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原发性甲状旁腺功能亢进症患者的心血管和代谢状况:单中心经验。

Cardiovascular and metabolic status in patients with primary hyperparathyroidism: a single-center experience.

机构信息

Department of Parathyroid Glands Pathology, Endocrinology Research Centre, Moscow, Russia.

Administration, Endocrinology Research Centre, Moscow, Russia.

出版信息

Front Endocrinol (Lausanne). 2023 Sep 29;14:1266728. doi: 10.3389/fendo.2023.1266728. eCollection 2023.

Abstract

INTRODUCTION

Cardiovascular diseases (CVD) and metabolic disorders (MD) have retained leading positions in the structure of morbidity and mortality for many years. Primary hyperparathyroidism (PHPT) is also associated with a greater incidence of CVD and MD. The aim of the present study was to describe the prevalence and structure of CVD and MD in hospitalized patients with PHPT and to search for possible associations between these pathologies.

METHODS

838 patients with a verified PHPT were included in the study. The studied cohort was divided into 2 groups according to their age at the time of admission: patients aged 18 to 49 years (group A, n = 150); patients aged 50 years and older (group B, n = 688).

RESULTS

There were no significant differences between two groups in parameters of calcium-phosphorus metabolism. Obesity was diagnosed in 24.2% of patients in group A and in 35.9% in group B. Type 2 diabetes mellitus was more common in older patients (14.4% in group B vs. 2.6% in group A). Arterial hypertension, ischemic heart disease, chronic heart failure and brachiocephalic arteries atherosclerosis were more frequent in older patients, occurring in 79.1%, 10.8%, 8.4%, and 84% of cases respectively. The cutoff points that increased the risk of CVD detection turned out to be age above 56 years, eGFR below 92 ml/min/1.73m2, BMI above 28.3 kg/m2.

DISCUSSION

The present study demonstrated a high incidence of some CVD, as well as disorders of lipid, carbohydrate and purine metabolism in patients with PHPT.

摘要

简介

心血管疾病 (CVD) 和代谢紊乱 (MD) 多年来一直占据发病率和死亡率的主要地位。原发性甲状旁腺功能亢进症 (PHPT) 也与 CVD 和 MD 的发病率增加有关。本研究旨在描述住院 PHPT 患者 CVD 和 MD 的患病率和结构,并寻找这些疾病之间可能存在的关联。

方法

本研究纳入了 838 例确诊的 PHPT 患者。根据入院时的年龄,将研究队列分为 2 组:年龄在 18 至 49 岁之间的患者(A 组,n=150);年龄在 50 岁及以上的患者(B 组,n=688)。

结果

两组患者钙磷代谢参数无显著差异。A 组患者中有 24.2%被诊断为肥胖,B 组患者中有 35.9%。B 组中年龄较大的患者更常见 2 型糖尿病(14.4%比 A 组的 2.6%)。动脉高血压、缺血性心脏病、慢性心力衰竭和头臂动脉粥样硬化在年龄较大的患者中更为常见,分别占 79.1%、10.8%、8.4%和 84%的病例。年龄超过 56 岁、eGFR 低于 92 ml/min/1.73m2、BMI 高于 28.3 kg/m2 是增加 CVD 检出风险的切点。

讨论

本研究表明 PHPT 患者中存在某些 CVD 以及脂质、碳水化合物和嘌呤代谢紊乱的高发率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7ed/10570793/c99ce98ec2bc/fendo-14-1266728-g001.jpg

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