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甲状旁腺功能减退症随访期间国际指南依从性评估

Evaluation of Compliance With International Guidelines During the Follow-Up of Hypoparathyroidism.

作者信息

Turan Erdogan Beril, Polat Sefika Burcak, Keskin Caglar, Nasiroglu İmga Narin, Ozdemir Didem, Topaloglu Oya, Ersoy Reyhan, Cakir Bekir

机构信息

Department of Endocrinology and Metabolism, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Türkiye.

Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University School of Medicine, Ankara, Türkiye.

出版信息

Int J Endocrinol. 2025 May 5;2025:3174295. doi: 10.1155/ije/3174295. eCollection 2025.

Abstract

Hypoparathyroidism is a disorder that causes renal complications, bone disease, an increased risk of cardiovascular diseases, neuromuscular complications, and ocular findings. In this study, we aimed to determine how well the existing guidelines were followed in the follow-up of patients with hypoparathyroidism. In the endocrinology and metabolism outpatient clinic, routine controls were conducted on patients 18 years of age and older with a diagnosis of hypoparathyroidism between February 2019 and September 2021. These individuals' test findings, imaging, hormones, and additional disorders were assessed. The mean age of 264 patients included in the study was 49.34 ± 12.98 (22-91). Of the patients, 211 (79.9%) were female. Blood biochemistry tests were performed on all patients. Ophthalmological examination was performed in 3% of the patients, brain imaging in 9.8%, renal imaging in 18.6%, and 24-h urinary Ca measurements in 11%. According to the results of the examinations, cataract was found in 2 (0.8%) patients and basal ganglia calcification was found in 4 (1.5%) patients. In addition, nephrocalcinosis or nephrolithiasis was seen in 2 patients (0.8%). Hypercalciuria was defined as a 24-h urinary calcium excretion of > 300 mg/24 h for males and > 250 mg/dL for females and was detected in 12 patients with hypoparathyroidism. In our research, it was discovered that patients with hypoparathyroidism had low compliance rates with the guidelines. We believe that the cause of this is the inability to provide the patients with enough time in intense polyclinic conditions. Given the information gathered from our study, it has been concluded that complication screening in hypoparathyroidism patients is just as crucial as blood tests and that allocating enough time for patients will enhance their follow-up and treatment.

摘要

甲状旁腺功能减退症是一种会引发肾脏并发症、骨骼疾病、心血管疾病风险增加、神经肌肉并发症以及眼部病变的病症。在本研究中,我们旨在确定在甲状旁腺功能减退症患者的随访过程中,现有指南的遵循情况如何。在内分泌与代谢门诊,于2019年2月至2021年9月期间,对18岁及以上诊断为甲状旁腺功能减退症的患者进行了常规检查。对这些个体的检查结果、影像学检查、激素水平及其他病症进行了评估。纳入研究的264例患者的平均年龄为49.34±12.98岁(22 - 91岁)。其中,211例(79.9%)为女性。对所有患者均进行了血液生化检查。3%的患者进行了眼科检查,9.8%的患者进行了脑部影像学检查,18.6%的患者进行了肾脏影像学检查,11%的患者进行了24小时尿钙测量。根据检查结果,2例(0.8%)患者发现有白内障,4例(1.5%)患者发现有基底节钙化。此外,2例患者(0.8%)出现了肾钙质沉着症或肾结石。高钙尿症定义为男性24小时尿钙排泄量>300mg/24小时,女性>250mg/dL,在12例甲状旁腺功能减退症患者中检测到。在我们的研究中,发现甲状旁腺功能减退症患者对指南的依从率较低。我们认为其原因在于在繁忙的门诊环境中无法为患者提供足够的时间。根据我们研究收集到的信息,得出结论:甲状旁腺功能减退症患者的并发症筛查与血液检查同样重要,为患者分配足够的时间将改善他们的随访和治疗。

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