Yanevskaya Liubov G, Karonova Tatiana, Sleptsov Ilya V, Boriskova Marina Evgenevna, Bakhtiyarova Aluza Ramilevna, Chernikov Roman A, Pogosian Karina Aleksandrovna, Andreeva Alena Timurovna, Lebedev Denis Andreevich, Grineva Elena Nikolaevna, Bilezikian John P
Almazov National Medical Research Centre, St. Petersburg, Russia.
First Pavlov State Medical University, St. Petersburg, Russia.
Endocr Connect. 2021 Feb;10(2):248-255. doi: 10.1530/EC-20-0515.
The aim of our study was to investigate the distribution of the PHPT clinical manifestations and biochemical features in patients who underwent parathyroidectomy.
Medical records of 449 patients from three Medical Centers (Saint-Petersburg, Russia), hospitalized during a period from 2011 to 2018, were reviewed. History and anthropometric data, laboratory results (iPTH, total and iCa, phosphorus, ALP, 24-h urinary calcium, 25(OH)D) and imaging data (ultrasonography, scintigraphy, CT/MRI scan, DXA) were analyzed.
Three hundred ninety-four patients were included in the final analysis. Median age was 60 years with 94.2% being women. Symptomatic disease was evident in 222 (56.4%) patients, asymptomatic in 172 (43.6%). Skeletal involvement was more common for women, while frequency of other manifestations did not differ in both genders. There was no difference between symptomatic and asymptomatic patients in age. Serum iPTH level was higher in symptomatic patients (202.9 and 181.0 pg/mL, P = 0.022). Serum 25(OH)D level was estimated in few patients and negatively correlated with PTH (r = ¯0.294, P = 0.005), iCa (r = ¯0.268, P = 0.010) and total Ca (r = ¯0.284, P = 0.014) levels. Manifestations of CVD were observed in 67.7% of cases and affected equally both symptomatic and asymptomatic patients (70.7 and 63.4%, P = 0.076). Both age and BMI were higher in patients with CVD, whether or not they were symptomatic (62 and 53 years, P < 0.0001; 30.4 vs 26.0 kg/m2, P < 0.0001, respectively).
This experience illustrates that symptomatic phenotype is still the most common form of PHPT.
本研究旨在调查接受甲状旁腺切除术患者的原发性甲状旁腺功能亢进症（PHPT）临床表现和生化特征的分布情况。
回顾了来自三个医疗中心（俄罗斯圣彼得堡）在2011年至2018年期间住院的449例患者的病历。分析了病史和人体测量数据、实验室检查结果（免疫反应性甲状旁腺激素（iPTH）、总钙和离子钙、磷、碱性磷酸酶（ALP）、24小时尿钙、25羟维生素D）以及影像学数据（超声检查、闪烁扫描、CT/MRI扫描、双能X线吸收法（DXA））。
394例患者纳入最终分析。中位年龄为60岁，女性占94.2%。222例（56.4%）患者有症状性疾病，172例（43.6%）无症状。骨骼受累在女性中更常见，而其他表现的发生率在两性中无差异。有症状和无症状患者在年龄上无差异。有症状患者的血清iPTH水平较高（分别为202.9和181.0 pg/mL，P = 0.022）。少数患者检测了血清25(OH)D水平，其与PTH（r = -0.294，P = 0.005）、离子钙（r = -0.268，P = 0.010）和总钙（r = -0.284，P = 0.014）水平呈负相关。67.7%的病例观察到心血管疾病（CVD）表现，有症状和无症状患者受影响程度相当（分别为70.7%和63.4%，P = 0.076）。无论有无症状，CVD患者的年龄和体重指数（BMI）均较高（分别为62岁和53岁，P < 0.0001；30.4 vs 26.0 kg/m2，P < 0.0001）。
该研究经验表明，有症状表型仍是PHPT最常见的形式。
