Takano Noriyoshi, Morimoto Satoshi, Muraoka Hiroyuki, Inada Ken, Nishimura Katsuji, Ichihara Atsuhiro
Division of Hormonal Medicine and Bioregulatory Science, Department of Medicine, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan.
Department of Medicine, Adachi Medical Center, Tokyo Women's Medical University, Adachi, Tokyo, Japan.
Int J Endocrinol. 2025 Jul 24;2025:6497151. doi: 10.1155/ije/6497151. eCollection 2025.
Lithium (Li), which is extensively used in the treatment of mood disorders such as bipolar disorder, has been associated with hyperparathyroidism. However, the relationship between the serum Li concentration and hyperparathyroidism remains unclear. This study aimed (1) to investigate the incidence of hyperparathyroidism and hypercalcemia in consecutive patients treated with Li, (2) to assess the correlation between serum Li concentration and hyperparathyroidism/hypercalcemia, and (3) to establish cutoff values for predicting hyperparathyroidism and hypercalcemia based on serum Li concentration. This retrospective cross-sectional study was conducted at the Department of Psychiatry and Department of Medicine at Tokyo Women's Medical University. Ninety-seven consecutive individuals without renal impairment and with an estimated glomerular filtration rate (eGFR) equal to or greater than 45 mL/min/1.73 m were included. Hyperparathyroidism and hypercalcemia were observed in 35.1% and 9.3% of the patients on Li, respectively. The serum Li concentration showed a significant positive correlation with hyperparathyroidism and hypercalcemia, independent of other factors. The cutoff values for predicting hyperparathyroidism and hypercalcemia were 0.52 and 0.62 mEq/L, respectively. This study confirmed that the high incidence of hyperparathyroidism and hypercalcemia in patients treated with Li. Clinicians should be aware that Li treatment may induce hyperparathyroidism, and a serum Li concentration exceeding 0.52 mEq/L may pose an increased risk. Monitoring serum calcium and Li concentrations is recommended in patients undergoing Li treatment.
锂（Li）被广泛用于治疗双相情感障碍等情绪障碍，它与甲状旁腺功能亢进有关。然而，血清锂浓度与甲状旁腺功能亢进之间的关系仍不清楚。本研究旨在：（1）调查连续接受锂治疗患者的甲状旁腺功能亢进和高钙血症的发生率；（2）评估血清锂浓度与甲状旁腺功能亢进/高钙血症之间的相关性；（3）基于血清锂浓度确定预测甲状旁腺功能亢进和高钙血症的临界值。这项回顾性横断面研究在东京女子医科大学精神病科和内科进行。纳入了97名无肾功能损害且估计肾小球滤过率（eGFR）等于或大于45 mL/min/1.73 m²的连续个体。接受锂治疗的患者中，甲状旁腺功能亢进和高钙血症的发生率分别为35.1%和9.3%。血清锂浓度与甲状旁腺功能亢进和高钙血症呈显著正相关，且不受其他因素影响。预测甲状旁腺功能亢进和高钙血症的临界值分别为0.52和0.62 mEq/L。本研究证实了接受锂治疗患者中甲状旁腺功能亢进和高钙血症的高发生率。临床医生应意识到锂治疗可能诱发甲状旁腺功能亢进，血清锂浓度超过0.52 mEq/L可能会增加风险。建议对接受锂治疗的患者监测血清钙和锂浓度。
