Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Solna, Sweden.
Department of Orthopedics, K54. Karolinska University Hospital, Huddinge, SE-141 86, Stockholm, Sweden.
World J Surg. 2022 Jan;46(1):128-135. doi: 10.1007/s00268-021-06331-w. Epub 2021 Oct 13.
Primary hyperparathyroidism (PHPT) is a common endocrine disorder with a wide range of adverse effects, such as osteoporosis. Many women are not diagnosed due to asymptomatic disease or vague symptoms but are still at risk of severe adverse effects. Early identification of patients with PHPT is therefore of importance. The aim of this study was to determine PHPT prevalence among postmenopausal women with a distal forearm fracture.
Recruitment was conducted in conjunction with the occurrence of a distal forearm fracture at Karolinska University Hospital. In total, 161 postmenopausal women were included in a cross-sectional study with repeated evaluations. Analyzes of serum calcium, ionized calcium, phosphate, parathyroid hormone (PTH), and vitamin D were performed. Diagnosis of PHPT was based on clinical evaluations and biochemical definitions of serum calcium and PTH in coherence with previous population prevalence reports.
Mean age was 64.7 (9.5) years, serum calcium 2.33 (0.10) mmol/L, ionized calcium 1.25 (0.05) mmol/L and PTH 54 (26) ng/L. PTH was elevated in 32 (20%) women. In total, 11 (6.8%) women were diagnosed with PHPT; 6 with classical PHPT and 5 with mild PHPT. The prevalence of PHPT was significantly increased compared to the population prevalence of 3.4% (p = 0.022).
Screening postmenopausal women in conjunction with low-energy distal forearm fracture revealed a large number of women with parathyroid disturbance. Evaluation of parathyroid hormone and calcium status in this group of patients seems beneficial.
原发性甲状旁腺功能亢进症（PHPT）是一种常见的内分泌疾病，具有广泛的不良影响，如骨质疏松症。许多女性由于无症状疾病或模糊症状而未被诊断，但仍有发生严重不良后果的风险。因此，早期识别 PHPT 患者非常重要。本研究旨在确定伴有远端前臂骨折的绝经后妇女中 PHPT 的患病率。
在 Karolinska 大学医院发生远端前臂骨折的同时进行招募。共有 161 名绝经后妇女参与了一项横断面研究，并进行了重复评估。对血清钙、离子钙、磷酸盐、甲状旁腺激素（PTH）和维生素 D 进行分析。根据临床评估和血清钙和 PTH 的生化定义诊断 PHPT，这些定义与以前的人群患病率报告一致。
平均年龄为 64.7（9.5）岁，血清钙 2.33（0.10）mmol/L，离子钙 1.25（0.05）mmol/L，PTH 54（26）ng/L。32 名（20%）女性的 PTH 升高。共有 11 名（6.8%）妇女被诊断为 PHPT；6 例为经典 PHPT，5 例为轻度 PHPT。与人群患病率 3.4%相比，PHPT 的患病率显著增加（p=0.022）。
在伴有低能量远端前臂骨折的绝经后妇女中进行筛查，发现大量甲状旁腺功能紊乱的妇女。评估该组患者的甲状旁腺激素和钙状态似乎有益。
