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Published in: Journal of Bone and Mineral Metabolism 3/2016

01-05-2016 | Original Article

Normocalcemic hyperparathyroidism is associated with complications similar to those of hypercalcemic hyperparathyroidism

Authors: Mazhar Müslüm Tuna, Mustafa Çalışkan, Mustafa Ünal, Taner Demirci, Berçem Ayçiçek Doğan, Kerim Küçükler, Mustafa Özbek, Dilek Berker, Tuncay Delibaşı, Serdar Güler

Published in: Journal of Bone and Mineral Metabolism | Issue 3/2016

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Abstract

Normocalcemic primary hyperparathyroidism (NC-PHPT) is a variant of hyperparathyroidism, characterized by normal serum calcium levels, high parathyroid hormone (PTH) and normal 25-OH vitamin D status. The present study aimed to compare complications related to hyperparathyroidism in patients with NC-PHPT and hypercalcemic PHPT (HC-PHPT). We retrospectively evaluated the records of 307 PHPT patients between January 2010 and March 2013. We excluded patients with impaired renal function and liver failure. All patients underwent a biochemical and hormonal examination including serum glucose, albumin, total calcium, phosphorus, creatinine, lipoproteins, PTH and 25-OH vitamin D. Nephrolithiasis and bone mineral density were documented based on a review of the medical records. The study population consisted of 36 (12 %) males and 271 (88 %) females with a mean age of 53.3 ± 9.5 years (29–70 years). Twenty-three of the patients were diagnosed with NC-PHPT (group 1) and 284 were diagnosed with HC-PHPT (group 2). There were no significant differences in terms of age, gender, prevalence of hypertension, low bone mineral density and kidney stones between the groups. The mean thyroid-stimulating hormone (TSH) and low-density lipoprotein (LDL) levels were significantly higher in group 1 than in group 2. Our study found that patients with NC-PHPT have similar several complications as patients with HC-PHPT. NC-PHPT patients have higher TSH levels despite being within the normal range, and higher LDL-C levels than patients with HC-PHPT. However, this relationship needs to be clarified in future studies with larger cohorts.
Literature
1.
go back to reference Yu N, Donnan PT, Murphy MJ, Leese GP (2009) Epidemiology of primary hyperparathyroidism in Tayside, Scotland, UK. Clin Endocrinol 71:485–493CrossRef Yu N, Donnan PT, Murphy MJ, Leese GP (2009) Epidemiology of primary hyperparathyroidism in Tayside, Scotland, UK. Clin Endocrinol 71:485–493CrossRef
2.
go back to reference Adami S, Marcocci C, Gatti D (2002) Epidemiology of primary hyperparathyroidism in Europe. J Bone Miner Res 17:18–23 Adami S, Marcocci C, Gatti D (2002) Epidemiology of primary hyperparathyroidism in Europe. J Bone Miner Res 17:18–23
3.
go back to reference Farahnak P, Larfars G, Sten-Linder M, Nilsson IL (2011) Mild primary hyperparathyroidism: 25-OH Vitamin D deficiency and cardiovascular risk markers. J Clin Endocrinol Metab 96:2112–2118CrossRefPubMed Farahnak P, Larfars G, Sten-Linder M, Nilsson IL (2011) Mild primary hyperparathyroidism: 25-OH Vitamin D deficiency and cardiovascular risk markers. J Clin Endocrinol Metab 96:2112–2118CrossRefPubMed
4.
