Clinical phenotypes of primary hyperparathyroidism in hospitalized patients who underwent parathyroidectomy

in Endocrine Connections
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  • 1 L Yanevskaya, Clinical Endocrinology Research Laboratory, Almazov National Medical Research Centre, Sankt Peterburg, Russian Federation
  • 2 T Karonova, Clinical Endocrinology Research Laboratory, Almazov National Medical Research Centre, Sankt Peterburg, Russian Federation
  • 3 I Sleptsov, Endocrine surgery department, Saint-Petersburg State University N.I. Pirogov Clinic of High Medical Technologies, St.Petersburg, Russian Federation
  • 4 M Boriskova, Endocrine surgery, First Pavlov State Medical University of Saint Peterburg, Sankt Peterburg, Russian Federation
  • 5 A Bakhtiyarova, Endocrinology department, Almazov National Medical Research Centre, Sankt Peterburg, Russian Federation
  • 6 R Chernikov, Endocrine surgery department, Saint-Petersburg State University N.I. Pirogov Clinic of High Medical Technologies, Sankt-Peterburg, Russian Federation
  • 7 K Pogosian, Edocrinology department, Almazov National Medical Research Centre, Sankt Peterburg, Russian Federation
  • 8 A Andreeva, Clinical Endocrinology Research Laboratory, Almazov National Medical Research Centre, Sankt Peterburg, Russian Federation
  • 9 D Lebedev, Clinical Endocrinology Research Laboratory, Almazov National Medical Research Centre, Sankt Peterburg, Russian Federation
  • 10 E Grineva, chief of Institute of Endocrinilogy, Almazov National Medical Research Centre, Sankt Peterburg, Russian Federation
  • 11 J P. Bilezikian, Division of Endocrinology, Columbia University College of Physicians and Surgeons, New York, United States

Correspondence: Liubov Yanevskaya, Email: fosterthefire@yandex.ru

Objective. The aim of our study was to investigate the distribution of the PHPT clinical manifestations and biochemical features in patients who underwent parathyroidectomy.

Materials and methods. Medical records of 449 patients from three Medical Centers (Saint-Petersburg, Russia), hospitalized during a period from 2011 to 2018, were reviewed. History and anthropometric data, laboratory results (iPTH, total and  iCa, phosphorus, ALP, 24-h urinary calcium, 25(OH)D) and imaging data (ultrasonography, scintigraphy, CT/MRI scan, DXA) were analyzed.

Results. Three hundred ninety-four patients were included in the final analysis. Median age was 60 years with 94.2 % being women. Symptomatic disease was evident in 222 (56.4%) patients, asymptomatic in 172 (43.6%). Skeletal involvement was more common for women, while frequency of other manifestations did not differ in both genders. There was no difference between symptomatic and asymptomatic patients in age. Serum iPTH level was higher in symptomatic patients (202.9 and 181.0 pg/ml, p=0.022). Serum 25(OH)D level was estimated in few patients and negatively correlated with PTH (r= -0.294, p=0.005), iCa (r= -0.268, p=0.010) and total Ca (r= -0.284, p=0.014) levels. Manifestations of CVD were observed in 67.7% of cases and affected equally both symptomatic and asymptomatic patients (70.7% and 63.4%, p=0.076). Both age and BMI were higher in patients with CVD, whether or not they were symptomatic (62 and 53 years, p<0.0001; 30.4 vs 26.0 kg/m2, p<0.0001, respectively).

Conclusions. This experience illustrates that symptomatic phenotype is still the most common form of PHPT.

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