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MON-390 Vitamin D Metabolism in Patients with Acromegaly: A Case-Control Pilot Study

Objective: to study the differences in the metabolism of vitamin D and calcium-phosphorus metabolism in patients with an active phase of acromegaly in comparison with healthy individuals. Materials and methods: The study included 8 patients with an active acromegaly, median age 36.5 ± 6.25 years, BM...

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Autores principales: Povaliaeva, Alexandra, Pigarova, Ekaterina, Zhukov, Artem, Dzeranova, Larisa, Bogdanov, Victor, Ioutsi, Vitaliy, Rozhinskaya, Liudmila
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7208073/
http://dx.doi.org/10.1210/jendso/bvaa046.1824
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author Povaliaeva, Alexandra
Pigarova, Ekaterina
Zhukov, Artem
Dzeranova, Larisa
Bogdanov, Victor
Ioutsi, Vitaliy
Rozhinskaya, Liudmila
author_facet Povaliaeva, Alexandra
Pigarova, Ekaterina
Zhukov, Artem
Dzeranova, Larisa
Bogdanov, Victor
Ioutsi, Vitaliy
Rozhinskaya, Liudmila
author_sort Povaliaeva, Alexandra
collection PubMed
description Objective: to study the differences in the metabolism of vitamin D and calcium-phosphorus metabolism in patients with an active phase of acromegaly in comparison with healthy individuals. Materials and methods: The study included 8 patients with an active acromegaly, median age 36.5 ± 6.25 years, BMI 27.9 ± 1.95 kg/m2, IGF-1 907.3 ± 239 ng/ml, as well as 8 conditionally healthy individuals selected by age, sex and level of 25(OH)D determined by the immunochemiluminescent method (DEQAS certified). All participants were tested for calcium-phosphorus metabolism, PTH, and vitamin D metabolites by HPLC/MS-MS (25(OH)D3, 25(OH)D2, 3-epi-25(OH)D3 and 24,25(OH)2D3) before oral administration of 150 000 IU of an aqueous solution of cholecalciferol and 7 days after administration. Results: In the Acromegaly group, on the 7th day after taking the drug, there was a statistically significant increase in 25(OH)D3 (89.8 ± 10.5 vs. 54.1 ± 14.8 nmol/L), 3-epi-25(OH)D3 (9.0 ± 2.6 vs. 3.3± 1.1 nmol/L) and 24,25(OH)2D3 (8.3 ± 1.9 vs. 6.4 ± 2.1 nmol/L), and a decrease of 25(OH)D2 (0.8 ± 0.2 vs. 1.1 ± 0.3 nmol/L) and a ratio of 24,25(OH)2D3 to 25(OH)D3 (0.1 ± 0.02 vs. 0.13 ± 0.03). A statistically significant increase in albumin-adjusted calcium was also noted (2.39 ± 0.14 vs. 2.31 ± 0.13 mmol/L). The medians of the levels of PTH and phosphorus initially were 27.1 ± 13.5 pg/ml and 1.6 ± 0.3 mmol/l and did not change by day 7 after taking the drug; creatinine and magnesium levels also remained the same. The level of calcium-creatinine ratio in a single portion of urine (CCR) was initially within the reference interval for all patients, its median did not change by day 7, however, in two patients there was a clinically insignificant increase higher than the upper limit of the reference interval; the phosphorus-creatinine ratio in a single portion of urine increased significantly. In the control group, after taking cholecalciferol similar changes in the levels of the studied vitamin D metabolites were observed, the levels of PTH also remained the same, however, there were no changes in the median biochemical parameters of blood and urine by day 7 after drug intake. Among the studied vitamin D metabolites, there were initially no significant differences between the groups; on day 7 a difference was recorded for the level of 3-epi-25(OH)D3 (9.0 ± 2.6 in the Acromegaly group vs. 18.8 ± 8.9 nmol/L in the control group). Among the biochemical parameters in the Acromegaly group higher levels of ionized blood calcium (1.14 ± 0.05 vs 1.1 ± 0.03 mmol/L), blood phosphorus (1.61 ± 0.26 vs 1.15 ± 0.09 mmol/L) and CCR were observed. Conclusion: Loading dose of cholecalciferol in patients with acromegaly is associated with less production of 3-epi-25(OH)D3, and results in lower inactive fraction of vitamin D than in healthy controls. More studies are needed to evaluate the effect of 1.25(OH)2D3 level on calcium-phosphorus metabolism in acromegaly.
