Role of vitamin D and calcium nutrition in disease expression and parathyroid tumor growth in primary hyperparathyroidism: a global perspective.

摘要: Since the classic description by Fuller Albright in 1940s, primary hyperparathyroidism has evolved from a disease with signs and symptoms to search of symptoms! that time, two major events have occurred. First, United States, Kingdom, most European countries, there been steady rise apparent incidence disease. Second, dramatic shift pattern presentation. A majority patients countries multichannel screening panels are asymptomatic. Skeletal renal complications uncommon, osteitis fibrosa is rare. In contrast, clinical presentation changed very little other regions such as East, Middle some parts southern hemisphere over same period observation. Accordingly, we assessed influence vitamin D calcium nutrition on expression parathyroid tumor growth different world. Between 1945 1950, both prevalence weight declined dramatically coinciding fortification milk D. world where depletion endemic. Furthermore, for comparable degree depletion, Asian Indians significantly larger tumors compared Americans (3.95 +/- 2.23 vs. 0.66 2.84 g; p < 0.001). Within blacks whites (0.78 2.87 0.58 2.78 0.01). However, slopes regression between serum 25-hydroxyvitamin D, best index nutrition, weight, available growth, were not Indians, whites, blacks. We conclude population affect hyperparathyroidism. It will be interest see if changes when better nutritional policies implemented developing countries.