Correlation of intact parathormone levels with serum calcium, serum phosphorus and serum vitamin d levels in surgical patients
Keywords:
Parathormone, Vitamin D, Calcium, Phosphorus
Abstract
Aim: The aim of our study was to determine a correlation between hyperparathyroidism and Serum Calcium, Phosphorus and Vitamin D levels.
Study Design: A Hospital based cross-sectional study was conducted on the patients attending the Out patient Department of Surgery, of SGRR Medical College, Dehradun (UK), during a period of 6 months from November 2016 to April 2017. A total number of 66 cases (32 male + 34 female) and 45 controls (20 male +25female) in the age group of 20-60 years were selected randomly for this study. Exclusion criteria were age less than 20 years and more than 60 years, pregnancy, diabetes, tuberculosis etc.
Methodology: The blood samples were collected in fasting state and Serum iPTH, Vitamin-D, Calcium & Phosphorus levels were estimated on a fully automated machine 5600 of Orthodiagnostics.
Results: The levels of iPTH were found to be higher in female cases than male cases and much higher when compared with controls both male & female. Both male & female hyper parathyroid cases were normocalcemic. Vitamin D levels were found to be lower in both male & female cases as compared to their normal counterparts. Serum Phosphorus levels were found to be on the lower side in both cases as compared with normal controls.
Downloads
Download data is not yet available.
References
1. Physiology: 5/5 ch.6/S 5ch-11-Essentials of Human Physiology.
2. Coetzee M, Kruger MC. Osteoprotegerin-receptor activator of nuclear factor-kappaB ligand ratio: a new approach to osteoporosis treatment?South Med J.2004 May;97(5):506-11. [PubMed]
3. Gardener D, Shoback D (2011). Green spans Basic & Clinical Endocrinology (9thEdt.), McGraw Hill p232. ISBN 978-0-07-162243-1.
4. Silver J &Naveh-Many T. Vitamin D and the parathyroid. In Vitamin D. edn 2, Eds D Feldman. F Glorieux & J Wesley Pike. San Diego, Elsevier, 2004.
5. Lips P.Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications.Endocr Rev. 2001 Aug;22(4):477-501. [PubMed]
6. Lips P, Netlembos JC, Jongen MJ et al, Histomorphometric profile and Vitamin D status in patients with femoral neck fracture. Metabolic Bone Disease and Related Research 1982; 4: 85-93.
7. Kuchuk NO, Pluijm SM, van Schoor NM, Looman CW, Smit JH, Lips P. Relationships of serum 25-hydroxyvitamin D to bone mineral density and serum parathyroid hormone and markers of bone turnover in older persons.J Clin Endocrinol Metab. 2009 Apr;94(4):1244-50. doi: 10.1210/jc.2008-1832. Epub 2009 Jan 21. [PubMed]
8. Trivedi DP, Doll R, Khaw KT.Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial.BMJ.2003 Mar 1;326(7387):469. [PubMed]
9. Lemire JM, Adams JS et al. 1-alpha 25 dihydroxy vitamin D3 suppresses proliferation and Immunoglobulin production by normal human peripheral blood mononuclear cells. J Clin Investing. 1984; 74:1451-55.
10. Rigby WF, Stacy T, Fanger MW. Inhibition of T lymphocyte mitogenesis by 1,25-dihydroxyvitamin D3 (calcitriol).J Clin Invest. 1984 Oct;74(4):1451-5. [PubMed]
11. Armitage EK. Parathyrin (parathyroid hormone): metabolism and methods for assay.Clin Chem. 1986 Mar;32(3):418-24. [PubMed]
12. Lai JK, Lucas RM, Clements MS, Harrison SL, Banks E. Assessing vitamin D status: pitfalls for the unwary.MolNutr Food Res. 2010 Aug;54(8):1062-71. doi: 10.1002/mnfr.200900468. [PubMed]
13. Teitz. NW (ed). Fundamentals of Clinical Chemistry ed3. Philadelphia: WB Saunders; 705-713; 1987.
14. Teitz NW (ed). Fundamentals of Clinical Chemistry. Ed 3. Philadelphia: WB Saunders; 706-716; 1987.
15. Lundgren E, Hagstrom EG, Lundin J, Winnerback KL, Ross J, Ljunghall S, et al. Primary hyperparathydoidism revisited in menopausal women with serum calcium in the upper normal range at population based screening 8 years ago. World S Surg 2002; 26(8):931-6.
