Yuan Runxue, Song An, Zhang Yun, Sha Yue, Wang Ou, Jiang Yan, Li Mei, Xia Weibo, Zeng Xuejun, Xing Xiaoping
Department of Family Medicine & Division of General Internal Medicine, Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases (Peking Union Medical College Hospital), Peking Union Medical College, Beijing, China.
Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China.
Endocrine. 2025 May 23. doi: 10.1007/s12020-025-04276-x.
Primary hyperparathyroidism (PHPT) is characterized by autonomous and excessive parathyroid hormone (PTH) secretion due to parathyroid gland lesions. Patients can be complicated with hyperuricemia (HUA), however, data about HUA in Chinese PHPT patients are lacking. This study aimed to explore the prevalence of HUA, factors influencing serum uric acid (SUA) level and the impacts of parathyroidectomy (PTX).
328 inpatients diagnosed with PHPT were included in total. Clinical data were collected and compared between HUA and non-HUA group. Multivariate linear regression was used to explore the factors affecting preoperative SUA and its variation after PTX. The impacts of SUA on bone mineral density (BMD) under different models were also analyzed.
The prevalence of HUA in PHPT patients was nearly 32%. Compared with non-HUA group, HUA group had significantly higher serum calcium (Ca) (2.92 [2.75, 3.26] vs. 2.78 [2.62, 3.03] mmol/L, P < 0.001), while PTH increased without significance. Gender, body mass index, serum Ca, triglycerides and renal function were independently associated with SUA. SUA decreased after PTX (340.00 [291.50, 421.00] vs. 315.00 [270.50, 375.00] μmol/L, P = 0.018), with change of SUA significantly associating with changes in serum Ca and phosphate. Presurgical SUA was positively related with femoral neck, total hip and lumbar spine BMDs after adjusting for confounders.
A relatively high proportion of HUA was found in our study. Besides the common risk factors, hypercalcemia may contribute to the increased SUA in PHPT patients, which could be significantly improved by curative PTX. SUA might have a protective effect on bone loss in PHPT patients.
原发性甲状旁腺功能亢进症（PHPT）的特征是由于甲状旁腺病变导致甲状旁腺激素（PTH）自主且过度分泌。患者可能并发高尿酸血症（HUA），然而，关于中国PHPT患者中HUA的数据尚缺乏。本研究旨在探讨HUA的患病率、影响血清尿酸（SUA）水平的因素以及甲状旁腺切除术（PTX）的影响。
共纳入328例诊断为PHPT的住院患者。收集临床数据并在HUA组和非HUA组之间进行比较。采用多变量线性回归来探讨影响术前SUA及其在PTX后变化的因素。还分析了不同模型下SUA对骨密度（BMD）的影响。
PHPT患者中HUA的患病率近32%。与非HUA组相比，HUA组的血清钙（Ca）显著更高（2.92[2.75, 3.26] vs. 2.78[2.62, 3.03] mmol/L，P < 0.001），而PTH升高无显著性差异。性别、体重指数、血清Ca、甘油三酯和肾功能与SUA独立相关。PTX后SUA降低（340.00[291.50, 421.00] vs. 315.00[270.50, 375.00] μmol/L，P = 0.018），SUA的变化与血清Ca和磷酸盐的变化显著相关。校正混杂因素后，术前SUA与股骨颈、全髋和腰椎骨密度呈正相关。
在我们的研究中发现HUA的比例相对较高。除常见危险因素外，高钙血症可能导致PHPT患者SUA升高，而根治性PTX可使其显著改善。SUA可能对PHPT患者的骨质流失有保护作用。
