正常钙血症原发性甲状旁腺功能亢进症的生化特征和临床表现。

IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Endocrine Pub Date : 2024-07-01 Epub Date: 2024-03-15 DOI:10.1007/s12020-024-03768-6
Inna Yankova, Lora Lilova, Daniela Petrova, Inna Dimitrova, Mariya Stoynova, Alexander Shinkov, Roussanka Kovatcheva
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引用次数: 0

摘要

背景:正常钙血症原发性甲状旁腺功能亢进症(nPHPT)是指在没有其他继发性甲状旁腺功能亢进症病因的情况下,甲状旁腺激素(PTH)水平持续偏高而血清钙水平正常的一种疾病。本研究旨在评估nPHPT患者的临床表现和生化特征,并将其与高钙血症型PHPT(hPHPT)患者的临床表现和生化特征进行比较:研究纳入了 316 名确诊为 PHPT 的患者(女性 277 人,男性 39 人,平均年龄(58.7 ± 12.1)岁)。对所有患者的血清总钙、无机磷酸盐 (PO4)、PTH、尿钙 (uCa)、白蛋白、肌酐、25(OH)D 和骨标记物(b-CTX 和 ALP)进行了检测。腰椎(LS)、桡骨远端三分之一(DR)、股骨颈(FN)和总股骨近端(TF)的 BMD 均通过双能 X 射线吸收仪(DXA)进行测量。根据白蛋白校正钙(Ca)水平,将患者分为两组--hPHPT(Ca>2.62 mmol/L)和nPHPT(Ca 2.12-2.62 mmol/L)(无其他继发性甲状旁腺功能亢进的原因):nPHPT的发病率为15.2%。正常钙血症患者的PTH水平较低,PO4和25(OH)D较高,甲状旁腺腺瘤较小。nPHPT和hPHPT患者发生骨质疏松症、低能量骨折、肾结石和胃肠道疾病的频率没有明显差异。结论:结论:nPHPT 患者的生化指标优于 hPHPT 患者。结论:与 hPHPT 患者相比,nPHPT 患者的生化指标更佳,但临床表现和并发症相似,骨质疏松症、肾结石、胃肠功能紊乱和低能量骨折的发生率无明显差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Biochemical characteristics and clinical manifestation of normocalcemic primary hyperparathyroidism.

Biochemical characteristics and clinical manifestation of normocalcemic primary hyperparathyroidism.

Background: Normocalcemic primary hyperparathyroidism (nPHPT) is a condition characterized by persistently high levels of parathyroid hormone (PTH) and normal serum calcium levels in the absence of other causes for secondary hyperparathyroidism. The aim of the present study was to assess the clinical presentation and the biochemical characteristics in patients with nPHPT and to compare them with those in patients with hypercalcemic PHPT (hPHPT).

Materials and methods: The study included 316 patients (277 women and 39 men, average age 58.7 ± 12.1) diagnosed with PHPT. Total serum calcium, inorganic phosphates (PO4), PTH, urinary Ca (uCa), albumin, creatinine, 25(OH)D and bone markers (b-CTX and ALP) were examined in all of them. BMD of the lumbar spine (LS), distal third of the radius (DR), femoral neck (FN) and total proximal femur (TF) were measured by a dual-energy X-ray absorptiometry (DXA). The patients were divided into two groups according to albumin-corrected calcium (Ca) level - with hPHPT (Ca>2.62 mmol/L) and with nPHPT (Ca 2.12-2.62 mmol/l), without other causes for secondary hyperparathyroidism.

Results: The frequency of nPHPT was 15.2%. Normocalcemic patients had lower levels of PTH, higher PO4 and 25(OH)D, and smaller parathyroid adenomas. No significant difference in the frequency of osteoporosis, low-energy fractures, nephrolithiasis and gastrointestinal disorders was found between nPHPT and hPHPT. There was no difference in BMD between the two groups.

Conclusion: The patients with nPHPT show a more favorable biochemical profile compared to those with hPHPT. Nevertheless, clinical manifestations and complications are similar, without a significant difference in the frequency of osteoporosis, nephrolithiasis, gastrointestinal disorders and low-energy fractures.

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来源期刊
Endocrine
Endocrine ENDOCRINOLOGY & METABOLISM-
CiteScore
6.50
自引率
5.40%
发文量
295
审稿时长
1.5 months
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.
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