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

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: Article
Published: National Center for Biotechnology Information Search database 2017
Subjects:
Q Science (General)
Online Access:http://ir.unimas.my/15615/
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spelling unimas-156152017-03-21T07:52:10Z http://ir.unimas.my/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 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.
repository_type Digital Repository
institution_category Local University
institution Universiti Malaysia Sarawak
building UNIMAS Institutional Repository
collection Online Access
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 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/15615/
http://ir.unimas.my/15615/
http://ir.unimas.my/15615/
first_indexed 2018-09-06T16:23:29Z
last_indexed 2018-09-06T16:23:29Z
_version_ 1610875938497626112

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