Letter to the Editor: “Hypoparathyroidism: Less Severe Hypocalcemia With Treatment With Vitamin D2 Compared With Calcitriol”

摘要

In their recent study, Streeten et al. (1) reported that patients with hypoparathyroidism treated chronically with vitamin D2 had less morbidity from hypocalcemia than patients treated with calcitriol. Although the authors highlight the limitations of the retrospective design of the study, there may be additional explanations for their findings. First, half of the patients in the calcitriol group were not taking calcium supplements, whereas almost all of the patients in the vitamin D2 group were on calcium supplementation. This could indicate that dietary calcium was the main source of calcium intake in at least half the patients in the calcitriol group, a source that is inconsistent on a daily basis. Did the episodes of hypocalcemia differ according to the use of calcium supplements? Compliance with medication is another important issue that was not controlled for because of the retrospective nature of the...