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The effects of season (spring versus autumn) on diagnosis of normocalcemic primary hyperparathyroidism

BACKGROUND: Raised parathormone (PTH) and normal calcium concentrations can be observed both in normocalcemic primary hyperparathyroidism (nPHPT) and in secondary hyperparathyroidism, e.g. due to vitamin D deficiency. We assessed the impact of season on the validity of diagnosis of nPHPT in terms of...

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Autores principales: Basińska-Lewandowska, Magdalena, Lewiński, Andrzej, Lewandowski, Krzysztof C., Skowrońska-Jóźwiak, Elżbieta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9515376/
https://www.ncbi.nlm.nih.gov/pubmed/36187131
http://dx.doi.org/10.3389/fendo.2022.1013362
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author Basińska-Lewandowska, Magdalena
Lewiński, Andrzej
Lewandowski, Krzysztof C.
Skowrońska-Jóźwiak, Elżbieta
author_facet Basińska-Lewandowska, Magdalena
Lewiński, Andrzej
Lewandowski, Krzysztof C.
Skowrońska-Jóźwiak, Elżbieta
author_sort Basińska-Lewandowska, Magdalena
collection PubMed
description BACKGROUND: Raised parathormone (PTH) and normal calcium concentrations can be observed both in normocalcemic primary hyperparathyroidism (nPHPT) and in secondary hyperparathyroidism, e.g. due to vitamin D deficiency. We assessed the impact of season on the validity of diagnosis of nPHPT in terms of screening investigations to be performed in the primary care settings. MATERIAL AND METHODS: On two occasions (March/April & September/October) we measured vitamin D (25OHD), PTH and total calcium in 125 healthy subjects, age range 6-50, not taking any vitamin D supplements. RESULTS: In autumn there was an increase in 25OHD concentrations (from 18.1 ± 7.37ng/ml to 24.58 ± 7.72ng/ml, p<0.0001), a decline in PTH from 44.40 ± 17.76pg/ml to 36.63 ± 14.84pg/ml, p<0.001), without change in calcium levels. Only 45 subjects (36%) were vitamin D sufficient (25OHD>20/ml) in spring versus 83 (66.4%) in autumn, p<0.001. Elevated PTH concentrations were noted in 10 subjects in spring (8%) and in six subjects (4.8%) (p<0.05) in autumn. In spring, however, eight out of ten of these subjects (80%) had 25OHD<20 ng/ml, versus one in six (16.7%) in autumn (p<0.01). Normalization of PTH was observed in seven out ten subjects (70%), and all of them had 25-OHD<20 ng/ml in spring. CONCLUSIONS: In spring elevated PTH concentrations in the setting of normocalcemia are more likely to be caused by 25OHD deficiency rather by nPHPT. In contrast, in autumn, increased PTH concentrations are more likely to reflect nPHPT. We postulate that screening for nPHPT should be done in 25OHD replete subjects, i.e. in autumn rather than in spring.
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spelling pubmed-95153762022-09-29 The effects of season (spring versus autumn) on diagnosis of normocalcemic primary hyperparathyroidism Basińska-Lewandowska, Magdalena Lewiński, Andrzej Lewandowski, Krzysztof C. Skowrońska-Jóźwiak, Elżbieta Front Endocrinol (Lausanne) Endocrinology BACKGROUND: Raised parathormone (PTH) and normal calcium concentrations can be observed both in normocalcemic primary hyperparathyroidism (nPHPT) and in secondary hyperparathyroidism, e.g. due to vitamin D deficiency. We assessed the impact of season on the validity of diagnosis of nPHPT in terms of screening investigations to be performed in the primary care settings. MATERIAL AND METHODS: On two occasions (March/April & September/October) we measured vitamin D (25OHD), PTH and total calcium in 125 healthy subjects, age range 6-50, not taking any vitamin D supplements. RESULTS: In autumn there was an increase in 25OHD concentrations (from 18.1 ± 7.37ng/ml to 24.58 ± 7.72ng/ml, p<0.0001), a decline in PTH from 44.40 ± 17.76pg/ml to 36.63 ± 14.84pg/ml, p<0.001), without change in calcium levels. Only 45 subjects (36%) were vitamin D sufficient (25OHD>20/ml) in spring versus 83 (66.4%) in autumn, p<0.001. Elevated PTH concentrations were noted in 10 subjects in spring (8%) and in six subjects (4.8%) (p<0.05) in autumn. In spring, however, eight out of ten of these subjects (80%) had 25OHD<20 ng/ml, versus one in six (16.7%) in autumn (p<0.01). Normalization of PTH was observed in seven out ten subjects (70%), and all of them had 25-OHD<20 ng/ml in spring. CONCLUSIONS: In spring elevated PTH concentrations in the setting of normocalcemia are more likely to be caused by 25OHD deficiency rather by nPHPT. In contrast, in autumn, increased PTH concentrations are more likely to reflect nPHPT. We postulate that screening for nPHPT should be done in 25OHD replete subjects, i.e. in autumn rather than in spring. Frontiers Media S.A. 2022-09-14 /pmc/articles/PMC9515376/ /pubmed/36187131 http://dx.doi.org/10.3389/fendo.2022.1013362 Text en Copyright © 2022 Basińska-Lewandowska, Lewiński, Lewandowski and Skowrońska-Jóźwiak https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Basińska-Lewandowska, Magdalena
Lewiński, Andrzej
Lewandowski, Krzysztof C.
Skowrońska-Jóźwiak, Elżbieta
The effects of season (spring versus autumn) on diagnosis of normocalcemic primary hyperparathyroidism
title The effects of season (spring versus autumn) on diagnosis of normocalcemic primary hyperparathyroidism
title_full The effects of season (spring versus autumn) on diagnosis of normocalcemic primary hyperparathyroidism
title_fullStr The effects of season (spring versus autumn) on diagnosis of normocalcemic primary hyperparathyroidism
title_full_unstemmed The effects of season (spring versus autumn) on diagnosis of normocalcemic primary hyperparathyroidism
title_short The effects of season (spring versus autumn) on diagnosis of normocalcemic primary hyperparathyroidism
title_sort effects of season (spring versus autumn) on diagnosis of normocalcemic primary hyperparathyroidism
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9515376/
https://www.ncbi.nlm.nih.gov/pubmed/36187131
http://dx.doi.org/10.3389/fendo.2022.1013362
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