16. Cusano NE, Silverberg SJ, Bilezikian JP. Normocalcemic primary hyperparathyroidism.J ClinDensitom. 2013 Jan-Mar;16(1):33-9. doi: 10.1016/j.jocd.2012.12.001. [PubMed]
17. Heaney RP. The Vitamin D requirement in health and disease.J Steroid BiochemMol Biol. 2005 Oct;97(1-2):13-9. Epub 2005 Jul 18. [PubMed]
18. Eastell R, Arnold A, Brandi ML, Brown EM, D'Amour P, Hanley DA, Rao DS, Rubin MR, Goltzman D, Silverberg SJ, Marx SJ, Peacock M, Mosekilde L, Bouillon R, Lewiecki EM. Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the third international workshop.J Clin Endocrinol Metab. 2009 Feb;94(2):340-50. doi: 10.1210/jc.2008-1758. [PubMed]
19. Silverberg SJ, Lewiecki EM, Mosekilde L, Peacock M, Rubin MR. Presentation of asymptomatic primary hyperparathyroidism: proceedings of the third international workshop. J Clin Endocrinol Metab 2009; 94(2):351-65. [PubMed]
20. Dawson-Hughes B, Harris SS, Dallal GE. Plasma calcidiol, season, and serum parathyroid hormone concentrations in healthy elderly men and women.Am J ClinNutr. 1997 Jan;65(1):67-71. [PubMed]
21. Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, Meunier PJ. Prevalence of vitamin D insufficiency in an adult normal population.Osteoporos Int. 1997;7(5):439-43. [PubMed]
22. Adami S, Viapiana O, Gatti D, Idolazzi L, Rossini M.Relationship between serum parathyroid hormone, vitamin D sufficiency, age, and calcium intake.Bone. 2008 Feb;42(2):267-70. Epub 2007 Oct 16. [PubMed]
23. Willett AM. Vitamin D status and its relationship with parathyroid hormone and bone mineral status in older adolescents.Proc Nutr Soc. 2005 May;64(2):193-203.
24. Elsammak MY, Al-Wosaibi AA, Al-Howeish A, Alsaeed J. Vitamin d deficiency in Saudi Arabs.HormMetab Res. 2010 May;42(5):364-8. doi: 10.1055/s-0030-1248296. Epub 2010 Mar 8. [PubMed]
25. Arabi A, Baddoura R, El-Rassi R, El-Hajj Fuleihan G.Age but not gender modulates the relationship between PTH and vitamin D.Bone. 2010 Aug;47(2):408-12. doi: 10.1016/j.bone.2010.05.002. Epub 2010 May 7.
26. Ardawi MS, Sibiany AM, Bakhsh TM, Qari MH, Maimani AA. High prevalence of vitamin D deficiency among healthy Saudi Arabian men relationship to bone mineral density, parathyroid hormone, bone turnover markers, and lifestyle factors. Osteoporos. Int. 2012; 23(2):675-86. [PubMed]
27. Phelan PJ, O'Kelly P, Walshe JJ, Conlon PJ. The importance of serum albumin and phosphorous as predictors of mortality in ESRD patients.Ren Fail. 2008;30(4):423-9. doi: 10.1080/08860220801964236. [PubMed]
2. Coetzee M, Kruger MC. Osteoprotegerin-receptor activator of nuclear factor-kappaB ligand ratio: a new approach to osteoporosis treatment?South Med J.2004 May;97(5):506-11. [PubMed]
3. Gardener D, Shoback D (2011). Green spans Basic & Clinical Endocrinology (9thEdt.), McGraw Hill p232. ISBN 978-0-07-162243-1.
4. Silver J &Naveh-Many T. Vitamin D and the parathyroid. In Vitamin D. edn 2, Eds D Feldman. F Glorieux & J Wesley Pike. San Diego, Elsevier, 2004.
5. Lips P.Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications.Endocr Rev. 2001 Aug;22(4):477-501. [PubMed]
6. Lips P, Netlembos JC, Jongen MJ et al, Histomorphometric profile and Vitamin D status in patients with femoral neck fracture. Metabolic Bone Disease and Related Research 1982; 4: 85-93.
7. Kuchuk NO, Pluijm SM, van Schoor NM, Looman CW, Smit JH, Lips P. Relationships of serum 25-hydroxyvitamin D to bone mineral density and serum parathyroid hormone and markers of bone turnover in older persons.J Clin Endocrinol Metab. 2009 Apr;94(4):1244-50. doi: 10.1210/jc.2008-1832. Epub 2009 Jan 21. [PubMed]
8. Trivedi DP, Doll R, Khaw KT.Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial.BMJ.2003 Mar 1;326(7387):469. [PubMed]
9. Lemire JM, Adams JS et al. 1-alpha 25 dihydroxy vitamin D3 suppresses proliferation and Immunoglobulin production by normal human peripheral blood mononuclear cells. J Clin Investing. 1984; 74:1451-55.
