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Normocalcaemic, vitamin D-sufficient hyperparathyroidism - high prevalence and low morbidity in the general population: A long-term follow-up study, the WHO MONICA project, Gothenburg, Sweden.
- Source :
-
Clinical endocrinology [Clin Endocrinol (Oxf)] 2015 Aug; Vol. 83 (2), pp. 277-84. Date of Electronic Publication: 2015 Jun 15. - Publication Year :
- 2015
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Abstract
- Objective: There is limited knowledge about the natural history of normocalcaemic, vitamin D-sufficient hyperparathyroidism (nHPT). The aim was to study the prevalence of nHPT and its relation to morbidity.<br />Design: Cross-sectional and retrospective study at the Sahlgrenska University Hospital, Gothenburg, Sweden.<br />Subjects: A random population of 608 men and women, age 25-64 years, was studied in 1995 as part of the WHO MONICA study and reinvestigated in 2008 (n = 410, of whom 277 were vitamin D sufficient).<br />Measurements: A serum intact parathyroid hormone (S-PTH) ≥60 ng/l was considered as HPT, S-calcium 2·15-2·49 mmol/l as normocalcaemia and S-25(OH)D ≥ 50 nmol/l as vitamin D sufficiency. Data on fractures, stroke and myocardial infarction were retrieved until 2013, that is a 17-year follow-up.<br />Results: The prevalence of nHPT was 2·0% in 1995 (age 25-64) and 11·0% in 2008 (age 38-79). S-PTH was positively correlated with age and BMI. After adjustment for these variables, a high S-PTH level (≥60 ng/l) at follow-up was associated with previously low S-25(OH)D, high osteocalcin, S-PTH and both past and presently treated hypertension. No relation was seen with creatinine, cystatin C, malabsorption markers, thyroid function, glucose, insulin, lipids, calcaneal quantitative ultrasound, fractures, myocardial infarction, stroke or death at follow-up.<br />Conclusions: This small random population study showed that nHPT was common, 11% at follow-up. Only one individual developed mild hypercalcaemia in 13 years. Previous S-PTH was predictive of nHPT and hypertension was prevalent, but no increase in hard end-points was seen over a 17-year period.<br /> (© 2015 The Authors. Clinical Endocrinology Published by John Wiley & Sons Ltd.)
- Subjects :
- Adult
Aged
Anthropometry
Body Mass Index
Bone and Bones metabolism
Bone and Bones pathology
Cross-Sectional Studies
Electric Impedance
Female
Follow-Up Studies
Humans
Hypercalcemia blood
Hyperparathyroidism epidemiology
Hyperparathyroidism mortality
Hypertension blood
Male
Middle Aged
Myocardial Infarction blood
Prevalence
Regression Analysis
Stroke blood
Sweden epidemiology
Calcium blood
Hyperparathyroidism blood
Vitamin D blood
Subjects
Details
- Language :
- English
- ISSN :
- 1365-2265
- Volume :
- 83
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Clinical endocrinology
- Publication Type :
- Academic Journal
- Accession number :
- 25988687
- Full Text :
- https://doi.org/10.1111/cen.12819