Biochemical characteristics and calcium and PTH levels of patients with high normal and elevated serum 25(OH)D levels in Turkey: DeVIT-TOX survey

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dc.contributor.authorPekkolay, Zafer
dc.contributor.authorYavuz, Dilek Gogas
dc.contributor.authorSaygili, Emre Sedar
dc.contributor.authorDegertekin, Ceyla Konca
dc.contributor.authorTopaloglu, Omercan
dc.contributor.authorOnder, Cagatay Emir
dc.contributor.authorSoylu, Hikmet
dc.date.accessioned2024-04-24T16:02:30Z
dc.date.available2024-04-24T16:02:30Z
dc.date.issued2021
dc.departmentDicle Üniversitesien_US
dc.description.abstractA Summary Vitamin D intake over the recommended dose is usually associated with high serum 25(OH)D levels and generally not associated with symptoms of hypercalcemia. High doses of cholecalciferol need to be avoided to protect against vitamin D toxicity and related complications. Strict adherence to the clinical guidelines for treating vitamin D deficiency can ensure safe and effective treatment. Purpose We observed a tendency to use high doses of cholecalciferol for vitamin D deficiency treatment or vitamin D supplementation. We aimed to determine the biochemical characteristics of patients with high normal and elevated serum 25(OH)D levels. Methods An online invitation was sent to all tertiary endocrinology clinics in Turkey to complete an online retrospective survey (DeVIT-TOX Survey) for patients diagnosed with high serum 25(OH)D levels (> 88 ng/mL) between January 2019 and December 2019. The patients were evaluated according to the presence of signs and symptoms of hypercalcemia and doses of vitamin D intake, evaluated into the following three groups according to their 25(OH)D levels: group 1, > 150 ng/mL; group 2, 149-100 ng/mL; and group 3, 99-88 ng/mL. Results A total of 253 patients were included in the final analysis (female/male: 215/38; mean age, 51.5 +/- 15.6 years). The average serum 25(OH)D level was 119.9 +/- 33 (range, 88-455) ng/mL, and the average serum calcium level was 9.8 +/- 0.7 (range, 8.1-13.1) mg/dL. Most (n = 201; 75.4%) patients were asymptomatic despite having high serum 25(OH)D and calcium levels. The serum 25(OH)D level was significantly higher in the symptomatic groups than in the asymptomatic groups (138.6 +/- 64 ng/mL vs. 117.7 +/- 31 ng/mL, p < 0.05). The most common cause (73.5%) associated with high serum 25(OH) D levels was the inappropriate prescription of a high dose of oral vitamin D (600.000-1.500.000 IU) for treating vitamin D deficiency/insufficiency in a short time (1-3 months). The cut-off value of 25 (OH) D level in patients with hypercalcemia was found to be 89 ng/mL [median 116.5 (89-216)]. Conclusions High dose of vitamin D intake is associated with a high serum 25 OH D level, without symptoms of hypercalcemia. Inappropriate prescription of vitamin D is the primary cause for elevated 25(OH) D levels and related hypercalcemia. Hypercalcemia may not be observed in every patient at very high 25(OH) D levels. Adherence to the recommendation of guidelines is essential to ensure safe and effective treatment of vitamin D deficiency.en_US
dc.description.sponsorshipSociety of Endocrinology and Metabolism of Turkeyen_US
dc.description.sponsorshipPreparation for publication of this article is supported by the Society of Endocrinology and Metabolism of Turkey.en_US
dc.identifier.doi10.1007/s11657-021-01002-8
dc.identifier.issn1862-3522
dc.identifier.issn1862-3514
dc.identifier.issue1en_US
dc.identifier.pmid34536116
dc.identifier.scopus2-s2.0-85115190405
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://doi.org/10.1007/s11657-021-01002-8
dc.identifier.urihttps://hdl.handle.net/11468/14814
dc.identifier.volume16en_US
dc.identifier.wosWOS:000697070700003
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoenen_US
dc.publisherSpringer London Ltden_US
dc.relation.ispartofArchives of Osteoporosis
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectVitamin D Toxicityen_US
dc.subject25-Oh Vitamin Den_US
dc.subjectHypercalcemiaen_US
dc.subjectCholecalciferolen_US
dc.titleBiochemical characteristics and calcium and PTH levels of patients with high normal and elevated serum 25(OH)D levels in Turkey: DeVIT-TOX surveyen_US
dc.titleBiochemical characteristics and calcium and PTH levels of patients with high normal and elevated serum 25(OH)D levels in Turkey: DeVIT-TOX survey
dc.typeArticleen_US

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