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Effect of Vitamin D replacement in Primary Hyperparathyroidism with concurrent Vitamin D deficiency: a systematic review and meta-analysis

INTRODUCTION: We conducted a meta-analysis to assess the effects of vitamin D replacement on biochemical and skeletal parameters in subjects with mild primary hyperparathyroidism (PHPT) and coexistent vitamin D deficiency. EVIDENCE ACQUISITION: A systematic search of all English-language medical...

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Main Authors: Loh, HH, Lim, LL, Yee, A., Loh, HS, Vethakkan, SR
Format: E-Article
Published: National Center for Biotechnology Information Search database 2017
Subjects:
Q Science (General)
Online Access:http://ir.unimas.my/id/eprint/15615/
https://www.ncbi.nlm.nih.gov/pubmed/28294593
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spelling my.unimas.ir.156152017-03-21T07:52:10Z http://ir.unimas.my/id/eprint/15615/ Effect of Vitamin D replacement in Primary Hyperparathyroidism with concurrent Vitamin D deficiency: a systematic review and meta-analysis Loh, HH Lim, LL Yee, A. Loh, HS Vethakkan, SR Q Science (General) INTRODUCTION: We conducted a meta-analysis to assess the effects of vitamin D replacement on biochemical and skeletal parameters in subjects with mild primary hyperparathyroidism (PHPT) and coexistent vitamin D deficiency. EVIDENCE ACQUISITION: A systematic search of all English-language medical literature published from 1980 till May 2016 using Pubmed, Embase and Ovid was performed. Nine observational studies were evaluated after fulfilling the inclusion and exclusion criteria. EVIDENCE SYNTHESIS: A total of 547 patients were examined. All studies used vitamin D2/D3 or calcifediol (25-hydroxyvitamin D3), There was significant improvement of serum 25(OH)D with unchanged serum iPTH level after vitamin D replacement, with pooled d+: 3.10 (95% CI 2.25 to 3.95), p<0.01 and pooled d+: 0.82 (95% CI -0.35 to 1.98), p=0.16 respectively. There was neither worsening of the pre-existing hypercalcaemia [pooled d+: -0.27 (95% CI -1.09 to 0.64, p=0.56) nor hypercalciuria [pooled d+: 3.64 (95% CI -0.55 to 7.83, p=0.09). Two studies assessed in this meta-analysis reported unchanged bone density with vitamin D replacement. CONCLUSIONS: Vitamin D replacement in subjects with mild PHPT and coexistent vitamin D deficiency improved serum 25(OH)D level without worsening of pre-existing hypercalcemia or hypercalciuria. Well-designed multicenter randomized controlled trials examining pre- and post- operative outcomes of vitamin D therapy in patients with different severities of PHPT and vitamin D inadequacy, are warranted to elucidate the most appropriate vitamin D treatment protocol and determine the long-term safety concerns. National Center for Biotechnology Information Search database 2017 E-Article PeerReviewed Loh, HH and Lim, LL and Yee, A. and Loh, HS and Vethakkan, SR (2017) Effect of Vitamin D replacement in Primary Hyperparathyroidism with concurrent Vitamin D deficiency: a systematic review and meta-analysis. Minerva Endocrinologica, 2017. ISSN 1827-1634 https://www.ncbi.nlm.nih.gov/pubmed/28294593 doi: 10.23736/S0391-1977.17.02584-6.
institution Universiti Malaysia Sarawak
building Centre for Academic Information Services (CAIS)
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaysia Sarawak
content_source UNIMAS Institutional Repository
url_provider http://ir.unimas.my/
topic Q Science (General)
spellingShingle Q Science (General)
Loh, HH
Lim, LL
Yee, A.
Loh, HS
Vethakkan, SR
Effect of Vitamin D replacement in Primary Hyperparathyroidism with concurrent Vitamin D deficiency: a systematic review and meta-analysis
description INTRODUCTION: We conducted a meta-analysis to assess the effects of vitamin D replacement on biochemical and skeletal parameters in subjects with mild primary hyperparathyroidism (PHPT) and coexistent vitamin D deficiency. EVIDENCE ACQUISITION: A systematic search of all English-language medical literature published from 1980 till May 2016 using Pubmed, Embase and Ovid was performed. Nine observational studies were evaluated after fulfilling the inclusion and exclusion criteria. EVIDENCE SYNTHESIS: A total of 547 patients were examined. All studies used vitamin D2/D3 or calcifediol (25-hydroxyvitamin D3), There was significant improvement of serum 25(OH)D with unchanged serum iPTH level after vitamin D replacement, with pooled d+: 3.10 (95% CI 2.25 to 3.95), p<0.01 and pooled d+: 0.82 (95% CI -0.35 to 1.98), p=0.16 respectively. There was neither worsening of the pre-existing hypercalcaemia [pooled d+: -0.27 (95% CI -1.09 to 0.64, p=0.56) nor hypercalciuria [pooled d+: 3.64 (95% CI -0.55 to 7.83, p=0.09). Two studies assessed in this meta-analysis reported unchanged bone density with vitamin D replacement. CONCLUSIONS: Vitamin D replacement in subjects with mild PHPT and coexistent vitamin D deficiency improved serum 25(OH)D level without worsening of pre-existing hypercalcemia or hypercalciuria. Well-designed multicenter randomized controlled trials examining pre- and post- operative outcomes of vitamin D therapy in patients with different severities of PHPT and vitamin D inadequacy, are warranted to elucidate the most appropriate vitamin D treatment protocol and determine the long-term safety concerns.
format E-Article
author Loh, HH
Lim, LL
Yee, A.
Loh, HS
Vethakkan, SR
author_facet Loh, HH
Lim, LL
Yee, A.
Loh, HS
Vethakkan, SR
author_sort Loh, HH
title Effect of Vitamin D replacement in Primary Hyperparathyroidism with concurrent Vitamin D deficiency: a systematic review and meta-analysis
title_short Effect of Vitamin D replacement in Primary Hyperparathyroidism with concurrent Vitamin D deficiency: a systematic review and meta-analysis
title_full Effect of Vitamin D replacement in Primary Hyperparathyroidism with concurrent Vitamin D deficiency: a systematic review and meta-analysis
title_fullStr Effect of Vitamin D replacement in Primary Hyperparathyroidism with concurrent Vitamin D deficiency: a systematic review and meta-analysis
title_full_unstemmed Effect of Vitamin D replacement in Primary Hyperparathyroidism with concurrent Vitamin D deficiency: a systematic review and meta-analysis
title_sort effect of vitamin d replacement in primary hyperparathyroidism with concurrent vitamin d deficiency: a systematic review and meta-analysis
publisher National Center for Biotechnology Information Search database
publishDate 2017
url http://ir.unimas.my/id/eprint/15615/
https://www.ncbi.nlm.nih.gov/pubmed/28294593
_version_ 1644512189085646848
score 13.211869

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