Journal of Clinical Densitometry
Volume 13, Issue 4 , Pages 462-466, October 2010

Hypovitaminosis D and Bone Mineral Metabolism and Bone Density in Hyperthyroidism

  • Dinesh Kumar Dhanwal

      Affiliations

    • MRC Epidemiology Resource Centre, Southampton General Hospital, University of Southampton, Southampton, UK
    • Maulana Azad Medical College, New Delhi, India
    • Corresponding Author InformationAddress correspondence to: Dinesh K. Dhanwal, DM, Deapartment of Medicine (Endocrinology Division), Maulana Azad Medical College, New Delhi, India 110002.
  • ,
  • Narayana Kochupillai

      Affiliations

    • SRM Medical College, Kattankulathur, India
  • ,
  • Nandita Gupta

      Affiliations

    • All India Institute of Medical Sciences, New Delhi, India
  • ,
  • Cyrus Cooper

      Affiliations

    • MRC Epidemiology Resource Centre, Southampton General Hospital, University of Southampton, Southampton, UK
    • Botnar Research Centre, Institute of Musculoskeletal Sciences, University of Oxford, Oxford, UK
  • ,
  • Elaine M. Dennison

      Affiliations

    • MRC Epidemiology Resource Centre, Southampton General Hospital, University of Southampton, Southampton, UK

Received 14 April 2010; received in revised form 21 May 2010; accepted 23 May 2010. published online 22 July 2010.

Abstract 

Little is known about the impact of concomitant vitamin D deficiency on bone mineral density in hyperthyroidism. Therefore, we evaluated bone mineral measures in vitamin D–deficient and sufficient patients with hyperthyroidism. Thirty newly diagnosed consecutive patients with hyperthyroidism were included. Blood samples were used for measurement of calcium, phosphate, alkaline phosphatase, 25-hydroxy vitamin D [25(OH) D], and parathyroid hormone (PTH). Bone mineral density (BMD) was measured at the hip, spine, and forearm. The patients were divided into vitamin D–deficient (<25nmol/L) and vitamin D–sufficient groups (≥25nmol/L). Eight (26.6%) patients had 25(OH) D levels less than 25nmol/L, with mean±standard deviation (SD) level of 16.5±3.2 (vitamin D–deficient group 1), and the remainder had a mean±SD of 46.0±13.5nmol/L (vitamin D–sufficient group 2). Serum-intact PTH levels were significantly higher in group 1 compared with those in group 2 (31.2±16.3 vs 18.0±13.1pg/mL; p=0.041). In the vitamin D–deficient group, the mean BMD T-scores were in the osteoporotic range at hip and forearm (−2.65±1.13 and −3.04±1.3) and in the osteopenia range at lumbar spine (−1.83±1.71). However, in vitamin D–sufficient group, the mean BMD T-scores were in the osteopenia range (−1.64±1.0, −1.27±1.6, and −1.60±0.7) at hip, forearm, and lumbar spine, respectively. The mean BMD Z-scores were also significantly lower in vitamin D–deficient group compared with those in vitamin D–sufficient group. Finally, BMD values (gm/cm2) at the hip and forearm were significantly lower in the vitamin D–deficient group compared with those in the vitamin D–sufficient group. In conclusion, hyperthyroid patients with concomitant vitamin D deficiency had lower BMD compared with vitamin D–sufficient patients.

Key Words: Bone mineral density, hyperthyroidism, hypovitaminosis D, thyrotoxicosis, vitamin D deficiency

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PII: S1094-6950(10)00196-4

doi:10.1016/j.jocd.2010.05.008

Journal of Clinical Densitometry
Volume 13, Issue 4 , Pages 462-466, October 2010