Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Endocr Pract. 2022 Jan;28(1):96-101. doi: 10.1016/j.eprac.2021.09.012. Epub 2021 Sep 30.
To describe the prevalence and compare the clinicobiochemical profile of patients with primary hyperparathyroidism (PHPT) with and without type 2 diabetes mellitus (T2DM).
We conducted a retrospective observational study wherein the details of patients with PHPT with T2DM (PHPT-T2DM) and without T2DM were retrieved from the Indian PHPT Registry (www.indianphptregistry.com) between 2005 and 2019. We compared the clinical, biochemical, and postoperative findings of patients with PHPT-T2DM with age-, sex-, and body mass index-matched patients with PHPT without T2DM (in 1:2 ratio).
Of the 464 patients with PHPT, 54 (11.6%) had T2DM. We observed an increase in the prevalence of PHPT-T2DM cases over time; only 7 (7.1%) of the total patients with PHPT had T2DM between 2005 and 2009 that increased to 31 (12.8%) in the last half decade (2015-2019). Patients with PHPT-T2DM had a significantly lower prevalence of nephrolithiasis (18.5% vs 36.1%, respectively; P = .03) and a higher prevalence of pancreatitis (22.2% vs 5.6%, respectively; P = .007) than those without T2DM. Furthermore, intact parathyroid hormone (203 pg/mL [139.8-437.3 pg/mL] vs 285 pg/mL [166-692 pg/mL], respectively; P = .04) and serum creatinine (0.90 mg/dL [0.67-1.25 mg/dL] vs 1.10 mg/dL [0.73-1.68 mg/dL], respectively; P = .03) levels were significantly lower in patients with PHPT-T2DM than those without T2DM. Also, tumor weight tended to be lower in patients with PHPT-T2DM than in the non-T2DM counterparts (1.05 g [0.5-2.93 g] vs 2.16 g [0.81-7.0 g], respectively; P = .06).
The prevalence of T2DM in Asian Indians with PHPT is 11.6%. Patients with PHPT-T2DM are characterized by a higher prevalence of pancreatitis, a lower prevalence of nephrolithiasis, and lower levels of intact parathyroid hormone/creatinine. Part of the clinical picture can possibly be explained by early detection of PHPT in patients with T2DM consequent to more frequent screening.
描述原发性甲状旁腺功能亢进症（PHPT）伴发和不伴发 2 型糖尿病（T2DM）患者的患病率，并比较其临床生化特征。
我们开展了一项回顾性观察性研究，检索了 2005 年至 2019 年间印度甲状旁腺功能亢进症登记处（www.indianphptregistry.com）中 T2DM 伴发和不伴发 PHPT 患者的详细资料。我们将 T2DM 伴发 PHPT 患者（PHPT-T2DM）与年龄、性别和体重指数匹配的单纯 PHPT 患者（1:2 比例）的临床、生化和术后发现进行了比较。
在 464 例 PHPT 患者中，54 例（11.6%）合并 T2DM。我们观察到 PHPT-T2DM 病例的患病率随时间推移而增加；在 2005 年至 2009 年间，所有 PHPT 患者中仅有 7 例（7.1%）合并 T2DM，而在过去的 5 年（2015-2019 年）中增加到 31 例（12.8%）。PHPT-T2DM 患者肾结石的患病率明显较低（18.5%比 36.1%，P=0.03），胰腺炎的患病率较高（22.2%比 5.6%，P=0.007）。此外，PHPT-T2DM 患者的全段甲状旁腺激素（203 pg/mL[139.8-437.3 pg/mL]比 285 pg/mL[166-692 pg/mL]，P=0.04）和血清肌酐（0.90 mg/dL[0.67-1.25 mg/dL]比 1.10 mg/dL[0.73-1.68 mg/dL]，P=0.03）水平明显低于非 T2DM 患者。此外，PHPT-T2DM 患者的肿瘤重量也倾向于低于非 T2DM 患者（1.05 g[0.5-2.93 g]比 2.16 g[0.81-7.0 g]，P=0.06）。
在合并 PHPT 的亚裔印度人群中，T2DM 的患病率为 11.6%。PHPT-T2DM 患者的特征为胰腺炎患病率较高、肾结石患病率较低，以及全段甲状旁腺激素/肌酐水平较低。部分临床表现可能与 T2DM 患者 PHPT 的早期发现有关，这是由于 T2DM 患者更频繁的筛查所致。