go back to reference Wermers RA, Khosla S, Atkinson EJ, Grant CS, Hodgson SF, O’Fallon WM, Melton LJ (1998) Survival after the diagnosis of hyperparathyroidism: a population-based study. Am J Med 104:115–122CrossRefPubMed Wermers RA, Khosla S, Atkinson EJ, Grant CS, Hodgson SF, O’Fallon WM, Melton LJ (1998) Survival after the diagnosis of hyperparathyroidism: a population-based study. Am J Med 104:115–122CrossRefPubMed
5.
go back to reference Hagstrom E, Lundgren E, Rastad J, Hellman P (2006) Metabolic abnormalities in patients with normocalcemic hyperparathyroidism detected at a population-based screening. Eur J Endocrinol 155:33–39CrossRefPubMed Hagstrom E, Lundgren E, Rastad J, Hellman P (2006) Metabolic abnormalities in patients with normocalcemic hyperparathyroidism detected at a population-based screening. Eur J Endocrinol 155:33–39CrossRefPubMed
6.
go back to reference Ross AC, Taylor CL, Yaktine AL, Del Valle HB (eds) (2011) Dietary reference intakes for calcium and 25-OH vitamin D. The National Academies Press, Washington Ross AC, Taylor CL, Yaktine AL, Del Valle HB (eds) (2011) Dietary reference intakes for calcium and 25-OH vitamin D. The National Academies Press, Washington
8.
go back to reference Silverberg SJ, Bilezikian JP (2003) Incipient primary hyperparathyroidism: a forme fruste of an old disease. J Clin Endocrinol Metab 88:5348–5352CrossRefPubMed Silverberg SJ, Bilezikian JP (2003) Incipient primary hyperparathyroidism: a forme fruste of an old disease. J Clin Endocrinol Metab 88:5348–5352CrossRefPubMed
10.
go back to reference Grant FD, Conlin PR, Brown EM (1990) Rate and concentration dependence of parathyroid hormone dynamics during stepwise changes in serum ionized calcium in normal humans. J Clin Endocrinol Metab 71:370–378CrossRefPubMed Grant FD, Conlin PR, Brown EM (1990) Rate and concentration dependence of parathyroid hormone dynamics during stepwise changes in serum ionized calcium in normal humans. J Clin Endocrinol Metab 71:370–378CrossRefPubMed
11.
go back to reference Orwoll E, Blank JB, Barrett-Connor E, Cauley J, Cummings S, Ensrud K, Lewis C, Cawthon PM, Marcus R, Marshall LM, McGowan J, Phipps K, Sherman S, Stefanick ML, Stone K (2005) Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study—a large observational study of the determinants of fracture in older men. Contemp Clin Trials 26:569–585CrossRefPubMed Orwoll E, Blank JB, Barrett-Connor E, Cauley J, Cummings S, Ensrud K, Lewis C, Cawthon PM, Marcus R, Marshall LM, McGowan J, Phipps K, Sherman S, Stefanick ML, Stone K (2005) Design and baseline characteristics of the osteoporotic fractures in men (MrOS) study—a large observational study of the determinants of fracture in older men. Contemp Clin Trials 26:569–585CrossRefPubMed
12.
go back to reference Lowe H, McMahon DJ, Rubin MR, Bilezikian JP, Silverberg SJ (2007) Normocalcemic primary hyperparathyroidism: further characterization of a new clinical phenotype. J Clin Endocrinol Metab 92:3001–3005CrossRefPubMed Lowe H, McMahon DJ, Rubin MR, Bilezikian JP, Silverberg SJ (2007) Normocalcemic primary hyperparathyroidism: further characterization of a new clinical phenotype. J Clin Endocrinol Metab 92:3001–3005CrossRefPubMed
13.
go back to reference Maruani G, Hertig A, Paillard M, Houillier P (2003) Normocalcemic primary hyperparathyroidism: evidence for a generalized target-tissue resistance to parathyroid hormone. J Clin Endocrinol Metab 88:4641–4648CrossRefPubMed Maruani G, Hertig A, Paillard M, Houillier P (2003) Normocalcemic primary hyperparathyroidism: evidence for a generalized target-tissue resistance to parathyroid hormone. J Clin Endocrinol Metab 88:4641–4648CrossRefPubMed
