Interactions across parathyroid hormone (PTH), 25-hydroxyvitamin D (25-OHD) and calcium levels in white and black women with primary hyperparathyroidism (PHPT)

Document Type

Conference Proceeding

Publication Date

9-27-2024

Publication Title

J Bone Miner Res

Abstract

There is a feedback loop between vitamin D, calcium, and PTH levels. Adequate vitamin D nutrition, as assessed by serum 25-OHD, promotes calcium absorption and prevents excessive PTH secretion. Low vitamin D levels can lead to decreased calcium absorption, potentially resulting in elevated PTH levels. However, it is unclear whether the supernormal PTH level in PHPT patients is associated with vitamin D levels and if there is a difference in this relationship between white and black women. This study examined serum PTH, vitamin D (25(OH)D), and calcium (Ca) levels in 250 women with PHPT, 96 black and 154 white women, aged between 50-91 years. Serum PTH levels exceeded the normal range (>65 pg/ mL) in 83% of black and 82% of white women diagnosed with PHPT. No significant differences were observed in serum PTH, Ca, and 25(OH)D levels between black and white women. When compared to healthy women (data not shown), all serum PTH, Ca, and 25(OH)D levels were significantly elevated in both black and white women with PHPT. Moreover, the difference in 25(OH)D levels between black and white women, observed in healthy women (Qiu et al, Bone Rep 18: 101650, 2023), was absent in women with PHPT. Interestingly, although there was a significant positive correlation between serum Ca and PTH in both black and white women with PHPT, there was no significant correlation between serum 25-OHD and PTH levels. These findings provide a new perspective on the complex regulation of PTH and calcium levels in relation to vitamin D nutrition, different from the effect of vitamin D deficiency on parathyroid adenoma weight (Rao et al. J Steroid Biochem Mol Biol. 2020). highlighting the need for further research to fully understand the underlying mechanisms and their implications for PHPT management. One limitation was lack of data on vitamin D supplements for some patients. However, the higher levels of both vitamin D and PTH and the lack of a significant correlation between them suggest that vitamin D levels may not be closely related to PTH production in PHPT patients regardless of ethnicity.

Volume

39

First Page

234

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