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Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
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Role of Vitamins in Maintaining Bone Health01:25

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The skin plays a crucial role in the synthesis of vitamin D, a vital nutrient for various physiological processes in the body. Vitamin D is unique because it can be synthesized in the skin through a series of chemical reactions triggered by exposure to ultraviolet B (UVB) radiation from sunlight.
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Morbidity Associated With Primary Hyperparathyroidism-A Population-based Study With a Subanalysis on Vitamin D.

Enrique Soto-Pedre1, Yeun Yi Lin2, Jimena Soto-Hernaez3

  • 1Division of Population Health & Genomics, School of Medicine, Ninewells Hospital & Medical School, University of Dundee, Dundee DD1 9SY, UK.

The Journal of Clinical Endocrinology and Metabolism
|February 22, 2023
PubMed
Summary

Primary hyperparathyroidism (PHPT) significantly increases the risk of death, diabetes, kidney stones, and osteoporosis. These associations remain even after accounting for vitamin D levels in a large population study.

Keywords:
calciummortalityprimary hyperparathyroidismvitamin D

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Area of Science:

  • Endocrinology
  • Public Health
  • Clinical Epidemiology

Background:

  • Primary hyperparathyroidism (PHPT) is linked to increased morbidity and mortality.
  • Vitamin D levels may confound the observed risks associated with PHPT.

Purpose of the Study:

  • To assess the association between primary hyperparathyroidism (PHPT) and clinical outcomes, including morbidity and mortality.
  • To determine if these associations are independent of serum vitamin D concentrations.

Main Methods:

  • A population-based, retrospective, matched cohort study was conducted in Tayside, Scotland (1997-2019).
  • Data linkage included biochemistry, hospital admissions, prescribing, imaging, pathology, and death records.
  • Cox proportional hazards models were used to analyze outcomes in patients with PHPT compared to a matched cohort.

Main Results:

  • The study included 11,616 individuals with PHPT.
  • PHPT was associated with a 2.05-fold increased risk of death.
  • Increased risks for diabetes (HR=1.39), renal stones (HR=3.02), and osteoporosis (HR=1.31) persisted after adjusting for vitamin D levels.

Conclusions:

  • Primary hyperparathyroidism (PHPT) is independently associated with increased mortality, diabetes, renal stones, and osteoporosis.
  • These risks are evident irrespective of serum vitamin D concentrations.
  • The findings highlight the significant long-term health implications of untreated PHPT.