Hyperparathyrodisim in Men - Low Morbidity and Mortality during 20 Years´Follow-up

Presentation Number: FRI 341
Date of Presentation: April 1st, 2016

Georgios Kontogeorgos*1, Christine Laine1, Lennart X Welin2, Michael Fu3, Per-Olof Hansson4 and Kerstin Landin-Wilhelmsen1
1Section for Endocrinology, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, 2Department of Medicine, Gothenburg, Sweden, 3Dept of Cardiology, Gothenburg, Sweden, 4Dept of Medicine, Gothenburg, Sweden

Abstract

Objective: Normocalcemic, vitamin D sufficient hyperparathyroidism (nHPT) in men and women has been shown to have a benign course1. The aim was to study the prevalence and morbidity of nHPT and other parathyroid hormone (PTH) and calcium aberrations in 50-year-old men during 20 years´ follow-up.

Design: Cross-sectional and retrospective study at the Sahlgrenska University Hospital, Gothenburg, Sweden.

Subjects: A random population of 797 men born in 1943, was studied in 1993 (of whom 47% were vitamin D sufficient).

Measurements: A serum-(S) PTH >6.9 pmol/l was considered as HPT, S-calcium 2.15-2.49 mmol/l as normocalcemia, and S-25(OH)D >50 nmol/l as vitamin D sufficiency. Data on fractures, stroke and myocardial infarction were retrieved until 2013, yielding a 20-year follow-up.

Results: The prevalence of primary (p) HPT was 0.4% (one man with kidney stones; underwent parathyroid surgery), secondary HPT 0.3%, nHPT 2.7%, hypercalcemia with normal S-PTH 0.3%,  hypocalcemia with normal S-PTH 3.1%, and HPT with vitamin D insufficiency 5.5% in 1993 (age 50). Hypertension developed in all with pHPT. Hypertension was not more common in nHPT than in men without calcium/PTH aberrations during follow-up. No increase in fractures, diabetes, kidney stones (except for the man with pHPT), myocardial infarction, stroke, cancer or death was seen at follow-up.

Conclusions: Primary HPT was rare (0.4%), but normocalcemic, vitamin D sufficient HPT was common, 2.7%, in men aged 50 years. No increase in hard end points was seen in men with, compared with men without, calcium/PTH aberrations over a 20-year period.

 

Nothing to Disclose: GK, CL, LXW, MF, POH, KL