14.
go back to reference Tordjman KM, Greenman Y, Osher E, Shenkerman G, Stern N (2004) Characterization of normocalcemic primary hyperparathyroidism. Am J Med 117:861–863CrossRefPubMed Tordjman KM, Greenman Y, Osher E, Shenkerman G, Stern N (2004) Characterization of normocalcemic primary hyperparathyroidism. Am J Med 117:861–863CrossRefPubMed
15.
go back to reference Amaral LM, Queiroz DC, Marques TF, Mendes M, Bandeira F (2012) Normocalcemic versus hypercalcemic primary hyperparathyroidism: more stone than bone? J Osteoporos 3:128352 Amaral LM, Queiroz DC, Marques TF, Mendes M, Bandeira F (2012) Normocalcemic versus hypercalcemic primary hyperparathyroidism: more stone than bone? J Osteoporos 3:128352
16.
go back to reference Cakir I, Unluhizarci K, Tanriverdi F (2012) Investigation of insulin resistance in patients with normocalcemic primary hyperparathyroidism. Endocrine 42:419–422CrossRefPubMed Cakir I, Unluhizarci K, Tanriverdi F (2012) Investigation of insulin resistance in patients with normocalcemic primary hyperparathyroidism. Endocrine 42:419–422CrossRefPubMed
17.
go back to reference Gillet C, Bergmann P, Francois D, Body JJ, Corvilain J (1989) Low basal thyrotropin with normal thyroid function in primary hyperparathyroidism. Acta Endocrinol 121:638–642PubMed Gillet C, Bergmann P, Francois D, Body JJ, Corvilain J (1989) Low basal thyrotropin with normal thyroid function in primary hyperparathyroidism. Acta Endocrinol 121:638–642PubMed
18.
go back to reference Ignjatovic VD, Matovic MD, Vukomanovic VR, Jankovic SM, Džodić RR (2013) Is there a link between Hashimoto’s thyroiditis and primary hyperparathyroidism? A study of serum parathormone and anti-TPO antibodies in 2267 patients. Hell J Nucl Med 16:86–90PubMed Ignjatovic VD, Matovic MD, Vukomanovic VR, Jankovic SM, Džodić RR (2013) Is there a link between Hashimoto’s thyroiditis and primary hyperparathyroidism? A study of serum parathormone and anti-TPO antibodies in 2267 patients. Hell J Nucl Med 16:86–90PubMed
19.
go back to reference Hagström E, Lundgren E, Rastad J, Hellman P (2006) Metabolic abnormalities in patients with normocalcemic hyperparathyroidism detected at a population-based screening. Eur J Endocrinol 155:33–39CrossRefPubMed Hagström E, Lundgren E, Rastad J, Hellman P (2006) Metabolic abnormalities in patients with normocalcemic hyperparathyroidism detected at a population-based screening. Eur J Endocrinol 155:33–39CrossRefPubMed
20.
go back to reference Temizkan S, Kocak O, Aydin K, Ozderya A, Arslan G, Yucel N, Sargin M (2014) Normocalcemic hyperparathyroidism and insulin resistance. Endocr Pract 6:1–19 Temizkan S, Kocak O, Aydin K, Ozderya A, Arslan G, Yucel N, Sargin M (2014) Normocalcemic hyperparathyroidism and insulin resistance. Endocr Pract 6:1–19
Metadata
Title
Normocalcemic hyperparathyroidism is associated with complications similar to those of hypercalcemic hyperparathyroidism
Authors
Mazhar Müslüm Tuna
Mustafa Çalışkan
Mustafa Ünal
Taner Demirci
Berçem Ayçiçek Doğan
Kerim Küçükler
Mustafa Özbek
Dilek Berker
Tuncay Delibaşı
Serdar Güler
Publication date
01-05-2016
Publisher
Springer Japan
Published in
Journal of Bone and Mineral Metabolism / Issue 3/2016
Print ISSN: 0914-8779
Electronic ISSN: 1435-5604
DOI
https://doi.org/10.1007/s00774-015-0673-3

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