Pipili Chrysoula, Sekecioglu Nigar, Oreopoulos Dimitrios G
Kidney Stone Clinic, Toronto Western Hospital, Division of Nephrology, University Health Network and University of Toronto, Toronto, Canada.
Clin Nephrol. 2012 May;77(5):352-7. doi: 10.5414/cn107355.
This retrospective data analysis was undertaken to examine the biochemical differences between renal stone formers with normocalcemic hyperparathyroidism (NHPT) and those with normal parathyroid hormone (PTH) levels. Our goal was to ascertain whether 25-hydroxyvitamin D (25(OH)D) status related to PTH levels in this patient cohort. Our findings among 74 patients with NHPT indicate that stone formers with NHPT had significantly lower 25(OH)D levels compared to 192 controls (p = 0.0001) and that 25(OH)D is positively correlated with 1,25-dihydroxyvitamin D values (R = 0.736, p = 0.015). Sequential measurements (after 3 - 5 years), among 11 patients with NHPT who did not receive vitamin D (VitD) preparations, showed a significant increase in urinary calcium (3.43 ± 1.96 vs. 5.72 ± 3.95, p = 0.0426) without a significant change in PTH levels. VitD supplementation, to 3 patients resulted in significant PTH decrease (11.8 ± 1.8 vs. 9.8 ± 1.3, p = 0.003). Prospective studies are needed to confirm the role of vitamin supplementation in renal stone formers with NHPT.
进行这项回顾性数据分析是为了研究血钙正常的甲状旁腺功能亢进症（NHPT）患者与甲状旁腺激素（PTH）水平正常的肾结石患者之间的生化差异。我们的目标是确定在该患者队列中25-羟维生素D（25(OH)D）状态是否与PTH水平相关。我们在74例NHPT患者中的研究结果表明，与192例对照相比，NHPT肾结石患者的25(OH)D水平显著降低（p = 0.0001），且25(OH)D与1,25-二羟维生素D值呈正相关（R = 0.736，p = 0.015）。在11例未接受维生素D（VitD）制剂的NHPT患者中进行的连续测量（3 - 5年后）显示，尿钙显著增加（3.43 ± 1.96对5.72 ± 3.95，p = 0.0426），而PTH水平无显著变化。对3例患者补充VitD导致PTH显著降低（11.8 ± 1.8对9.8 ± 1.3，p = 0.003）。需要进行前瞻性研究以证实维生素补充在NHPT肾结石患者中的作用。
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