Pelineagră Oriana-Eliana, Golu Ioana, Balaș Melania, Amzăr Daniela, Plotuna Iulia, Popa Oana, Vlad Mihaela
2nd Department of Internal Medicine-Discipline of Endocrinology, "Victor Babes" University of Medicine and Pharmacy, P-Ta Eftimie Murgu 2, 300041 Timisoara, Romania.
Department of Endocrinology, County Emergency Hospital Timisoara, Blvd. Liviu Rebreanu 156, 300723 Timisoara, Romania.
Int J Mol Sci. 2025 May 7;26(9):4434. doi: 10.3390/ijms26094434.
Suboptimal vitamin D status is commonly observed in primary hyperparathyroidism but is rarely considered in management decisions. The present study aimed to bring additional insights on vitamin D status in primary hyperparathyroidism patients, particularly those presenting with the normocalcemic phenotype. A retrospective study was conducted on 53 confirmed primary hyperparathyroidism patients, stratified into hypercalcemic and normocalcemic groups, hospitalized at the "Pius Brînzeu" Emergency Clinical Country Hospital in Timișoara, Romania. Patients presenting with the normocalcemic phenotype had similar target-organ involvement compared to their counterparts. In this subgroup, 25 hydroxyvitamin D showed an inverse correlation with serum calcium ( = 0.048), and regression analysis identified iPTH and 25OH vitamin D as significant predictors of calcium levels ( < 0.0001; R2 = 0.571). Adenoma volume showed a significant negative correlation with 25OH vitamin D levels ( = 0.021; r = -0.61) but was later found as insignificant after confounder analysis. Postoperative measurements of 25OH vitamin D levels confirmed increasing levels after parathyroidectomy. Our findings highlight a complex relationship between PTH and vitamin D in primary hyperparathyroidism, especially in the often-underdiagnosed normocalcemic phenotype. The inverse correlation between vitamin D and calcium suggests altered homeostasis, rather than true deficiency.
在原发性甲状旁腺功能亢进症中，维生素D状态欠佳的情况较为常见，但在治疗决策中很少被考虑。本研究旨在进一步深入了解原发性甲状旁腺功能亢进症患者的维生素D状态，特别是那些表现为血钙正常表型的患者。对罗马尼亚蒂米什瓦拉“皮乌斯·布林泽乌”紧急临床乡村医院收治的53例确诊原发性甲状旁腺功能亢进症患者进行了一项回顾性研究，这些患者被分为高钙血症组和血钙正常组。表现为血钙正常表型的患者与其对应患者相比，靶器官受累情况相似。在这个亚组中，25羟维生素D与血清钙呈负相关（ = 0.048），回归分析确定iPTH和25OH维生素D是血钙水平的重要预测因子（ < 0.0001；R2 = 0.571）。腺瘤体积与25OH维生素D水平呈显著负相关（ = 0.021；r = -0.61），但在进行混杂因素分析后发现其无统计学意义。甲状旁腺切除术后对25OH维生素D水平的测量证实其水平升高。我们的研究结果突出了原发性甲状旁腺功能亢进症中PTH与维生素D之间的复杂关系，尤其是在常被漏诊的血钙正常表型中。维生素D与钙之间的负相关表明内环境稳态发生了改变，而非真正的缺乏。
