Chen Jari, Song Zhixing, Balachandra Sanjana, Gillis Andrea, Fazendin Jessica, Lindeman Brenessa, Chen Herbert
Division of Breast and Endocrine Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Division of Breast and Endocrine Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
J Surg Res. 2025 Jul;311:137-142. doi: 10.1016/j.jss.2025.04.024. Epub 2025 May 24.
Previous studies from single-institution cohorts have shown that patients with normocalcemic primary hyperparathyroidism (ncPHPT) are just as symptomatic as patients with classic PHPT. There is currently no large-scale database analysis of ncPHPT, so with the TriNetX database, a large international database, trends on ncPHPT can be studied over a large cohort of patients. The aim of this project is to characterize the diagnostic and treatment paradigm for ncPHPT in the TriNetX database.
We conducted a retrospective cohort study of patients with ncPHPT using the TriNetX Research Network, which includes patients from 52 healthcare organizations from 2007 to 2023. ncPHPT was defined as having parathyroid hormone (PTH) ≥66pg/mL and calcium between 8.4 and 10.4 mg/dL. We excluded patients with secondary, tertiary, and classic hyperparathyroidism and other hypercalcemia inducing factors.
We found 5092 patients with ncPHPT; 78.2% were female, average age was 69 ± 13 y, and 78.9% were White. The average serum calcium was 9.7 ± 0.5 mg/dL, while the average serum PTH level was 97 ± 77.5 pg/mL. Of these, 2036 (40%) underwent a parathyroidectomy. Presurgery, calcium averaged 9.9 ± 0.1 mg/dL and PTH averaged 96 ± 152 pg/mL. Postsurgery, calcium averaged 9.3 ± 0.6 mg/dL, while PTH averaged 52 ± 33pg/mL.
In this large multi-institutional cohort, the minority of patients with ncPHPT underwent a parathyroidectomy. Education about the benefits of surgery for these patients to these providers is needed.
来自单机构队列的既往研究表明，血钙正常的原发性甲状旁腺功能亢进症（ncPHPT）患者与典型甲状旁腺功能亢进症（PHPT）患者的症状一样明显。目前尚无对ncPHPT的大规模数据库分析，因此借助大型国际数据库TriNetX，可以在大量患者队列中研究ncPHPT的趋势。本项目的目的是描述TriNetX数据库中ncPHPT的诊断和治疗模式。
我们使用TriNetX研究网络对ncPHPT患者进行了一项回顾性队列研究，该网络包括2007年至2023年来自52个医疗机构的患者。ncPHPT定义为甲状旁腺激素（PTH）≥66pg/mL且血钙在8.4至10.4mg/dL之间。我们排除了继发性、三发性和典型甲状旁腺功能亢进症患者以及其他高钙血症诱发因素的患者。
我们发现了5092例ncPHPT患者；78.2%为女性，平均年龄为69±13岁，78.9%为白人。平均血清钙为9.7±0.5mg/dL，而平均血清PTH水平为97±77.5pg/mL。其中，2036例（40%）接受了甲状旁腺切除术。术前，血钙平均为9.9±0.1mg/dL，PTH平均为96±152pg/mL。术后，血钙平均为9.3±0.6mg/dL，而PTH平均为52±33pg/mL。
在这个大型多机构队列中，少数ncPHPT患者接受了甲状旁腺切除术。需要向这些医疗服务提供者宣传手术对这些患者的益处。
