Palabras clave
paratohormona
hiperparatiroidismo
calcio
Vitamin D
parathyroid hormone
hyperparathyroidism
calcium
Cómo citar
Resumen
Se incluyeron 501 pacientes, 420 mujeres (83,8%), con mediana de edad de 50 (18-60) años, mediana de PTH de: 42,3 (15,9-113,8) pg/ml, mediana de niveles de 25 hidroxivitamina D (25 (OH) D) de 24 (6,1-68) ng/ml, creatinina sérica de 0,76 (0,42-1,17) mg/dl. Los niveles de 25 (OH) D se distribuyeron así: ? 30 ng/ml: 24,9%, entre 20 y 29,9 ng/ml: 45,9%, entre 15 y 19,9 ng/ml: 17,9% y ? 15 ng/ml: 11,1%. Se encontró una relación inversa entre los valores de calcio y PTH, aunque la presencia de calcio sérico menor de 9 mg/dl fue del 23% en sujetos con 25 OH vit D menor de 15 ng/ml. El 52,2%, el 59,6% y el 63,2% de los pacientes con valores de 25 (OH) D de 15 a 19,9, de 20 a 30 y ?30 ng/ml, tuvieron PTH? 45 pg/ml. La probabilidad de tener un valor de PTH ? 45 pg/ml no tuvo diferencias estadísticamente significativas entre 20 y 30 ng/ml de 25 (OH) D. Los valores de 25 (OH) D ? 30 ng/ml tuvieron menor probabilidad de presentar PTH? 65 pg/ml, siendo del 14,3% con valores menores de 15 ng/ml vs 4,8% con valores ? 30 ng/ml. Aunque el 75% de la población evaluada tiene valores de 25 OH D menores de 30 ng/ml, la presencia de PTH mayor de 45 pg/ml ocurre en 40% de los sujetos entre 20 y 30 y cursan con calcio sérico menor de 9 mg/dl en 21%.
Conclusión: Según el comportamiento del eje calcio-PTH- Vit D debe reconsiderarse el punto de corte de normalidad de la 25 OH D en 20 ng/ml para esta población entre 20 y 60 años sin otras comorbilidades.
Abstract
A total of 501 patients were included, 420 women (83.8%), median age 50 (18-60) years, median PTH: 42.3 (15.9-113.8) pg/ml, 25 hydroxy vitamin D (25 (OH) D: 24 (6.1-68) ng/ml, serum creatinine of 0.76 (0.42-1.17) mg/dl. Levels of 25 (OH) D were distributed as follows: ? 30 ng/ml: 24.9%, between 20 and 29.9 ng/ml: 45.9%, between 15 and 19.9 ng/ mL: 17.9% and ? 15 ng/ml: 11.1%. An inverse relationship was found between calcium and PTH values, although serum calcium below 9 mg/ dl was 23% in subjects with 25 oh vit D less than 15 ng/ml. The 52.2%, 59.6% and 63.2% of patients with 25 (OH) D with values between 15 to 19.9, 20 to 30 and ?30 ng/ml had PTH? 45 pg/ ml. The probability of having a PTH value ? 45 pg/ml had no statistically significant differences between 20 and 30 ng/ml of 25 (OH) D. The values of 25 (OH) D ? 30 ng/ml were less likely to present PTH?65 pg/ml, being 14.3% with values lower than 15 ng/ml vs 4.8% with values ? 30 ng/ml. Although 75% of the evaluated population has values of 25 oh D lower than 30 ng/ ml, the presence of PTH greater than 45 pg/ml occurs in 40% of the subjects between 20 and 30 and they present with serum calcium lower than 9 mg/dl in 21%.
Conclusion: According to the behavior of the calcium-PTH- vit D axis, the normal cut-off point of 25 OH D of 20 ng/ml should be reconsidered for this population between 20 and 60 years without other comorbidities.
Citas
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