Hypoparathyroidism: what is the best calcium carbonate supplementation intake form?

Abstract Introduction: In hypoparathyroidism, calcium supplementation using calcium carbonate is necessary for the hypocalcemia control. The best calcium carbonate intake form is unknown, be it associated with feeding, juice or in fasting. Objective: The objective was to evaluate the calcium, phosphorus and calcium × phosphorus product serum levels of hypoparathyroidism women after total thyroidectomy, following calcium carbonate intake in three different forms. Methods: A crossover study was carried out with patients presenting definitive hypoparathyroidism, assessed in different situations (fasting, with water, orange juice, breakfast with a one-week washout). Through the review of clinical data records of tertiary hospital patients from 1994 to 2010, 12 adult women (18-50 years old) were identified and diagnosed with definitive post-thyroidectomy hypoparathyroidism. The laboratory results of calcium and phosphorus serum levels dosed before and every 30 min were assessed, for 5 h, after calcium carbonate intake (elementary calcium 500 mg). Results: The maximum peak average values for calcium, phosphorus and calcium × phosphorus product were 8.63 mg/dL (water), 8.77 mg/dL (orange juice) and 8.95 mg/dL (breakfast); 4.04 mg/dL (water), 4.03 mg/dL (orange juice) and 4.12 mg/dL (breakfast); 34.3 mg2/dL2 (water), 35.8 mg2/dL2 (orange juice) and 34.5 mg2/dL2 (breakfast), respectively, and the area under the curve 2433 mg/dL min (water), 2577 mg/dL min (orange juice) and 2506 mg/dL min (breakfast), 1203 mg/dL min (water), 1052 mg/dL min (orange juice) and 1128 mg/dL min (breakfast), respectively. There was no significant difference among the three different tests (p > 0.05). Conclusion: The calcium, phosphorus and calcium × phosphorus product serum levels evolved in a similar fashion in the three calcium carbonate intake forms.

摘要：甲状旁腺功能减退症患者需通过补充碳酸钙以控制低钙血症。目前尚不明确碳酸钙的最佳服用形式——是随餐、配果汁，还是空腹服用。研究目的：本研究旨在评估全甲状腺切除术后甲状旁腺功能减退症女性患者，在三种不同碳酸钙服用方式下的血清钙、磷及钙磷乘积水平。研究方法：本研究采用交叉设计，纳入确诊为永久性甲状旁腺功能减退症的受试者，设置不同评估场景：空腹状态、配清水服用、配橙汁服用、随早餐服用，各场景间设置为期1周的洗脱期。通过回顾1994年至2010年某三级医院的临床病历数据，共筛选出12名年龄介于18~50岁的成年女性，均被诊断为甲状腺切除术后永久性甲状旁腺功能减退症。受试者服用含元素钙500mg的碳酸钙后，于5小时内分别于给药前及每30分钟采集血样，检测血清钙与磷水平，并对检测结果进行分析。研究结果：钙、磷及钙磷乘积的平均峰值分别为：清水组8.63mg/dL、橙汁组8.77mg/dL、早餐组8.95mg/dL；清水组4.04mg/dL、橙汁组4.03mg/dL、早餐组4.12mg/dL；清水组34.3mg²/dL²、橙汁组35.8mg²/dL²、早餐组34.5mg²/dL²。三种组别的曲线下面积分别为：钙的曲线下面积：清水组2433mg/dL·min、橙汁组2577mg/dL·min、早餐组2506mg/dL·min；磷的曲线下面积：清水组1203mg/dL·min、橙汁组1052mg/dL·min、早餐组1128mg/dL·min。三种不同服用方式下的各项指标均无显著统计学差异（p>0.05）。研究结论：三种碳酸钙服用方式对血清钙、磷及钙磷乘积水平的影响趋势相似。