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Vitamin D metabolism in normal and hypoparathyroid pregnancy and lactation

1983; Wiley; Volume: 90; Issue: 10 Linguagem: Inglês

10.1111/j.1471-0528.1983.tb06774.x

1471-0528

Trond Markestad, Magnar Ulstein, Hans H. Bassøe, Lage Aksnes, Dagfinn Aarskog,

Parathyroid Disorders and Treatments

Summary. Plasma concentrations of vitamin D metabolites in −17 non‐pregnant women, 22 pregnant women at delivery, and in eight lactating women 3 and 16 days after delivery, were compared with those in a postpartum hypoparathyroid patient treated with 1α‐hydroxyvitamin D (1α‐OHD). The mean concentration of 1,25‐dihydroxy vitamin D [1,25–(OH) 2 D] was 203 (SD 61) pmol/1 in the pregnant, and 86 (SD 27) pmol/1 in the non‐pregnant women ( P <0.0005). The levels 3. and 16 days after delivery were similar [57 (11) compared with 62 (19) pmol/1], and lower than the non‐pregnant value ( P <0.01). The 25‐hydroxyvitamin D (25‐OHD) concentration remained unchanged between the 3rd and 16th days after delivery, whereas the 24,25‐dihydroxyvitamin D [24,25‐(OH) 2 D] level increased from 2.7 (SD 1.8) to 3.7 (SD 2.3)nmol/l ( P <0.025). The patient temporarily required an increased supplement of 1α‐OHD during pregnancy, but a dose which was appropriate before pregnancy resulted in marked hypercalcaemia and a rise of 1,25‐(OH) 2 D concentration within 16 days of delivery despite lactation. The results suggest that the metabolic need for the active vitamin D metabolite 1,25‐(OH) 2 D is increased during pregnancy and rapidly reduced during early lactation in healthy and hypoparathyroid women.