Hypoparathyroidism in adults with iron overload diseases (IOD): evidence of a subclinical phenotype.

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2024-12-04 DOI:10.1007/s12020-024-04124-4

Sara De Vincentis, Selene Evangelisti, Barbara Rossi, Maria Chiara Decaroli, Michela Locaso, Anna Ansaloni, Francesca Ferrara, Elena Corradini, Antonello Pietrangelo, Vincenzo Rochira

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引用次数: 0

Abstract

Purpose: To explore the prevalence of hypoparathyroidism (HPT), overt and subclinical, in a cohort of adults with Iron Overload Diseases (IOD). Secondary aim was to test the calcium (Ca)-to-phosphorus (P) ratio performance in identifying HPT.

Methods: Single-center, prospective, case-control study. Sixty-five IOD, 40 with thalassemia major/intermedia (TMI) and 25 with hemochromatosis (HC), and 76 age-matched controls were included. Main outcomes (serum Ca, P, Ca/P ratio, intact parathyroid hormone (PTH), albumin) defined overt and subclinical HPT.

Results: Albumin-adjusted Ca was lower (p = 0.004) and P higher (p = 0.002) comparing IOD to controls. Ca/P ratio was lower in IOD than controls (p < 0.001); PTH did not change. P was higher and Ca/P lower comparing TMI to HC and controls (p < 0.001); Ca did not change. A total of 28/65 IOD (43%) had HPT (9.2% overt, 33.8% subclinical) whose prevalence was higher in TMI than HC (p < 0.001). Ca/P ratio <2.32 had sensitivity 71.4% and specificity 83.9% in detecting overt/subclinical HPT. IOD with Ca/P ratio <2.32 (1.78 in SI) had an almost 12-fold increased likelihood to be affected by HPT (OR 12.92 [3.90-42.82]; p < 0.001). Ca/P (p = 0.002) was the only independent risk factor for HPT at multivariate analysis.

Conclusions: HPT, especially non-classical subclinical HPT, is common in adult IOD with higher prevalence in TMI than HC. Ca/P ratio <2.32 is accurate to screen for overt/subclinical HPT and should be periodically evaluated in IOD to early detect an unbalanced mineral metabolism, and to monitor a possible evolution from subclinical to overt HPT.

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成人铁超载疾病（IOD）的甲状旁腺功能低下：亚临床表型的证据。

目的：探讨甲状旁腺功能减退症（HPT）在铁超载症（IOD）成人队列中显性和亚临床的患病率。第二个目的是测试钙（Ca）磷(P)比在鉴别HPT中的性能。方法：单中心、前瞻性、病例对照研究。65例IOD， 40例重度/中度地中海贫血（TMI）和25例血色素沉着症（HC）， 76例年龄匹配的对照组。主要指标（血清钙、磷、钙/磷比、完整甲状旁腺激素（PTH）、白蛋白）定义显性和亚临床HPT。结果：与对照组相比，白蛋白调节钙降低（p = 0.004）， p升高（p = 0.002）。结论：HPT，特别是非经典亚临床HPT，在成人IOD中很常见，TMI的患病率高于HC。Ca / P比值

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.