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正常血钙水平原发性甲状旁腺功能亢进患者的冠状动脉钙化评分评估

Evaluation of coronary calcium score in patients with normocalcemic primary hyperparathyroidism.

作者信息

Mesquita Patrícia Nunes, Dornelas Leão Leite Ana Paula, Chagas Crisóstomo Stella das, Veras Filho Enio, da Cunha Xavier Lucas, Bandeira Francisco

机构信息

Unit of Endocrinology, Diabetes and Bone Diseases, Hospital Agamenon Magalhães.

Department of Radiology, University of Pernambuco, Cardiac Emergency Hospital of Pernambuco, Recife, Pernambuco, Brazil.

出版信息

Vasc Health Risk Manag. 2017 Jun 22;13:225-229. doi: 10.2147/VHRM.S128084. eCollection 2017.

Abstract

RATIONALE

Given that the diagnosis of primary hyperparathyroidism (PHPT) is given at an increasingly less-symptomatic phase, and the literature data on the cardiovascular risk of patients with normocalcemic primary hyperparathyroidism (NPHPT) are controversial, the coronary calcium score (CCS), which is correlated with coronary artery disease, may be useful for clarifying the association between cardiovascular risk and NPHPT.

OBJECTIVE

This research aims to describe the CCS and the clinical and laboratory variables of patients with NPHPT compared with a control group and to verify the presence of an association between NPHPT and CCS.

STUDY POPULATION AND METHODS

A questionnaire on anthropometric data (weight, height, waist circumference, and blood pressure) was used, laboratory examinations (estimations of glucose, glycated hemoglobin [HbA1c], total cholesterol [TC] and its fractions, triglycerides, creatinine, calcium, parathyroid hormone, and 25-OH vitamin D) were conducted, and computerized tomography was carried out to measure the CCS in 13 patients diagnosed with NPHPT and 16 controls.

RESULTS

There was no association between NPHPT and altered CCS (odds ratio [OR]: 0.27; 95% confidence interval [CI]: 0.05-1.26; =0.095). Differences between the case and control groups were found in terms of body mass index (BMI) (26.97 kg/m vs 31.53 kg/m, respectively; =0.044), HbA1c (5.59% vs 6.62%; =0.000), and TC (188.07 mg/dL vs 220.64 mg/dL; =0.088). After adjustment for potential confounders, no statistical significance was observed for the association between changes in CCS and presence of NPHPT (adjusted OR: 1.64; 95% CI: 0.1-26.43; =0.726).

CONCLUSION

No association was found between the CCS and the presence of NPHPT.

摘要

原理

鉴于原发性甲状旁腺功能亢进症(PHPT)的诊断越来越多地处于症状较轻的阶段,且关于血钙正常的原发性甲状旁腺功能亢进症(NPHPT)患者心血管风险的文献数据存在争议,与冠状动脉疾病相关的冠状动脉钙化评分(CCS)可能有助于阐明心血管风险与NPHPT之间的关联。

目的

本研究旨在描述NPHPT患者与对照组相比的CCS以及临床和实验室变量,并验证NPHPT与CCS之间是否存在关联。

研究人群与方法

使用了一份关于人体测量数据(体重、身高、腰围和血压)的问卷,进行了实验室检查(血糖、糖化血红蛋白[HbA1c]、总胆固醇[TC]及其组分、甘油三酯、肌酐、钙、甲状旁腺激素和25-羟基维生素D的测定),并对13例诊断为NPHPT的患者和16例对照进行了计算机断层扫描以测量CCS。

结果

NPHPT与CCS改变之间无关联(优势比[OR]:0.27;95%置信区间[CI]:0.05-1.26;P = 0.095)。病例组和对照组在体重指数(BMI)(分别为26.97 kg/m²和31.53 kg/m²;P = 0.044)、HbA1c(5.59%对6.62%;P = 0.000)和TC(188.07 mg/dL对220.64 mg/dL;P = 0.088)方面存在差异。在对潜在混杂因素进行调整后,CCS变化与NPHPT存在之间的关联未观察到统计学意义(调整后OR:1.64;95% CI:0.1-26.43;P = 0.726)。

结论

未发现CCS与NPHPT的存在之间存在关联。

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