Multiple myeloma (MM) causes generalized bone loss leading to lytic bone lesions and pathologic fractures. The increased osteoclast activity and reduced osteoblast function favors bone resorption and decrease bone formation. Vitamin D is vital in regulating calcium homeostasis and osteoclast-mediated bone resorption. Deficiency of Vitamin D among MM patients may complicate bone mineralization problems and fractures.
General Objective: To determine the status of Vitamin D in patients with multiple myeloma
Specific Objective: To determine the levels of Vitamin D, intact parathyroid hormone and ionized calcium among MM patients
This is a prospective, cross-sectional study which included patients who were 18-year old and above, male or female, diagnosed with multiple myeloma at the University of Santo Tomas Hospital, with or without treatment. Excluded in the study were those with Vitamin D and calcium supplementation. Eligible subjects were extracted blood for Vitamin D assay, intact parathyroid hormone and ionized calcium.
A total of 22 patients with multiple myeloma were included in the study. Sixteen patients (72.7%) had hypovitaminosis D. Among these sixteen patients, seven (31.8%) had vitamin D deficiency (Vitamin D levels <20 ng/mL [50 nmol/L]) and nine (40.9%) had vitamin D insufficiency (levels of 21-29 ng/mL [52.5-72.5 nmol/L]). Only 6 (27.3%) of them were found to have normal serum vitamin D (levels of >29 ng/mL [>72.5 nmol/L]). The mean age (p=0.069), intact PTH (p=0.062) and ionized calcium (p=0.188) of the three groups of patients did not differ.
This study found a high incidence of Vitamin D deficiency among multiple myeloma patients seen at the University of Santo Tomas Hospital. Vitamin D deficiency was independent of age, intact PTH and ionized calcium. It was more common in male subjects. Patients with hypovitaminosis D are at risk for having secondary hyperparathyroidism.
Vitamin D status should be determined among patients with multiple myeloma. Early recognition and treatment of hypovitaminosis D will prevent risk of having secondary hyperparathyroidism that can complicate skeletal-related events.
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