High Ionized Calcium in the General Population and Risk of Primary Hyperparathyroidism.

IF 5.1 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Camilla J Kobylecki, Børge G Nordestgaard, Shoaib Afzal
{"title":"High Ionized Calcium in the General Population and Risk of Primary Hyperparathyroidism.","authors":"Camilla J Kobylecki, Børge G Nordestgaard, Shoaib Afzal","doi":"10.1210/clinem/dgaf106","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although it is generally held that in otherwise healthy individuals, primary hyperparathyroidism is the most likely cause of persistent hypercalcemia, solid research supporting this assumption is absent. We aimed to examine the relative and absolute risk of primary hyperparathyroidism associated with an incidental high ionized calcium in the general population.</p><p><strong>Methods: </strong>We used the Danish Copenhagen General Population Study, a prospective cohort study with inclusion in 2003-2015, to investigate the association of ionized calcium on continuous and categorical scales with primary hyperparathyroidism using Cox regression and competing-risk regression. Hazard ratios and absolute 10-year risks of primary hyperparathyroidism were calculated.</p><p><strong>Results: </strong>In 106 588 individuals, 2497 (2.5%) had moderately high (1.33-1.40 mmol/L) or high (>1.40 mmol/L) plasma ionized calcium at baseline and 441 (0.4%) were diagnosed with primary hyperparathyroidism during follow-up. The multivariable adjusted hazard ratios for primary hyperparathyroidism for moderately high and high plasma ionized calcium vs low normal ionized calcium were 65 (95% confidence interval: 46-92) and 350 (251-489). Stratified on sex, the corresponding hazard ratios were 63 (42-95) and 326 (221-482) for women and 73 (37-145) and 490 (256-935) for men. For women and men above 65 years, absolute risks of primary hyperparathyroidism were 7.9% and 3.3% in those with moderately high plasma ionized calcium and 44% and 21% in those with high plasma ionized calcium.</p><p><strong>Conclusion: </strong>High ionized calcium found in 1:40 in the general population conferred absolute 10-year risks of primary hyperparathyroidism of up to 44%. These findings support further diagnostic workup following an incidentally observed high plasma ionized calcium in otherwise healthy individuals.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e3878-e3885"},"PeriodicalIF":5.1000,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Endocrinology & Metabolism","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1210/clinem/dgaf106","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Although it is generally held that in otherwise healthy individuals, primary hyperparathyroidism is the most likely cause of persistent hypercalcemia, solid research supporting this assumption is absent. We aimed to examine the relative and absolute risk of primary hyperparathyroidism associated with an incidental high ionized calcium in the general population.

Methods: We used the Danish Copenhagen General Population Study, a prospective cohort study with inclusion in 2003-2015, to investigate the association of ionized calcium on continuous and categorical scales with primary hyperparathyroidism using Cox regression and competing-risk regression. Hazard ratios and absolute 10-year risks of primary hyperparathyroidism were calculated.

Results: In 106 588 individuals, 2497 (2.5%) had moderately high (1.33-1.40 mmol/L) or high (>1.40 mmol/L) plasma ionized calcium at baseline and 441 (0.4%) were diagnosed with primary hyperparathyroidism during follow-up. The multivariable adjusted hazard ratios for primary hyperparathyroidism for moderately high and high plasma ionized calcium vs low normal ionized calcium were 65 (95% confidence interval: 46-92) and 350 (251-489). Stratified on sex, the corresponding hazard ratios were 63 (42-95) and 326 (221-482) for women and 73 (37-145) and 490 (256-935) for men. For women and men above 65 years, absolute risks of primary hyperparathyroidism were 7.9% and 3.3% in those with moderately high plasma ionized calcium and 44% and 21% in those with high plasma ionized calcium.

Conclusion: High ionized calcium found in 1:40 in the general population conferred absolute 10-year risks of primary hyperparathyroidism of up to 44%. These findings support further diagnostic workup following an incidentally observed high plasma ionized calcium in otherwise healthy individuals.

普通人群中高离子钙与原发性甲状旁腺功能亢进的风险
背景:虽然人们普遍认为,在其他健康个体中,原发性甲状旁腺功能亢进是最可能导致持续性高钙血症的原因,但缺乏支持这一假设的可靠研究。我们的目的是研究在普通人群中偶发高离子钙相关的原发性甲状旁腺功能亢进的相对和绝对风险。方法:我们使用2003-2015年纳入的丹麦哥本哈根普通人群研究(Danish Copenhagen General Population Study)前瞻性队列研究,使用Cox回归和竞争风险回归,在连续和分类尺度上研究离子钙与原发性甲状旁腺功能亢进的关系。计算原发性甲状旁腺功能亢进的风险比和绝对10年风险。结果:在106588例患者中,2497例(2.5%)在基线时血浆离子钙中高(1.33-1.40 mmol/L)或高(bb0 -1.40 mmol/L), 441例(0.4%)在随访期间被诊断为原发性甲状旁腺功能亢进。原发性甲状旁腺功能亢进中、高血浆电离钙相对于低正常电离钙的多变量校正危险比分别为65(95%CI: 46-92)和350(251 - 489)。按性别分层,女性相应的风险比分别为63(42-95)和326(221-482),男性相应的风险比分别为73(37-145)和490(256-935)。对于65岁以上的女性和男性,中度高血浆离子钙患者原发性甲状旁腺功能亢进的绝对风险分别为7.9%和3.3%,而高血浆离子钙患者的绝对风险分别为44%和21%。结论:在普通人群中发现1:40的高离子钙,原发性甲状旁腺功能亢进症的10年绝对风险高达44%。这些发现支持进一步的诊断工作后,偶然观察到高血浆电离钙在其他健康个体。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Clinical Endocrinology & Metabolism
Journal of Clinical Endocrinology & Metabolism 医学-内分泌学与代谢
CiteScore
11.40
自引率
5.20%
发文量
673
审稿时长
1 months
期刊介绍: The Journal of Clinical Endocrinology & Metabolism is the world"s leading peer-reviewed journal for endocrine clinical research and cutting edge clinical practice reviews. Each issue provides the latest in-depth coverage of new developments enhancing our understanding, diagnosis and treatment of endocrine and metabolic disorders. Regular features of special interest to endocrine consultants include clinical trials, clinical reviews, clinical practice guidelines, case seminars, and controversies in clinical endocrinology, as well as original reports of the most important advances in patient-oriented endocrine and metabolic research. According to the latest Thomson Reuters Journal Citation Report, JCE&M articles were cited 64,185 times in 2008.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信