BACKGROUND: Primary hyperparathyroidism (pHPT) is associated with decreased bone density and increased fracture risk. A significant number of pHPT patients have low calcium intake and suffer from vitamin deficiency. Thus, we adopted a policy of postoperative supplements with calcium and vitamin D after parathyroid surgery. In this study, we investigated if this policy enhanced the postoperative increase in bone density. PATIENTS/ METHODS: Forty-two consecutive patients (83% female) were studied. The first 21 patients received no supplements, whereas the following 21 patients received 1,000 g calcium and 800 IU hydroxy D: -vitamin daily (Ca-D group) for 1 year postoperatively. The patients were monitored with bone density and biochemistry pre- and at 1 year postoperatively. RESULTS: Preoperatively, the patients without vitamin D supplementation (non-Ca-D group) did neither differ in biochemistry, clinical features, nor in bone density from patients in Ca-D group. Postoperatively, there was a tendency that patients in Ca-D group increased their bone density, at all sites measured, in a greater extent than patients that did not receive calcium and vitamin D supplementation. CONCLUSION: In conclusion, based on our results, it is difficult to give a recommendation of vitamin D supplementation in routine use following surgery for primary hyperparathyroidism. Based on the present data, a calculation of sample size for a future randomized controlled trial is presented.
BACKGROUND:Primary hyperparathyroidism (pHPT) is associated with decreased bone density and increased fracture risk. A significant number of pHPT patients have low calcium intake and suffer from vitamin deficiency. Thus, we adopted a policy of postoperative supplements with calcium and vitamin D after parathyroid surgery. In this study, we investigated if this policy enhanced the postoperative increase in bone density. PATIENTS/ METHODS: Forty-two consecutive patients (83% female) were studied. The first 21 patients received no supplements, whereas the following 21 patients received 1,000 g calcium and 800 IU hydroxy D: -vitamin daily (Ca-D group) for 1 year postoperatively. The patients were monitored with bone density and biochemistry pre- and at 1 year postoperatively. RESULTS: Preoperatively, the patients without vitamin D supplementation (non-Ca-D group) did neither differ in biochemistry, clinical features, nor in bone density from patients in Ca-D group. Postoperatively, there was a tendency that patients in Ca-D group increased their bone density, at all sites measured, in a greater extent than patients that did not receive calcium and vitamin D supplementation. CONCLUSION: In conclusion, based on our results, it is difficult to give a recommendation of vitamin D supplementation in routine use following surgery for primary hyperparathyroidism. Based on the present data, a calculation of sample size for a future randomized controlled trial is presented.
Authors: M K Thomas; D M Lloyd-Jones; R I Thadhani; A C Shaw; D J Deraska; B T Kitch; E C Vamvakas; I M Dick; R L Prince; J S Finkelstein Journal: N Engl J Med Date: 1998-03-19 Impact factor: 91.245
Authors: Rebecca D Jackson; Andrea Z LaCroix; Margery Gass; Robert B Wallace; John Robbins; Cora E Lewis; Tamsen Bassford; Shirley A A Beresford; Henry R Black; Patricia Blanchette; Denise E Bonds; Robert L Brunner; Robert G Brzyski; Bette Caan; Jane A Cauley; Rowan T Chlebowski; Steven R Cummings; Iris Granek; Jennifer Hays; Gerardo Heiss; Susan L Hendrix; Barbara V Howard; Judith Hsia; F Allan Hubbell; Karen C Johnson; Howard Judd; Jane Morley Kotchen; Lewis H Kuller; Robert D Langer; Norman L Lasser; Marian C Limacher; Shari Ludlam; JoAnn E Manson; Karen L Margolis; Joan McGowan; Judith K Ockene; Mary Jo O'Sullivan; Lawrence Phillips; Ross L Prentice; Gloria E Sarto; Marcia L Stefanick; Linda Van Horn; Jean Wactawski-Wende; Evelyn Whitlock; Garnet L Anderson; Annlouise R Assaf; David Barad Journal: N Engl J Med Date: 2006-02-16 Impact factor: 91.245
Authors: Erik Nordenström; Antonio Sitges-Serra; Joan J Sancho; Mark Thier; Martin Almquist Journal: Int J Endocrinol Date: 2013-08-05 Impact factor: 3.257