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Primary hyperparathyroidism revisited in menopausal women with serum calcium in upper normal range at population-based screening 8 years ago
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery.
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2002 (English)In: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 26, no 8, 931-936 p.Article in journal (Refereed) Published
Abstract [en]

Abstract. Population-based screening showed 2.1% prevalence of primary

hyperparathyroidism (pHPT) in postmenopausal women. Individuals

with total serum (s)-calcium levels of 2.55 mmol/L or more at screening

were diagnosed with pHPT when subsequent analysis supported inappropriately

elevated intact parathormone (PTH) levels in relation to even

normal s-calcium levels. The arbitrary diagnostic criteria were validated

by parathyroidectomy. Herein we reinvestigated biochemical signs of

pHPT in women not diagnosed with pHPT due to s-calcium 2.50 to 2.54

mmol/L (group A, n 160) at screening or due to appropriate PTH levels

on two occasions after screening (group B, n 70). Altogether, 99 women

in group A and 47 in group B underwent reinvestigation 8.8 years after

screening when they were 65 to 84 years old. The s-calcium levels averaged

2.56 mmol/L and had increased in group A (mean 0.04 mmol/L) and

decreased in group B (mean 0.05 mmol/L). A total of 48 and 18 females

(48%, 38%), respectively, met the previously validated criteria of pHPT.

Altogether 21% of them were hypercalcemic (range 2.60 –3.12 mmol/L).

Subgroup analysis showed that PTH had not increased with time (n 47)

and that atherogenic blood lipids, but not glucose levels, were similar in

pHPT patients and matched controls (n 37). Assuming the existence of

pHPT already at screening, the prevalence of pHPT could be adjusted to

3.4%. Even the most liberal diagnostic criteria utilized at pHPT screening

seemed to underdiagnose the disease by inefficient cutoff limits for scalcium

and PTH. Because one-fifth of the women with pHPT progressed

to hypercalcemia, long-term follow-up is advocated for those with scalcium

in the upper normal range.

Place, publisher, year, edition, pages
2002. Vol. 26, no 8, 931-936 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-221960DOI: 10.1007/s00268-002-6621-0PubMedID: 12045863OAI: oai:DiVA.org:uu-221960DiVA: diva2:710503
Available from: 2014-04-07 Created: 2014-04-07 Last updated: 2017-12-05

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