Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy.
Department of Internal Medicine and Medical Disciplines, "Sapienza", Rome University, Rome, Italy.
Calcif Tissue Int. 2018 Aug;103(2):144-150. doi: 10.1007/s00223-018-0405-5. Epub 2018 Mar 8.
Epidemiological data on prevalence and incidence of chronic hypoparathyroidism are still scarce. This study aimed to establish prevalence of chronic hypoparathyroidism and incidence of surgical hypoparathyroidism using the analysis of electronic anonymous public health care database. Data referred to a 5-year period (2009-2013, Region of Tuscany, Italy, as a sample representative of the whole Mediterranean/European population, estimated mean population: 3,750,000 inhabitants) were retrieved by the analysis of pharmaceutical distribution dataset, containing data related to drugs reimbursed by public health system, hospital discharge and procedures codes, and ICD9 exemption codes for chronic diseases. The application of a specific algorithm was applied to indirectly identify people with chronic hypoparathyroidism as assuming chronic therapy with active vitamin D metabolites (AVDM). The number of people taking AVDM for a period equal to or longer than 6 months till the end of the study period, with ICD9 exemption code for hypoparathyroidism, and with a disease-related discharge code were identified. Within this restricted group, patients with chronic kidney disease and osteoporosis were excluded. The indirect estimate of chronic hypoparathyroidism in a European Mediterranean subpopulation by means of the analysis of chronic therapy with AVDM was 27/100,000 inhabitants (female:male ratio = 2.2:1), with a mean age of 63.5 ± 16.7 years. The risk of developing hypoparathyroidism after neck surgery was 1.5%. While the epidemiological approaches based on disease code and hospital discharge code greatly underestimates the prevalence of hypoparathyroidism, the indirect estimate of this disease through the analysis of prescriptions of AVDM in a European region is in line with the results of studies performed in other regions of the world.
慢性甲状旁腺功能减退症的流行率和发病率的流行病学数据仍然很少。本研究旨在使用电子匿名公共卫生保健数据库的分析来建立慢性甲状旁腺功能减退症的流行率和手术性甲状旁腺功能减退症的发病率。通过对药物分布数据集的分析，检索了 2009-2013 年（意大利托斯卡纳地区，作为整个地中海/欧洲人口的样本代表，估计平均人口为 375 万居民）的 5 年数据，该数据集包含与公共卫生系统报销的药物、住院和程序代码以及慢性疾病 ICD9 豁免代码相关的数据。应用特定算法来间接识别患有慢性甲状旁腺功能减退症的人，假设他们正在接受活性维生素 D 代谢物（AVDM）的慢性治疗。确定了在研究期间内，使用 AVDM 治疗的时间等于或超过 6 个月、具有甲状旁腺功能减退症 ICD9 豁免代码且具有与疾病相关的出院代码的人群数量。在这个受限的人群中，排除了患有慢性肾脏病和骨质疏松症的患者。通过分析 AVDM 的慢性治疗，以间接方式估计欧洲地中海亚人群中的慢性甲状旁腺功能减退症，患病率为 27/100,000 居民（女性：男性比例=2.2:1），平均年龄为 63.5±16.7 岁。颈部手术后发生甲状旁腺功能减退症的风险为 1.5%。虽然基于疾病代码和住院出院代码的流行病学方法大大低估了甲状旁腺功能减退症的流行率，但通过分析欧洲一个地区的 AVDM 处方对这种疾病的间接估计与在世界其他地区进行的研究结果一致。
