Vitamin D Deficiency and PTH Levels in a Cohort of Acromegalic Patients Followed in a Tertiary Center

Presentation Number: SUN 465
Date of Presentation: April 2nd, 2017

Paula Paes B Silva*1, Raquel S Jallad2, Clarissa G B Herkenhoff3, Felipe H G Duarte4, Regina M Martin5, Pereira M Rosa6 and Marcello D Bronstein7
1University of Sao Paulo Medical School, Sao Paulo, Brazil, 2Hosp das Clinicas Univ of Sao Paulo Medical School, Sao Paulo SP, Brazil, 3University of Sao Paulo Medical School, Brazil, 4University of Sao Paulo Medical School, Sao Paulo, BRAZIL, 5Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Brazil, 6Faculdade de Medicina da USP, 7University of São Paulo Medical School, São Paulo, Brazil


Introduction: Vitamin D deficiency (VDD) is highly prevalent in normal population, becoming a public health problem, specially related to bone disease. Despite of country tropical latitude, in Brazil hypovitaminosis D may affect up to 90% of individuals, depending on the population studied [1]. Once some studies demonstrate high incidence of vertebral fractures and abnormal bone microarchitecture in acromegaly, the objectives of this study are to determine the prevalence of VDD and the impact of PTH levels on inappropriate diagnosis of hyperparathyroidism, including multiple endocrine neoplasia (MEN 1), in a group of patients followed in a neuroendocrine reference center

Study design: This is a retrospective cohort study

Patients and methods: After analysis of 144 consective medical records, 111 patients were selected based on the availability of lab tests: total serum calcium, phosphorus, 25 (OH) vitamin D, PTH, creatinine, urea, GH and IGF-1.Using definitions of deficiency and insufficiency based on Endocrine Society Guidelines (deficiency isbelow 20 ng/ml and vitamin D insufficiency is defined as a 25OHD level of 21–29 ng/ml and sufficiency above 29 ng/ml [2]. Patients on diuretic and vitamin D replacement were excluded as well as MEN-1 patients.

Results: The prevalence of vitamin D deficiency was 40 %; insufficiency was 43 % and sufficiency was 17 %. Elevated PTH levels (91-155 pg/mL) was found in 5% (5/111) of the total cohort. All of them had abnormal levels of vitamin D and normal levels of calcium and creatinine.

Discussion and conclusions: Hypovitaminosis D is frequent in acromegalic patients. In some of this patients the elevated PTH levels can be observed. In order to rule out these conditions and to properly interpret PTH values, VDD should always be corrected and the calcium levels and renal function should be determined. The last one to exclude secondary or tertiary hyperparathyroidism.


Nothing to Disclose: PPBS, RSJ, CGBH, FHGD, RMM, PMR, MDB