Weber Theresia, Hillenbrand Andreas, Peth Simon, Hummel Rainer
Department of Endocrine Surgery, Katholisches Klinikum Mainz, Mainz, Germany.
Department of General and Visceral Surgery, Ulm University, Ulm, Germany.
Visc Med. 2020 Feb;36(1):41-47. doi: 10.1159/000505497. Epub 2020 Jan 22.
Typical symptoms for primary hyperparathyroidism (pHPT) include osteoporosis, bone or joint pain, and nephrolithiasis, as well as fatigue, depression, gastritis, and cardiovascular disease. The female:male ratio was 3:1. The aim of this retrospective study was to evaluate the possible influence of gender-specific aspects of these symptoms.
From February 2018 to November 2019, parathyroid surgery was performed in 125 patients with pHPT (age: 23-83 years); 95 (76%) were female, and 30 (24%) were male. Preoperatively, a standardized medical history including 7 typical symptoms of pHPT was used for routine clinical documentation according to the StuDoQ Thyroid and Parathyroid Registry.
For both groups (mean age: 60.4 years for females and 60.2 years for males), no sex differences were found in serum calcium or parathyroid hormone levels. For females, there was a tendency towards smaller hyperfunctioning parathyroid glands (16.8 vs. 20.5 mm) with less weight (1.14 vs. 1.52 g) and multiglandular disease. Nephrolithiasis was significantly more frequent in men than in women (36.7 vs. 16.8%, respectively; = 0.036), but the difference in hypertension was not significant (60% in men vs. 47.4% in women, = 0.230). Women reported significantly more often bone and joint pain (44.2% in women vs. 20% in men, = 0.053) and depressive episodes (32.6% in women vs. 10% in men, = 0.016).
91.2% of patients transferred for parathyroidectomy described typical symptoms of pHPT. However, an unexpected high gender difference was found following the analysis of symptoms documented in the StuDoQ Registry.
原发性甲状旁腺功能亢进症（pHPT）的典型症状包括骨质疏松、骨或关节疼痛、肾结石，以及疲劳、抑郁、胃炎和心血管疾病。男女比例为3:1。这项回顾性研究的目的是评估这些症状的性别特异性方面可能产生的影响。
2018年2月至2019年11月，对125例pHPT患者（年龄23 - 83岁）进行了甲状旁腺手术；其中95例（76%）为女性，30例（24%）为男性。术前，根据StuDoQ甲状腺和甲状旁腺登记系统，一份包含pHPT 7种典型症状的标准化病史用于常规临床记录。
两组（女性平均年龄60.4岁，男性平均年龄60.2岁）的血清钙或甲状旁腺激素水平均未发现性别差异。对于女性，功能亢进的甲状旁腺腺体往往较小（16.8对20.5毫米），重量较轻（1.14对1.52克），且多腺体疾病更为常见。肾结石在男性中的发生率显著高于女性（分别为36.7%和16.8%；P = 0.036），但高血压的差异不显著（男性为60%，女性为47.4%，P = 0.230）。女性报告骨和关节疼痛（女性为44.2%，男性为20%，P = 0.053）和抑郁发作（女性为32.6%，男性为10%，P = 0.016）的频率明显更高。
91.2%接受甲状旁腺切除术的患者表现出pHPT的典型症状。然而，对StuDoQ登记系统记录的症状进行分析后发现，性别差异出乎意料地大。
