University of Alabama at Birmingham, Department of Surgery/ Division of Breast and Endocrine Surgery, Birmingham, AL, USA.
University of Alabama at Birmingham, Department of Surgery/ Division of Breast and Endocrine Surgery, Birmingham, AL, USA.
Am J Surg. 2022 Sep;224(3):914-917. doi: 10.1016/j.amjsurg.2022.04.005. Epub 2022 Apr 15.
Primary hyperparathyroidism (PHPT) with low preoperative vitamin D levels is thought to be related to 4-gland hyperplasia. We reviewed final parathyroid pathology in relationship to preoperative vitamin D levels.
A retrospective review was performed for all PHPT patients undergoing parathyroidectomy from 2001 to 2019. Patient demographics, laboratory studies, and final pathology were reviewed.
2230 patients were included in the analysis, 78.1% were female with a mean age of 59 years. Patients were stratified into 3 groups based on their preoperative 25-hydroxy vitamin D levels; "deficient" (<20 ng/mL) (n = 319), "insufficient" (20-30 ng/mL) (n = 1108), or "sufficient" (>30 ng/mL) (n = 803). Patients with deficient vitamin D had a higher frequency of single adenoma (71%) compared to sufficient vitamin D patients (62%) (p < 0.001) and fewer hyperplastic glands (19%) compared to sufficient vitamin D level patients (25%) (p < 0.001).
Vitamin D deficiency is more strongly associated with single-gland parathyroid disease than 4-gland hyperplasia. Further investigation into the complex interplay between vitamin D levels and autonomous parathyroid function is warranted.
术前维生素 D 水平较低的原发性甲状旁腺功能亢进症（PHPT）被认为与 4 腺增生有关。我们回顾了与术前维生素 D 水平相关的最终甲状旁腺病理。
对 2001 年至 2019 年间行甲状旁腺切除术的所有 PHPT 患者进行回顾性分析。回顾了患者的人口统计学、实验室研究和最终病理。
分析中纳入了 2230 例患者，其中 78.1%为女性，平均年龄为 59 岁。根据术前 25-羟维生素 D 水平将患者分为 3 组；“不足”（<20 ng/mL）（n=319）、“不足够”（20-30 ng/mL）（n=1108）或“充足”（>30 ng/mL）（n=803）。维生素 D 不足的患者中，单腺瘤的发生率（71%）高于维生素 D 充足的患者（62%）（p<0.001），增生的腺体（19%）低于维生素 D 充足的患者（25%）（p<0.001）。
维生素 D 缺乏与单腺甲状旁腺疾病的相关性强于 4 腺增生。需要进一步研究维生素 D 水平与自主甲状旁腺功能之间的复杂相互作用。
