Characterization of Vitamin D Metabolism in Active Acromegaly in the Setting of Bolus (150,000 IU) Cholecalciferol Treatment

Overview

Journal Endocrine

Specialty Endocrinology

Date 2022 Feb 9

PMID 35138562

Authors

Alexandra A Povaliaeva

Viktor P Bogdanov

Artem Yu Zhukov

Ekaterina A Pigarova

Larisa K Dzeranova

Liudmila Ya Rozhinskaya

Galina A Melnichenko

Natalia G Mokrysheva

Affiliations

Soon will be listed here.

Abstract

Purpose: To reveal distinctive features of vitamin D metabolism in patients with active acromegaly compared to healthy individuals, particularly in the setting of cholecalciferol treatment.

Methods: The study group included 34 adults with active acromegaly, and the control group included 30 apparently healthy adults with similar age, sex, and BMI. All participants received a single dose (150,000 IU) of cholecalciferol aqueous solution orally. Laboratory assessments including serum vitamin D metabolites (25(OH)D, 25(OH)D, 1,25(OH)D, 3-epi-25(OH)D and 24,25(OH)D), free 25(OH)D, vitamin D-binding protein (DBP) and parathyroid hormone (PTH) as well as serum and urine biochemical parameters were performed before the intake and on Days 1, 3, and 7 after the administration. All data were analyzed with nonparametric statistics.

Results: Patients with acromegaly had tendency to lower baseline 25(OH)D levels (p = 0.05) and lower 25(OH)D levels (p < 0.05) during the follow-up. They were also characterized by PTH suppression (lower baseline PTH levels and lower prevalence of secondary hyperparathyroidism), altered production of main vitamin D metabolites (higher 1,25(OH)D and lower 24,25(OH)D levels with corresponding lower 25(ОН)D/1,25(ОН)D and higher 25(ОН)D/24,25(ОН)D ratios) as well as concordant biochemical features (higher levels of serum phosphorus and albumin-adjusted calcium levels) throughout the study (p < 0.05). The acromegaly group showed an increase in DBP levels after cholecalciferol intake as opposed to the control group (p < 0.05) and had lower increase in free 25(OH)D levels (p < 0.05). Δ25(OH)D was similar between the groups (p > 0.05), showed a negative correlation with the disease activity markers-both IGF-1 levels (r = -0.44, p < 0.05) and fasting GH levels (r = -0.56, p < 0.05)-and lacked correlation with BMI in the acromegaly group (p > 0.05).

Conclusion: Patients with active acromegaly have dysregulated vitamin D metabolism characterized by higher 1,25(ОН)D, lower 24,25(ОН)D and altered DBP production. The response to vitamin D supplementation in acromegaly patients might be influenced by hormonal excess. Obtained results require reproducibility check and further study to develop specific clinical recommendations.

Trial Registration: NCT04844164 (release date: April 9, 2021; retrospectively registered).

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