Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy.
Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University, Rome, Italy.
Endocr Pract. 2021 Jan;27(1):21-26. doi: 10.4158/EP-2020-0405. Epub 2020 Nov 18.
There are no data regarding echocardiographic parameters in patients with normocalcemic primary hyperparathyroidism (NCPHPT). We compared the echocardiographic findings in postmenopausal women with NCPHPT with those in patients with hypercalcemic primary hyperparathyroidism (PHPT) and controls.
Seventeen consecutive Caucasian postmenopausal women with NCPHPT were compared with 20 women with hypercalcemic PHPT and 20 controls. Obesity, diabetes, kidney failure, and previous cardiovascular diseases were considered exclusion criteria. Each patient underwent biochemical evaluation, bone mineral density scan, and echocardiographic measurements. Patients with parathyroid disorders underwent kidney ultrasound evaluation.
Patients with PHPT had significantly higher mean total serum calcium, ionized calcium, 24-hour urinary calcium, and parathyroid hormone and lower mean phosphorus levels compared with those in the controls (all P < .05). The only differences between patients with NCPHPT and PHPT were significantly lower mean total serum calcium, ionized calcium, and 24-hour urinary calcium and higher phosphorus levels in patients with NCPHPT (all P < .05). The only biochemical difference between patients with NCPHPT and the controls was a higher level of mean parathyroid hormone in patients with NCPHPT. There were no differences in cardiovascular risk factors between patients with NCPHPT and PHPT and the controls. Hypertension was the most frequent cardiovascular risk factor, diagnosed in 65% of patients with PHPT. This high prevalence was not statistically significant compared with that observed in patients with NCPHPT (59%) and in the controls (30%). Echocardiography parameters were not different between patients with NCPHPT and PHPT and the controls when subdivided according to the presence of hypertension (ANOVA followed by Bonferroni correction).
In a population with a low cardiovascular risk, we found no differences in cardiovascular risk factors and echocardiographic parameters between patients with NCPHPT and PHPT and the controls.
目前尚无关于血钙正常的原发性甲状旁腺功能亢进症（NCPHPT）患者的超声心动图参数数据。我们比较了绝经后 NCPHPT 患者、高钙血症原发性甲状旁腺功能亢进症（PHPT）患者和对照组的超声心动图结果。
连续纳入 17 例高加索绝经后 NCPHPT 患者，与 20 例高钙血症 PHPT 患者和 20 例对照组进行比较。肥胖、糖尿病、肾衰竭和既往心血管疾病被视为排除标准。每位患者均接受生化评估、骨密度扫描和超声心动图检查。甲状旁腺疾病患者接受肾脏超声检查。
与对照组相比，PHPT 患者的平均总血清钙、离子钙、24 小时尿钙和甲状旁腺激素明显升高，而磷水平明显降低（均 P <.05）。NCPHPT 患者与 PHPT 患者的唯一差异是 NCPHPT 患者的平均总血清钙、离子钙和 24 小时尿钙明显降低，而磷水平升高（均 P <.05）。NCPHPT 患者与对照组的唯一生化差异是 NCPHPT 患者的平均甲状旁腺激素水平较高。NCPHPT 患者与 PHPT 患者和对照组的心血管危险因素无差异。高血压是最常见的心血管危险因素，在 PHPT 患者中诊断出 65%，与 NCPHPT 患者（59%）和对照组（30%）相比，这一高患病率无统计学差异。根据高血压的存在将 NCPHPT 患者、PHPT 患者和对照组进行亚组分析时，超声心动图参数无差异（方差分析后 Bonferroni 校正）。
在心血管风险较低的人群中，我们发现 NCPHPT 患者与 PHPT 患者和对照组在心血管危险因素和超声心动图参数方面无差异。
