Dundee Epidemiology and Biostatistics Unit, Division of Clinical and Population Sciences and Education, Dundee, UK.
Department of Medicine, University of Dundee, Dundee, UK.
J Bone Miner Res. 2018 Mar;33(3):478-485. doi: 10.1002/jbmr.3329. Epub 2017 Nov 30.
There are very few reports on the epidemiology of chronic hypoparathyroidism. A population-based study was undertaken to describe the prevalence and incidence of hypoparathyroidism in Tayside, Scotland. Data on biochemistry, hospital admissions, prescribing, and death records in Tayside, Scotland, from 1988 to 2015 were linked electronically. Patients with at least three serum albumin-corrected calcium concentrations below the reference range that were taken in an outpatient setting were included in the study. Patients with severe chronic kidney disease before low calcium were excluded from the study. Patients with hypocalcemia were included if they had either previous neck surgery/irradiation, a low serum parathyroid hormone (PTH), or were treated with vitamin D. Patients were identified as having either a postsurgical or a nonsurgical cause or had secondary hypoparathyroidism, eg, hypomagnesemia. Overall, 18,955 patients were identified with hypocalcemia. Of these, 222 patients had primary hypoparathyroidism, 116 with postsurgical and 106 with nonsurgical chronic hypoparathyroidism. In 2015, the prevalence of primary hypoparathyroidism was 40 per 100,000, with a rate of 23 and 17 per 100,000, respectively, for postsurgical and nonsurgical. Eighty percent of the former and 64% of the latter were female. The mean serum calcium at diagnosis was 1.82 mmol/L (SD ± 0.24) and the annual incidence varied from 1-4 per 100,000. Overall, 71% of patients were prescribed vitamin D and/or calcium, whereas activated vitamin D was used in 48% of postsurgical cases and 43% of nonsurgical cases. Thyroxine and/or hydrocortisone were prescribed in more than 90% of postsurgical and 64% of nonsurgical cases. In conclusion, the prevalence of nonsurgical chronic hypoparathyroidism was greater than previously reported using this population-based approach. Many had mild hypocalcemia and did not receive any treatment. © 2017 American Society for Bone and Mineral Research.
关于慢性甲状旁腺功能减退症的流行病学，仅有少量报道。本研究旨在采用基于人群的方法描述苏格兰泰赛德地区甲状旁腺功能减退症的患病率和发病率。从苏格兰泰赛德地区的 1988 年至 2015 年的生化数据、住院记录、处方和死亡记录被进行电子链接。本研究纳入了至少有三次血清白蛋白校正的钙浓度低于参考范围且在门诊就诊时的患者。研究排除了在发生低钙血症之前患有严重慢性肾脏病的患者。患有低钙血症的患者如果有过颈部手术/放疗史、甲状旁腺激素（PTH）水平低或接受维生素 D 治疗，也被纳入研究。患者被分为手术性或非手术性病因所致或继发性甲状旁腺功能减退症（例如低镁血症）。总的来说，共确定了 18955 例低钙血症患者。其中，222 例为原发性甲状旁腺功能减退症，116 例为手术性和 106 例为非手术性慢性甲状旁腺功能减退症。2015 年，原发性甲状旁腺功能减退症的患病率为每 10 万人中有 40 例，手术性和非手术性分别为每 10 万人中有 23 例和 17 例。前者女性占 80%，后者占 64%。诊断时的平均血清钙水平为 1.82mmol/L（标准差±0.24），年发病率为每 10 万人 1-4 例。总体而言，71%的患者接受了维生素 D 和/或钙的治疗，而活性维生素 D 仅用于 48%的手术性病例和 43%的非手术性病例。超过 90%的手术性病例和 64%的非手术性病例都接受了甲状腺素和/或氢化可的松的治疗。总之，本研究采用基于人群的方法发现，非手术性慢性甲状旁腺功能减退症的患病率高于以往报道。许多患者仅有轻度低钙血症，并未接受任何治疗。 © 2017 美国骨矿研究协会。
