早期阶段，所以维生素D缺乏可能与HPT的影响无关。