10. Rigby WF, Stacy T, Fanger MW. Inhibition of T lymphocyte mitogenesis by 1,25-dihydroxyvitamin D3 (calcitriol).J Clin Invest. 1984 Oct;74(4):1451-5. [PubMed]
11. Armitage EK. Parathyrin (parathyroid hormone): metabolism and methods for assay.Clin Chem. 1986 Mar;32(3):418-24. [PubMed]
12. Lai JK, Lucas RM, Clements MS, Harrison SL, Banks E. Assessing vitamin D status: pitfalls for the unwary.MolNutr Food Res. 2010 Aug;54(8):1062-71. doi: 10.1002/mnfr.200900468. [PubMed]
13. Teitz. NW (ed). Fundamentals of Clinical Chemistry ed3. Philadelphia: WB Saunders; 705-713; 1987.
14. Teitz NW (ed). Fundamentals of Clinical Chemistry. Ed 3. Philadelphia: WB Saunders; 706-716; 1987.
15. Lundgren E, Hagstrom EG, Lundin J, Winnerback KL, Ross J, Ljunghall S, et al. Primary hyperparathydoidism revisited in menopausal women with serum calcium in the upper normal range at population based screening 8 years ago. World S Surg 2002; 26(8):931-6.
16. Cusano NE, Silverberg SJ, Bilezikian JP. Normocalcemic primary hyperparathyroidism.J ClinDensitom. 2013 Jan-Mar;16(1):33-9. doi: 10.1016/j.jocd.2012.12.001. [PubMed]
17. Heaney RP. The Vitamin D requirement in health and disease.J Steroid BiochemMol Biol. 2005 Oct;97(1-2):13-9. Epub 2005 Jul 18. [PubMed]
18. Eastell R, Arnold A, Brandi ML, Brown EM, D'Amour P, Hanley DA, Rao DS, Rubin MR, Goltzman D, Silverberg SJ, Marx SJ, Peacock M, Mosekilde L, Bouillon R, Lewiecki EM. Diagnosis of asymptomatic primary hyperparathyroidism: proceedings of the third international workshop.J Clin Endocrinol Metab. 2009 Feb;94(2):340-50. doi: 10.1210/jc.2008-1758. [PubMed]
19. Silverberg SJ, Lewiecki EM, Mosekilde L, Peacock M, Rubin MR. Presentation of asymptomatic primary hyperparathyroidism: proceedings of the third international workshop. J Clin Endocrinol Metab 2009; 94(2):351-65. [PubMed]
20. Dawson-Hughes B, Harris SS, Dallal GE. Plasma calcidiol, season, and serum parathyroid hormone concentrations in healthy elderly men and women.Am J ClinNutr. 1997 Jan;65(1):67-71. [PubMed]
21. Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, Meunier PJ. Prevalence of vitamin D insufficiency in an adult normal population.Osteoporos Int. 1997;7(5):439-43. [PubMed]
22. Adami S, Viapiana O, Gatti D, Idolazzi L, Rossini M.Relationship between serum parathyroid hormone, vitamin D sufficiency, age, and calcium intake.Bone. 2008 Feb;42(2):267-70. Epub 2007 Oct 16. [PubMed]
23. Willett AM. Vitamin D status and its relationship with parathyroid hormone and bone mineral status in older adolescents.Proc Nutr Soc. 2005 May;64(2):193-203.
24. Elsammak MY, Al-Wosaibi AA, Al-Howeish A, Alsaeed J. Vitamin d deficiency in Saudi Arabs.HormMetab Res. 2010 May;42(5):364-8. doi: 10.1055/s-0030-1248296. Epub 2010 Mar 8. [PubMed]
25. Arabi A, Baddoura R, El-Rassi R, El-Hajj Fuleihan G.Age but not gender modulates the relationship between PTH and vitamin D.Bone. 2010 Aug;47(2):408-12. doi: 10.1016/j.bone.2010.05.002. Epub 2010 May 7.
26. Ardawi MS, Sibiany AM, Bakhsh TM, Qari MH, Maimani AA. High prevalence of vitamin D deficiency among healthy Saudi Arabian men relationship to bone mineral density, parathyroid hormone, bone turnover markers, and lifestyle factors. Osteoporos. Int. 2012; 23(2):675-86. [PubMed]
27. Phelan PJ, O'Kelly P, Walshe JJ, Conlon PJ. The importance of serum albumin and phosphorous as predictors of mortality in ESRD patients.Ren Fail. 2008;30(4):423-9. doi: 10.1080/08860220801964236. [PubMed]
CITATION
DOI: 10.17511/ijoso.2017.i04.08
Published: 2017-12-31
How to Cite
Kumar, N., Garg, N., & Gupta, I. (2017). Correlation of intact parathormone levels with serum calcium, serum phosphorus and serum vitamin d levels in surgical patients. Surgical Review: International Journal of Surgery, Trauma and Orthopedics, 3(4), 137-142. https://doi.org/10.17511/ijoso.2017.i04.08
Section
Original Article
OAI - Open Archives Initiative
Therapoid
