Mikhail Nasser
Division of Endocrinology, Olive-View-UCLA Medical Center, Sylmar, CA 91342, USA.
South Med J. 2011 Jan;104(1):29-33. doi: 10.1097/SMJ.0b013e3181fcd772.
Vitamin D deficiency occurs more frequently in patients with primary hyperparathyroidism (PHPT) compared with the general population, and is usually associated with an aggravated form of the disease. Current guidelines recommend measurement of serum levels of 25-hydroxy vitamin D (25-OHD) in all patients with PHPT, and their repletion if the levels are less than 50 mmol/L (20 ng/mL). Limited data suggest that vitamin D treatment is generally safe in subjects with mild PHPT and coexisting vitamin D deficiency. Adverse effects include hypercalcuria and, less commonly, exacerbation of hypercalcemia. Well-designed trials are needed to evaluate the safety of vitamin D replacement therapy in a wide spectrum of patients with concomitant PHPT and vitamin D deficiency. These trials should address the impact of such therapy on the complications and course of PHPT.
与普通人群相比，原发性甲状旁腺功能亢进症（PHPT）患者中维生素D缺乏更为常见，且通常与该疾病的加重形式相关。当前指南建议对所有PHPT患者检测血清25-羟维生素D（25-OHD）水平，若水平低于50 mmol/L（20 ng/mL）则进行补充。有限的数据表明，维生素D治疗在轻度PHPT且并存维生素D缺乏的患者中总体安全。不良反应包括高钙尿症，较少见的是高钙血症加重。需要设计良好的试验来评估维生素D替代疗法在广泛的合并PHPT和维生素D缺乏患者中的安全性。这些试验应探讨该疗法对PHPT并发症和病程的影响。
