Lars Rolighed1, Lars Rejnmark2, Tanja Sikjaer2, Lene Heickendorff2, Peter Vestergaard3, Leif Mosekilde2, Peer Christiansen2. 1. Breast and Endocrine SectionDepartment of Surgery PDepartment of Endocrinology and Internal MedicineAarhus University Hospital, Tage Hansens Gade 2, 8000 Aarhus C, DenmarkDepartment of Clinical BiochemistryAarhus University Hospital, NBG, Aarhus, DenmarkDepartment of Endocrinology and Clinical InstituteAalborg University Hospital, Aalborg, Denmark larsrolighed@gmail.com. 2. Breast and Endocrine SectionDepartment of Surgery PDepartment of Endocrinology and Internal MedicineAarhus University Hospital, Tage Hansens Gade 2, 8000 Aarhus C, DenmarkDepartment of Clinical BiochemistryAarhus University Hospital, NBG, Aarhus, DenmarkDepartment of Endocrinology and Clinical InstituteAalborg University Hospital, Aalborg, Denmark. 3. Breast and Endocrine SectionDepartment of Surgery PDepartment of Endocrinology and Internal MedicineAarhus University Hospital, Tage Hansens Gade 2, 8000 Aarhus C, DenmarkDepartment of Clinical BiochemistryAarhus University Hospital, NBG, Aarhus, DenmarkDepartment of Endocrinology and Clinical InstituteAalborg University Hospital, Aalborg, Denmark Breast and Endocrine SectionDepartment of Surgery PDepartment of Endocrinology and Internal MedicineAarhus University Hospital, Tage Hansens Gade 2, 8000 Aarhus C, DenmarkDepartment of Clinical BiochemistryAarhus University Hospital, NBG, Aarhus, DenmarkDepartment of Endocrinology and Clinical InstituteAalborg University Hospital, Aalborg, Denmark.
Abstract
CONTEXT: Impairments of muscle function and strength in patients with primary hyperparathyroidism (PHPT) are rarely addressed, although decreased muscle function may contribute to increased fracture risk. OBJECTIVE: We aimed to assess the changes in muscle strength, muscle function, postural stability, quality of life (QoL), and well-being during treatment with vitamin D or placebo before and after parathyroidectomy (PTX) in PHPT patients. DESIGN: A randomized placebo-controlled trial. PATIENTS: We included 46 PHPT patients, mean age 58 (range 29-77) years and 35 (76%) were women. INTERVENTIONS: Daily treatment with 70 μg (2800 IU) cholecalciferol or placebo for 52 weeks. Treatment was administered 26 weeks before PTX and continued for 26 weeks after PTX. MAIN OUTCOME MEASURES: Changes in QoL and measures of muscle strength and function. RESULTS:Preoperatively, 25-hydroxyvitamin D (25OHD) increased significantly (50-94 nmol/l) compared with placebo (57-52 nmol/l). We did not measure any beneficial effects of supplementation with vitamin D compared with placebo regarding well-being, QoL, postural stability, muscle strength, or function. In all patients, we measured marked improvements in QoL, well-being (P<0.01), muscle strength in the knee flexion and extension (P<0.001), and muscle function tests (P<0.01) after surgical cure. Postural stability improved during standing with eyes closed (P<0.05), but decreased with eyes open (P<0.05). CONCLUSIONS: Patients with PHPT and 25OHD levels around 50 nmol/l did not benefit from vitamin D supplementation concerning muscle strength, muscle function, postural stability, well-being, or QoL. Independent of preoperative 25OHD levels, PTX improved these parameters.
RCT Entities:
CONTEXT: Impairments of muscle function and strength in patients with primary hyperparathyroidism (PHPT) are rarely addressed, although decreased muscle function may contribute to increased fracture risk. OBJECTIVE: We aimed to assess the changes in muscle strength, muscle function, postural stability, quality of life (QoL), and well-being during treatment with vitamin D or placebo before and after parathyroidectomy (PTX) in PHPT patients. DESIGN: A randomized placebo-controlled trial. PATIENTS: We included 46 PHPT patients, mean age 58 (range 29-77) years and 35 (76%) were women. INTERVENTIONS: Daily treatment with 70 μg (2800 IU) cholecalciferol or placebo for 52 weeks. Treatment was administered 26 weeks before PTX and continued for 26 weeks after PTX. MAIN OUTCOME MEASURES: Changes in QoL and measures of muscle strength and function. RESULTS: Preoperatively, 25-hydroxyvitamin D (25OHD) increased significantly (50-94 nmol/l) compared with placebo (57-52 nmol/l). We did not measure any beneficial effects of supplementation with vitamin D compared with placebo regarding well-being, QoL, postural stability, muscle strength, or function. In all patients, we measured marked improvements in QoL, well-being (P<0.01), muscle strength in the knee flexion and extension (P<0.001), and muscle function tests (P<0.01) after surgical cure. Postural stability improved during standing with eyes closed (P<0.05), but decreased with eyes open (P<0.05). CONCLUSIONS:Patients with PHPT and 25OHD levels around 50 nmol/l did not benefit from vitamin D supplementation concerning muscle strength, muscle function, postural stability, well-being, or QoL. Independent of preoperative 25OHD levels, PTX improved these parameters.
Authors: Julius Simoni Leere; Jesper Karmisholt; Maciej Robaczyk; Peter Vestergaard Journal: Front Endocrinol (Lausanne) Date: 2017-04-20 Impact factor: 5.555
Authors: Elisa J de Koning; Natasja M van Schoor; Brenda W J H Penninx; Petra J M Elders; Annemieke C Heijboer; Jan H Smit; Pierre M Bet; Maurits W van Tulder; Martin den Heijer; Harm W J van Marwijk; Paul Lips Journal: BMC Geriatr Date: 2015-11-19 Impact factor: 3.921