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Different vitamin D substrate-product relationship after oral vitamin D supplementation in familial benign hypercalcemia, primary hyperaparathyroidism and healthy controls.
MedLine Citation:
PMID:  21310873     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Context: In healthy subjects and in patients with primary hyperparathyroidism (PH) the administration of a low dose of 25(OH)D (25 µg/day) increases the serum levels of both 25(OH)D and 1,25(OH)2D. It is unknown if in patients affected by familial benign hypocalciuric hypercalcemia (FBH) this relationship is present. Objective: to evaluate the different vitamin D substrate-product relationship after oral vitamin D supplementation in familial benign hypercalcemia, primary hyperaparathyroidism and healthy controls. Design: We evaluated the main physiological regulators of 1α-hydroxylase and the substrate-product relationship of 25(OH)D and 1,25(OH)2D in 20 patients with PH, 25 with FBH, and 122 healthy sex- and age-matched controls before and after administration of 25(OH)D for two weeks. Results: 25(OH)D increased significantly in all subjects, while 1,25(OH)2D serum levels increased significantly in PH patients and healthy controls but not in patients with FBH. Therefore, a significant positive substrate-product relationship of 25(OH)D-1,25(OH)2D was found in PH and healthy controls, but not in FBH. Monomeric calcitonin (hCT) was significantly lower at baseline and after 25(OH)D supplementation in the FBH group compared to the other two groups. Conclusions: The lack of a 1,25(OH)2D increase in FBH may be due to a direct inibitory effect on 1α-hydroxylase of hypercalcemia per se, increased metabolic clearance of 1,25(OH)2D, or a decreased stimulus of 1-α hydroxylase related to persistently low levels of hCT.
Authors:
Maurizio Bevilacqua; Marco Invernizzi; Velella Righini; Stefano Carda; Carlo Cisari
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-10
Journal Detail:
Title:  European journal of endocrinology / European Federation of Endocrine Societies     Volume:  -     ISSN:  1479-683X     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9423848     Medline TA:  Eur J Endocrinol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
M Bevilacqua, Department of Medicine, Luigi Sacco Hospital (Vialba), University of Milan, Endocrinology and Diabetes Unit, Milano, Italy.
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