Gómez-Alonso Carlos, Naves-Díaz Manuel L, Fernández-Martín Jose L, Díaz-López Jose B, Fernández-Coto Maria T, Cannata-Andía Jorge B
Bone and Mineral Research Unit, Instituto Reina Sofía de Investigación, Hospital Central de Asturias, Universidad de Oviedo, Spain.
Kidney Int Suppl. 2003 Jun(85):S44-8. doi: 10.1046/j.1523-1755.63.s85.11.x.
Serum 25-hydroxyvitamin D is the best indicator of vitamin D status. However, some controversy remains regarding "normal" and "abnormal" values. This study's aim was to assess vitamin D status and prevalence of secondary hyperparathyroidism.
A random sample of 326 subjects (164 women and 162 men, aged 68 +/- 9; range, 54 to 89) participating in the European Vertebral Osteoporosis Study (EVOS) was used to assess vitamin D status and secondary hyperparathyroidism. Only those subjects who had never received any kind of treatment for osteoporosis were included in this analysis.
Serum 25-hydroxyvitamin D levels were "deficient" (<10 ng/mL) in 27% of subjects, "borderline" (10-18 ng/mL) in 40% of subjects, and "normal" (>18 ng/mL) in 33% of subjects. The prevalence of secondary hyperparathyroidism (PTH>65 pg/mL) according to 25-hydroxyvitamin D levels was 33% (<10 ng/mL), 16% (10-18 ng/mL), and 12% (>18 ng/mL), respectively. There were no cases of secondary hyperparathyroidism with 25-hydroxyvitamin D levels>40 ng/mL. The independent predictors for PTH were 25-hydroxyvitamin D and serum creatinine in both sexes, but age was a predictor only in men.
These remarkable findings demonstrate the importance of maintaining higher 25-hydroxyvitamin D levels to avoid stimulation of the parathyroid gland.
血清25-羟维生素D是维生素D状态的最佳指标。然而，关于“正常”和“异常”值仍存在一些争议。本研究的目的是评估维生素D状态和继发性甲状旁腺功能亢进的患病率。
采用欧洲脊柱骨质疏松研究（EVOS）中的326名受试者（164名女性和162名男性，年龄68±9岁；范围54至89岁）的随机样本，评估维生素D状态和继发性甲状旁腺功能亢进。本分析仅纳入从未接受过任何骨质疏松症治疗的受试者。
27%的受试者血清25-羟维生素D水平“不足”（<10 ng/mL），40%的受试者为“临界”（10 - 18 ng/mL），33%的受试者为“正常”（>18 ng/mL）。根据25-羟维生素D水平，继发性甲状旁腺功能亢进（甲状旁腺激素>65 pg/mL）的患病率分别为33%（<10 ng/mL）、16%（10 - 18 ng/mL）和12%（>18 ng/mL）。25-羟维生素D水平>40 ng/mL时无继发性甲状旁腺功能亢进病例。甲状旁腺激素的独立预测因素在两性中均为25-羟维生素D和血清肌酐，但年龄仅在男性中是预测因素。
这些显著发现表明维持较高的25-羟维生素D水平以避免刺激甲状旁腺的重要性。
