Wang Xiangbing, Sheng Zhifeng, Meng Lingqiong, Su Chi, Trooskin Stanley, Shapses Sue A
Divisions of Endocrinology, Metabolism, and Nutrition, Departments of Medicine and Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, United States.
Institution of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China.
Front Endocrinol (Lausanne). 2019 Mar 27;10:171. doi: 10.3389/fendo.2019.00171. eCollection 2019.
To evaluate vitamin D binding protein and free 25-hydroxyvitamin D [25(OH)D] levels in healthy controls compared to primary hyperparathyroidism (PHPT) patients, and to examine PHPT before and after surgery. Seventy-five PHPT patients and 75 healthy age, gender, and body mass index (BMI) -matched control subjects were examined. In addition, 25 PHPT patients underwent parathyroidectomy and had a 3-month follow up visit. Levels of total and free 25(OH)D, DBP, and intact parathyroid hormone (iPTH) were determined before and 3 months after surgery. There was no significant difference in age and BMI between PHPT patients and controls. Levels of 25(OH)D and DBP were lower in PHPT patients compared to controls ( < 0.01). There was no significant difference in calculated free and bioavailable 25(OH)D levels between PHPT patients and controls. Calcium and iPTH levels decreased to normal but DBP and DBP-bound-25(OH)D increased ( < 0.001) after parathyroidectomy. Levels of DBP were inversely correlated with iPTH ( = -0.406, < 0.001) and calcium levels ( = -0.423, < 0.001). Serum DBP levels were lower in patients with PHPT and parathyroidectomy restored DBP levels. We suggest that lower DBP levels is one of contributing mechanisms of low total 25(OH)D in PTHP patients and the total 25(OH)D levels might not reflect true vitamin D status in PHPT patients.
评估与原发性甲状旁腺功能亢进症（PHPT）患者相比，健康对照者体内维生素D结合蛋白和游离25-羟基维生素D [25(OH)D] 的水平，并在手术前后检查PHPT患者的情况。对75例PHPT患者和75例年龄、性别及体重指数（BMI）匹配的健康对照者进行了检查。此外，25例PHPT患者接受了甲状旁腺切除术，并进行了3个月的随访。在手术前及术后3个月测定总25(OH)D、游离25(OH)D、DBP及完整甲状旁腺激素（iPTH）的水平。PHPT患者与对照组在年龄和BMI方面无显著差异。与对照组相比，PHPT患者的25(OH)D和DBP水平较低（<0.01）。PHPT患者与对照组之间计算得出的游离和生物可利用25(OH)D水平无显著差异。甲状旁腺切除术后，钙和iPTH水平降至正常，但DBP及与DBP结合的25(OH)D升高（<0.001）。DBP水平与iPTH（r = -0.406，<0.001）及钙水平（r = -0.423，<0.001）呈负相关。PHPT患者的血清DBP水平较低，甲状旁腺切除术后DBP水平得以恢复。我们认为，较低的DBP水平是PHPT患者总25(OH)D水平降低的原因之一，且总25(OH)D水平可能无法反映PHPT患者的真实维生素D状态。
