Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
J Surg Res. 2021 Aug;264:124-128. doi: 10.1016/j.jss.2021.03.002. Epub 2021 Apr 2.
Hyperparathyroidism (HPT) occurs in about 1% of the general population. Previous studies have suggested that the incidence is higher in those patients with thyroid disease who are undergoing thyroid surgery. The study purpose was to examine the incidence of concomitant HPT in patients already undergoing a thyroid procedure and to identify risk factors.
A prospective database of all patients who had thyroidectomy by the endocrine surgery team was reviewed between August 2012 and April 2020. Per institutional protocol, all patients having thyroid surgery were screened for concomitant hyperparathyroidism. ANOVA/T-Test and Chi-square were conducted to compare those with and without hyperparathyroidism.
The median age was 43 and 79% were female. Of the 481 patients undergoing thyroidectomy, 31 (6%) had HPT. The mean preoperative calcium and parathyroid hormone levels were 10 ± 0 mg/dL and 67 ± 5 pg/mL, respectively. When comparing the groups, patients with concomitant HPT were older (53 ± 4 versus 42 ± 1 y, P = 0.005). African American race was a significant risk factor for concomitant HPT. While African Americans represented only 29% of those undergoing surgery, 58% of those with concomitant HPT were African American (P = 0.007).
In patients having thyroid surgery, concomitant HPT was present in 6% of the population, higher than estimated general population prevalence. While we understand that primary HPT incidence increases with age, to our knowledge, this is the first report to document that African Americans are at a higher risk for concomitant HPT with thyroid disease. Thus, routine screening for hyperparathyroidism in patients undergoing thyroid surgery, especially in vulnerable populations, such as the older and African American population, is beneficial.
甲状旁腺功能亢进症（HPT）在普通人群中的发病率约为 1%。先前的研究表明，在接受甲状腺手术的甲状腺疾病患者中，发病率更高。本研究的目的是检查已经接受甲状腺手术的患者中同时发生 HPT 的发生率，并确定相关风险因素。
回顾了 2012 年 8 月至 2020 年 4 月间内分泌外科团队进行的所有甲状腺切除术患者的前瞻性数据库。根据机构方案，所有接受甲状腺手术的患者均接受了甲状旁腺功能亢进症的筛查。采用 ANOVA/T-Test 和卡方检验比较伴有和不伴有 HPT 的患者。
中位年龄为 43 岁，79%为女性。在 481 例行甲状腺切除术的患者中，有 31 例（6%）患有 HPT。术前血钙和甲状旁腺激素水平的平均值分别为 10 ± 0mg/dL 和 67 ± 5pg/mL。比较两组患者时，伴有 HPT 的患者年龄更大（53 ± 4 岁比 42 ± 1 岁，P = 0.005）。非裔美国人是同时患有 HPT 的显著风险因素。虽然非裔美国人仅占手术患者的 29%，但伴有 HPT 的患者中非裔美国人占 58%（P = 0.007）。
在接受甲状腺手术的患者中，同时患有 HPT 的人群占 6%，高于估计的普通人群患病率。虽然我们知道原发性 HPT 的发病率随年龄增长而增加，但据我们所知，这是首次报告表明非裔美国人患有甲状腺疾病合并 HPT 的风险更高。因此，在接受甲状腺手术的患者中，特别是在老年人和非裔美国人等弱势群体中，常规筛查甲状旁腺功能亢进症是有益的。
