Lundgren E, Ljunghall S, Akerström G, Hetta J, Mallmin H, Rastad J
Department of Surgery, University Hospital, Uppsala, Sweden.
Surgery. 1998 Dec;124(6):980-5; discussion 985-6.
Symptoms, signs, and treatment of mild primary hyperparathyroidism (HPT) are controversial.
One hundred two patients with HPT and matched controls were recruited from 5202 females attending population-based mammography screening at age 55 to 75 years. Patients' total serum calcium averaged 10.40 +/- 0.564 mg/dL and intact serum parathyroid hormone 58 +/- 33 ng/L. All patients lacked knowledge of their disease. Questions revealed traditional symptoms of HPT in 24% of cases and 43% of controls (P = .01). All individuals underwent the same biochemical analyses, bone mass determination, and questionnaires on symptoms, illnesses, medications, and background variables.
Patients with HPT had more psychic complaints (P = .03 to .007) of lassitude, fatigue, irritability, and lack of sexual and emotional interests. They had lower bone density in total body, spine, and hip (P = .008 to .0004) and higher serum alkaline phosphatase, cholesterol (very-low-density lipoprotein), triglycerides (total, very-low-density lipoprotein), glucose, urate, and hemoglobin values (P = .02 to .0001). Patients visited physicians more often (P = .008) and had more antihypertensive therapy (P = .02).
Mild, "asymptomatic" HPT in patients unaware of their disorder displays significant psychic symptoms, bone loss, and risk factors of cardiovascular disease.
轻度原发性甲状旁腺功能亢进症（HPT）的症状、体征及治疗存在争议。
从5202名年龄在55至75岁接受基于人群的乳腺钼靶筛查的女性中招募了102例HPT患者及匹配的对照组。患者血清总钙平均为10.40±0.564mg/dL，血清完整甲状旁腺激素为58±33ng/L。所有患者均不知自己患有该疾病。调查发现24%的病例和43%的对照组有HPT的传统症状（P = 0.01）。所有个体均接受相同的生化分析、骨量测定以及关于症状、疾病、用药和背景变量的问卷调查。
HPT患者有更多诸如倦怠、疲劳、易怒以及缺乏性趣和情感兴趣等精神方面的主诉（P = 0.03至0.007）。他们全身、脊柱和髋部的骨密度较低（P = 0.008至0.0004），血清碱性磷酸酶、胆固醇（极低密度脂蛋白）、甘油三酯（总甘油三酯、极低密度脂蛋白）、葡萄糖、尿酸和血红蛋白值较高（P = 0.02至0.0001）。患者看医生的频率更高（P = 0.008），接受抗高血压治疗的比例更高（P = 0.02）。
未意识到自己患病的患者中，轻度“无症状”HPT表现出明显的精神症状、骨质流失和心血管疾病风险因素。
