Underbjerg Line, Sikjaer Tanja, Mosekilde Leif, Rejnmark Lars
Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Aarhus, Denmark.
J Bone Miner Res. 2014 Nov;29(11):2504-10. doi: 10.1002/jbmr.2273.
Data on co-morbidity in patients with postsurgical hypoparathyroidism (HypoPT) are sparse. We aimed to assess risk of fractures, spinal stenosis, cataract, neuropsychiatric diseases, cancer, and infections within the historic cohort of patients with postsurgical HypoPT due to non-malignant causes that we previously have characterized. Patients were identified through the Danish National Patient Registry and regional prescription databases, with subsequent validation of their individual hospital records. Identified cases were matched with three age- (± 2 yr) and gender-matched controls from the general background population. Compared with controls, patients did not have an increased risk of cataract (p = 0.52), spinal stenosis (p = 0.59), or any fracture (p = 0.98). However, the risk of fractures at the upper extremities was significantly decreased in patients (HR 0.69, 95% CI 0.49-0.97). Compared with controls, patients had a significantly increased risk of hospitalization due to infections (HR 1.42, 95% CI 1.20-1.67) and depression/bipolar affective disorders (HR 1.99, 95% CI 1.14-3.46). The risk of malignant diseases did not differ between groups although the risk of gastrointestinal cancers was significantly lower in patients compared with controls (HR 0.63, 95% CI 0.44-0.93). In conclusion, HypoPT is associated with an increased risk of depression and other types of neuropsychiatric diseases as well as infections, whereas patients seem to be protected against fractures at the upper extremities and gastrointestinal malignancies.
关于术后甲状旁腺功能减退症(HypoPT)患者合并症的数据很少。我们旨在评估在我们之前已描述过的因非恶性原因导致术后HypoPT的患者历史队列中,骨折、脊柱狭窄、白内障、神经精神疾病、癌症和感染的风险。通过丹麦国家患者登记处和地区处方数据库识别患者,并随后对其个人医院记录进行验证。将识别出的病例与来自一般背景人群的三名年龄(±2岁)和性别匹配的对照进行匹配。与对照组相比,患者患白内障(p = 0.52)、脊柱狭窄(p = 0.59)或任何骨折(p = 0.98)的风险没有增加。然而,患者上肢骨折的风险显著降低(HR 0.69,95%CI 0.49 - 0.97)。与对照组相比,患者因感染(HR 1.42,95%CI 1.20 - 1.67)和抑郁/双相情感障碍(HR 1.99,95%CI 1.14 - 3.46)住院的风险显著增加。两组之间恶性疾病的风险没有差异,尽管与对照组相比,患者患胃肠道癌症的风险显著较低(HR 0.63,95%CI 0.44 - 0.93)。总之,HypoPT与抑郁和其他类型神经精神疾病以及感染的风险增加相关,而患者似乎对上肢骨折和胃肠道恶性肿瘤具有防护作用。