Begic-Karup S, Wagner B, Raber W, Schneider B, Hamwi A, Waldhäusl W, Vierhapper H
Division of Endocrinology and Metabolism, Department of Internal Medicine III.
Wien Klin Wochenschr. 2001 Jan 15;113(1-2):65-8.
Thyroid hormones are believed to influence calcium metabolism. In the present prospective study we investigated the influence of various thryroid diseases on serum calcium levels. In addition to screening for thyroid diseases we measured serum calcium concentrations (S-Ca) in individuals who came to our outpatient service for thyroid diseases from 1992 to 1998. 13,387 persons, among them 9017 patients with thyroid diseases and 4370 persons without thyroid dysfunction, were studied. S-Ca was found to be higher in patients with hyperthyroidism (2.36 +/- 0.11 mmol/L n = 1201, p < 0.05) than in those with subclinical hyperthyroidism (2.33 +/- 0.11 mmol/L, n = 494), with euthyroid goiter (2.32 +/- 0.10 mmol/l, n = 5599), with hypothyroidism (2.31 +/- 0.11 mmol/L, 344), with subclinical hypothyroidism (2.32 +/- 0.10 mmol/L, n = 1290) and in healthy persons (2.31 +/- 0.11 mmol/L, n = 4370). 173/13,387 persons had serum calcium levels < 2.1 mmol/L, among them 31 patients with hypoparathyroidism after strumectomy (31/592) and 2 patients with primary hypoparathyroidism. 106/13,387 persons showed a S-Ca of > 2.6 mmol/L, which in 30 cases was due to primary hyperparathyroidism. Of 55 persons with S-Ca of > 2.6 mmol/L and without any other reason for hypercalcaemia, 31 were found to be in a hyperthyroid state. In conclusion, a clinically not relevant influence on S-Ca was demonstrated in patients with hyperthyroidism as compared with other thyroid diseases and individuals with no thyroid diseases. Measurement of S-Ca in every patient being referred to a thyroid outpatient department is recommended because of the frequent occurrence of postoperative hypoparathyroidism and primary hyperparathyroidism in this setting.
甲状腺激素被认为会影响钙代谢。在本前瞻性研究中，我们调查了各种甲状腺疾病对血清钙水平的影响。除了筛查甲状腺疾病外，我们还测量了1992年至1998年到我们门诊治疗甲状腺疾病的个体的血清钙浓度（S-Ca）。共研究了13387人，其中9017例甲状腺疾病患者和4370例无甲状腺功能障碍者。结果发现，甲状腺功能亢进患者的S-Ca（2.36±0.11 mmol/L，n = 1201，p < 0.05）高于亚临床甲状腺功能亢进患者（2.33±0.11 mmol/L，n = 494）、甲状腺肿患者（2.32±0.10 mmol/l，n = 5599）、甲状腺功能减退患者（2.31±0.11 mmol/L，344例）、亚临床甲状腺功能减退患者（2.32±0.10 mmol/L，n = 1290）以及健康人（2.31±0.11 mmol/L，n = 4370）。13387人中173人的血清钙水平<2.1 mmol/L，其中31例为甲状腺切除术后甲状旁腺功能减退患者（31/592），2例为原发性甲状旁腺功能减退患者。13387人中106人的S-Ca>2.6 mmol/L，其中30例是由于原发性甲状旁腺功能亢进。在55例S-Ca>2.6 mmol/L且无其他高钙血症原因的患者中，31例被发现处于甲状腺功能亢进状态。总之，与其他甲状腺疾病患者和无甲状腺疾病者相比，甲状腺功能亢进患者对S-Ca的影响在临床上无显著意义。由于在此情况下术后甲状旁腺功能减退和原发性甲状旁腺功能亢进的发生率较高，建议对每个转诊至甲状腺门诊的患者进行S-Ca测量。
