University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Department of Endocrinology and Metabolism - Istanbul, Turkey.
Koc University, School of Medicine, Department of Endocrinology and Metabolism - Istanbul, Turkey.
Rev Assoc Med Bras (1992). 2023 Oct 27;69(11):e20230406. doi: 10.1590/1806-9282.20230406. eCollection 2023.
A significant problem that compels clinicians in the conventional treatment of hypoparathyroidism is patients' non-adherence to treatment. This study aimed to evaluate the effects of adequate Ca intake with dietary recommendations among hypoparathyroidism patients who persistently use Ca supplementation irregularly on plasma Ca and phosphate levels.
This prospective, randomized, controlled study was conducted on patients diagnosed with chronic hypoparathyroidism who persistently interrupt Ca supplementation therapy and therefore have a hypocalcemic course. Patients with a total daily Ca intake below 800 mg were randomized. All patients were advised to keep the doses of active vitamin D and Ca supplements they were currently using. The patients in the study group (n=32) were advised to consume 1,000-1,200 mg of Ca daily, and the patients in the control group (n=35) were advised to continue their diet according to their daily habits. After 12 weeks of follow-up, the patients' laboratory values were compared between groups to assess treatment goals.
The mean of the total Ca level was 8.56±0.36 mg/dL in the study group and was found to be significantly higher than that in the control group, which was 7.67±0.48 mg/dL (p<0.001). The mean serum phosphate and serum Ca-P product levels were significantly higher in the study group (p<0.001) but did not exceed the safe upper limits in any patient.
A suitable increase in dietary Ca intake could effectively control hypocalcemia in patients with hypoparathyroidism who persistently interrupt the recommended calcium supplementation.
在常规治疗甲状旁腺功能减退症时，一个迫使临床医生面临的重大问题是患者不遵医嘱治疗。本研究旨在评估对于持续不规律补钙且血钙水平持续较低的甲状旁腺功能减退症患者，给予充足的钙摄入（根据膳食建议）对其血浆钙和磷酸盐水平的影响。
这是一项前瞻性、随机、对照研究，纳入了持续中断补钙治疗且因此出现低钙血症的慢性甲状旁腺功能减退症患者。将每日总钙摄入量低于 800mg 的患者随机分组。所有患者均被建议维持当前正在使用的活性维生素 D 和钙补充剂剂量。研究组（n=32）的患者被建议每日摄入 1000-1200mg 的钙，对照组（n=35）的患者被建议继续根据日常习惯进食。随访 12 周后，比较两组患者的实验室值以评估治疗目标。
研究组的总钙水平平均值为 8.56±0.36mg/dL，明显高于对照组的 7.67±0.48mg/dL（p<0.001）。研究组的血清磷酸盐和血清 Ca-P 乘积水平明显较高（p<0.001），但在任何患者中均未超过安全上限。
适当增加膳食钙摄入可有效控制持续中断推荐补钙的甲状旁腺功能减退症患者的低钙血症。
