Department of Endocrinology, La Rabta university hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia.
Department of Radiology, La Rabta university hospital, Faculty of Medicine, University of Tunis-El Manar, Tunis, Tunisia.
Endocrine. 2024 Jun;84(3):1164-1171. doi: 10.1007/s12020-024-03765-9. Epub 2024 Mar 9.
Patients with Chronic hypoparathyroidism (CHPT) receiving conventional treatment are exposed to several long-term complications including basal ganglia calcifications, posterior subcapsular cataract, kidney stones, and renal insufficiency. The aim of this study was to assess the prevalence and the associated factors of these complications in patients with CHPT.
We conducted a cross-sectional study including 58 patients with CHPT. All participants underwent physical examination, biochemical assessment (total serum calcium, serum phosphorus, serum albumin, intact-PTH, serum magnesium, 25-hydroxy-vitamin D, serum creatinine, thyroid stimulating hormone (TSH), and 24-hour urinary calcium), slit lamp examination, brain computed tomography scan (CT-scan), and renal ultrasound.
Participants had a mean age of 52.6 ± 16.4 years and a gender ratio (women/men) of 3.5. Fahr syndrome, cataract, urolithiasis, and renal failure were found in 55%, 62%, 12%, and 17% of cases, respectively. CHPT duration >15 years (Adjusted-OR = 43.1, 95-CI: 2.63-703.06, p = 0.008) and poor adherence to treatment (Adjusted-OR = 8.04, 95%-CI: 1.52-42.42, p = 0.014) were independently associated with the risk of Fahr syndrome. Age >55 years (adjusted-OR = 5.07, 95-CI: 1.10-23.42, p = 0.037), disease duration >15 years (adjusted-OR = 20.21, 95-CI: 1.54-265.84, p = 0.022), and magnesium level <0.8 mmol/l (adjusted-OR = 36.46, 95-CI: 3.75-354.08, p = 0.002) were independently associated with the risk of subcapsular cataract. Only hypercalciuria (Adjusted-OR = 21.27, 95-CI: 2.31-195.91, p = 0.007) was an independent risk factor for kidney stones. Renal failure was not associated with kidney stones (p = 1). However, creatinine clearance was negatively correlated with age (r = -0.784; p < 10) and disease duration (r = -0.352; p = 0.007).
Our results revealed high prevalences of neurological, ocular, and renal complications in patients with CHPT and emphasized the importance of regular biological monitoring, therapeutic adjustments, screening, and adherence to treatment in the prevention of these complications.
接受常规治疗的慢性甲状旁腺功能减退症（CHPT）患者会出现多种长期并发症，包括基底节钙化、后发性白内障、肾结石和肾功能不全。本研究的目的是评估 CHPT 患者这些并发症的发生率及其相关因素。
我们进行了一项横断面研究，纳入了 58 例 CHPT 患者。所有参与者均接受体格检查、生化评估（血清总钙、血清磷、血清白蛋白、完整甲状旁腺激素、血清镁、25-羟维生素 D、血清肌酐、促甲状腺激素（TSH）和 24 小时尿钙）、裂隙灯检查、脑计算机断层扫描（CT 扫描）和肾脏超声检查。
参与者的平均年龄为 52.6±16.4 岁，性别比（女性/男性）为 3.5。Fahr 综合征、白内障、尿路结石和肾衰竭分别在 55%、62%、12%和 17%的病例中发现。CHPT 持续时间>15 年（调整后 OR=43.1，95%CI：2.63-703.06，p=0.008）和治疗依从性差（调整后 OR=8.04，95%CI：1.52-42.42，p=0.014）与 Fahr 综合征的风险独立相关。年龄>55 岁（调整后 OR=5.07，95%CI：1.10-23.42，p=0.037）、疾病持续时间>15 年（调整后 OR=20.21，95%CI：1.54-265.84，p=0.022）和镁水平<0.8mmol/L（调整后 OR=36.46，95%CI：3.75-354.08，p=0.002）与后发性白内障的风险独立相关。只有高钙尿症（调整后 OR=21.27，95%CI：2.31-195.91，p=0.007）是肾结石的独立危险因素。肾衰竭与肾结石无关（p=1）。然而，肌酐清除率与年龄（r=-0.784；p<10）和疾病持续时间（r=-0.352；p=0.007）呈负相关。
我们的研究结果揭示了 CHPT 患者存在较高的神经、眼部和肾脏并发症发生率，并强调了定期进行生物学监测、治疗调整、筛查和治疗依从性的重要性，以预防这些并发症。