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spelling pubmed-72080732020-05-13 MON-390 Vitamin D Metabolism in Patients with Acromegaly: A Case-Control Pilot Study Povaliaeva, Alexandra Pigarova, Ekaterina Zhukov, Artem Dzeranova, Larisa Bogdanov, Victor Ioutsi, Vitaliy Rozhinskaya, Liudmila J Endocr Soc Bone and Mineral Metabolism Objective: to study the differences in the metabolism of vitamin D and calcium-phosphorus metabolism in patients with an active phase of acromegaly in comparison with healthy individuals. Materials and methods: The study included 8 patients with an active acromegaly, median age 36.5 ± 6.25 years, BMI 27.9 ± 1.95 kg/m2, IGF-1 907.3 ± 239 ng/ml, as well as 8 conditionally healthy individuals selected by age, sex and level of 25(OH)D determined by the immunochemiluminescent method (DEQAS certified). All participants were tested for calcium-phosphorus metabolism, PTH, and vitamin D metabolites by HPLC/MS-MS (25(OH)D3, 25(OH)D2, 3-epi-25(OH)D3 and 24,25(OH)2D3) before oral administration of 150 000 IU of an aqueous solution of cholecalciferol and 7 days after administration. Results: In the Acromegaly group, on the 7th day after taking the drug, there was a statistically significant increase in 25(OH)D3 (89.8 ± 10.5 vs. 54.1 ± 14.8 nmol/L), 3-epi-25(OH)D3 (9.0 ± 2.6 vs. 3.3± 1.1 nmol/L) and 24,25(OH)2D3 (8.3 ± 1.9 vs. 6.4 ± 2.1 nmol/L), and a decrease of 25(OH)D2 (0.8 ± 0.2 vs. 1.1 ± 0.3 nmol/L) and a ratio of 24,25(OH)2D3 to 25(OH)D3 (0.1 ± 0.02 vs. 0.13 ± 0.03). A statistically significant increase in albumin-adjusted calcium was also noted (2.39 ± 0.14 vs. 2.31 ± 0.13 mmol/L). The medians of the levels of PTH and phosphorus initially were 27.1 ± 13.5 pg/ml and 1.6 ± 0.3 mmol/l and did not change by day 7 after taking the drug; creatinine and magnesium levels also remained the same. The level of calcium-creatinine ratio in a single portion of urine (CCR) was initially within the reference interval for all patients, its median did not change by day 7, however, in two patients there was a clinically insignificant increase higher than the upper limit of the reference interval; the phosphorus-creatinine ratio in a single portion of urine increased significantly. In the control group, after taking cholecalciferol similar changes in the levels of the studied vitamin D metabolites were observed, the levels of PTH also remained the same, however, there were no changes in the median biochemical parameters of blood and urine by day 7 after drug intake. Among the studied vitamin D metabolites, there were initially no significant differences between the groups; on day 7 a difference was recorded for the level of 3-epi-25(OH)D3 (9.0 ± 2.6 in the Acromegaly group vs. 18.8 ± 8.9 nmol/L in the control group). Among the biochemical parameters in the Acromegaly group higher levels of ionized blood calcium (1.14 ± 0.05 vs 1.1 ± 0.03 mmol/L), blood phosphorus (1.61 ± 0.26 vs 1.15 ± 0.09 mmol/L) and CCR were observed. Conclusion: Loading dose of cholecalciferol in patients with acromegaly is associated with less production of 3-epi-25(OH)D3, and results in lower inactive fraction of vitamin D than in healthy controls. More studies are needed to evaluate the effect of 1.25(OH)2D3 level on calcium-phosphorus metabolism in acromegaly. Oxford University Press 2020-05-08 /pmc/articles/PMC7208073/ http://dx.doi.org/10.1210/jendso/bvaa046.1824 Text en © Endocrine Society 2020. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Bone and Mineral Metabolism
Povaliaeva, Alexandra
Pigarova, Ekaterina
Zhukov, Artem
Dzeranova, Larisa
Bogdanov, Victor
Ioutsi, Vitaliy
Rozhinskaya, Liudmila
MON-390 Vitamin D Metabolism in Patients with Acromegaly: A Case-Control Pilot Study
title MON-390 Vitamin D Metabolism in Patients with Acromegaly: A Case-Control Pilot Study
title_full MON-390 Vitamin D Metabolism in Patients with Acromegaly: A Case-Control Pilot Study
title_fullStr MON-390 Vitamin D Metabolism in Patients with Acromegaly: A Case-Control Pilot Study
title_full_unstemmed MON-390 Vitamin D Metabolism in Patients with Acromegaly: A Case-Control Pilot Study
title_short MON-390 Vitamin D Metabolism in Patients with Acromegaly: A Case-Control Pilot Study
title_sort mon-390 vitamin d metabolism in patients with acromegaly: a case-control pilot study
topic Bone and Mineral Metabolism
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7208073/
http://dx.doi.org/10.1210/jendso/bvaa046.1824
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