Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, Madison, WI, USA.
Ann Surg Oncol. 2012 Sep;19(9):2958-62. doi: 10.1245/s10434-012-2378-3. Epub 2012 Apr 26.
Hyperparathyroidism is much more common in women and therefore may represent different diseases in men and women. In order to understand the role of gender in hyperparathyroidism, we reviewed our experience.
We analyzed a prospective database of 1309 consecutive patients with primary hyperparathyroidism who underwent parathyroidectomy at our institution between March 2001 and August 2010.
The female-to-male ratio was 3.3:1, and female patients were older at presentation (60 ± 0 vs. 57 ± 1 years, p < 0.005). Male patients were more commonly asymptomatic at presentation (25 % vs. 18 %, p = 0.005) and the most common symptom for men was kidney stones (23 % vs. 13 %, p < 0.0001). For patients with bone density scans, osteoporosis was more common in women (34 % vs. 17 %, p < 0.0001). Men had a slightly higher preoperative serum calcium level (11.1 ± 0 vs. 11.0 ± 0 mg/dl, p = 0.03), higher parathyroid hormone level (140 ± 7 vs. 124 ± 4 pg/ml, p = 0.04), higher urinary calcium level (376 ± 10 vs. 314 ± 5 mg/24 h, p < 0.005), and lower vitamin D level (28 ± 1 vs. 32 ± 0 ng/ml, p < 0.005). Men were more likely to have abnormally elevated creatinine values (15 % vs. 9 %, p = 0.004). The operative approach as well as the number of glands involved and their location did not significantly differ between the groups. The mean gland weight for a single adenomas was higher in male patients (1123 ± 128 vs. 636 ± 32 mg, p = 0.001). No significant difference was identified in the immediate and remote postoperative course.
Hyperparathyroidism appears to present differently depending on gender. Male patients more often present without symptoms, present with vitamin D deficiency, and have larger parathyroid glands. Importantly, surgical outcomes were equivalent between men and women.
甲状旁腺功能亢进症在女性中更为常见，因此男性和女性的甲状旁腺功能亢进症可能代表不同的疾病。为了了解性别在甲状旁腺功能亢进症中的作用，我们回顾了我们的经验。
我们分析了 2001 年 3 月至 2010 年 8 月期间在我院接受甲状旁腺切除术的 1309 例原发性甲状旁腺功能亢进症患者的前瞻性数据库。
男女比例为 3.3:1，女性患者的发病年龄较大（60 ± 0 岁比 57 ± 1 岁，p < 0.005）。男性患者在发病时更常无症状（25%比 18%，p = 0.005），男性最常见的症状是肾结石（23%比 13%，p < 0.0001）。对于接受骨密度扫描的患者，女性骨质疏松症更为常见（34%比 17%，p < 0.0001）。男性术前血清钙水平略高（11.1 ± 0 毫克/分升比 11.0 ± 0 毫克/分升，p = 0.03），甲状旁腺激素水平较高（140 ± 7 比 124 ± 4 皮克/毫升，p = 0.04），尿钙水平较高（376 ± 10 毫克/24 小时比 314 ± 5 毫克/24 小时，p < 0.005），维生素 D 水平较低（28 ± 1 比 32 ± 0 纳克/毫升，p < 0.005）。男性更有可能出现异常升高的肌酐值（15%比 9%，p = 0.004）。两组之间手术方式、受累腺体数量及其位置无显著差异。单个腺瘤的平均腺体重量在男性患者中较高（1123 ± 128 毫克比 636 ± 32 毫克，p = 0.001）。男性和女性在术后即刻和远期的过程中没有显著差异。
甲状旁腺功能亢进症的表现似乎因性别而异。男性患者更常无症状出现，表现为维生素 D 缺乏，且甲状旁腺腺体较大。重要的是，男性和女性的手术结果相当。
