Original Article
European Journal of Clinical Nutrition (2006) 60, 1214–1221. doi:10.1038/sj.ejcn.1602440; published online 24 May 2006
Postpartum vitamin D insufficiency and secondary hyperparathyroidism in healthy Danish women
Guarantor: UK Møller.
Contributors: UKM, CHR, LR, TBH and LM designed the study. UKM and CHR carried out the study. UKM performed the statistical calculations and analyses, wrote the original manuscript and edited all subsequent versions. LR, LM and TBH contributed to the interpretation of data and commented on the manuscript. All authors approved the final version of the manuscript.
U K Møller1, C H Ramlau-Hansen2, L Rejnmark1, L Heickendorff3, T B Henriksen4 and L Mosekilde1
- 1Department of Endocrinology and Metabolism C, Aarhus University Hospital, Aarhus, Denmark
- 2Department of Occupational Medicine, Institute of Public Health, Aarhus University Hospital, Aarhus, Denmark
- 3Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
- 4Perinatal Epidemiology Research Unit, Department of Obstetrics and Paediatrics, Aarhus University Hospital, Skejby, Aarhus, Denmark
Correspondence: UK Møller, Department of Endocrinology and Metabolism C, Aarhus Sygehus, Aarhus University Hospital, Tage-Hansens Gade 2, Aarhus 8000, Denmark. E-mail: Kristine.moller@ki.au.dk
Received 7 July 2005; Revised 9 January 2006; Accepted 30 January 2006; Published online 24 May 2006.
Abstract
Objective:
To examine vitamin D status and parathyroid function in normal Danish women postpartum.
Design:
Three cross-sectional measures during follow-up of 89 women postpartum.
Subjects and intervention:
We assessed vitamin D status by measuring plasma 25-hydroxyvitamin D (P-25OHD) and the degree of secondary hyperparathyroidism by measuring plasma parathyroid hormone (P-PTH) in 89 Caucasian women at three consecutive visits: (mean (range)) 23 (10–37) days (spring), 117 (95–140) days (late summer) and 274 (254–323) days (winter) postpartum.
Results:
P-25OHD showed seasonal variations with higher values in late summer than in the other periods (P<0.001). At the first visit, 65% received vitamin D supplements. At the following visits, almost 50% were supplemented. Vitamin D insufficiency (P-25OHD<50 nmol/l) occurred more often during winter (28%) than in spring (14%) (Fisher's exact test, P=0.02) or late summer (7%) (P=0.0001). Irrespective of season, vitamin D insufficiency occurred most frequent in women who did not take vitamin D supplements (Fisher's exact test, P<0.02). Frank vitamin D deficiency (P-25OHD<25 nmol/l) was observed during winter in 6%. At all three periods, P-25OHD correlated inversely with P-PTH indicating secondary hyperparathyroidism at deficient vitamin D status. During spring, late summer and winter three, one and four females, respectively, had elevated plasma PTH.
Conclusion:
Vitamin D insufficiency with secondary hyperparathyroidism is a frequent finding in healthy Danish women postpartum and especially during winter. Vitamin D supplements reduced the risk of vitamin D insufficiency, especially during winter. Our results support the importance of increased alertness regarding information of pregnant and lactating women about vitamin D supplements. Furthermore, it has to be studied whether the present recommendations of an intake of 5–10 
g vitamin D/day are sufficient, especially during winter months.
Keywords:
vitamin D, hyperparathyroidism, secondary, lactation, postpartum
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