Special Original Article on Thyroid and Parathyroid Gland
Clinical analysis of 30 cases of asymptomatic primary hyperparathyroidism
Zuo Qingyao, Cui Aimin, Wang Hong, Liu Baoyue, Wang Qianqian, Deng Wei
Published 2022-02-25
Cite as Chin J Endocr Surg, 2022, 16(1): 37-40. DOI: 10.3760/cma.j.cn.115807-20200625-00199
Abstract
ObjectiveTo analyze the clinical and pathological features of asymptomatic primary hyperparathyroidism (PHPT) .
MethodsA retrospective analysis was carried out in terms of the clinical characteristics and pathological data in 30 patients with asymptomatic PHPT and 86 patients with typical PHPT hospitalized in the Department of Endocrinology and General Surgery of Beijing Jishuitan Hospital from Jan. 2013 to Dec. 2018. There were 7 males (23.3%) and 23 females (76.7%) , with a male to female ratio of 1:3.3. The average age was 56.9±13.3 years. In typical PHPT group, there were 32 males (37.2%) and 54 females (62.8%) , with the average age of 46.4±17.0 years. Bone metabolism indicators included bone density and bone biochemical markers (parathyroid hormone, 25-hydroxyvitamin D and alkaline phosphatase) . The t test was used to compare normally distributed variables, the Mann-Whitney rank sum test was used to compare skewed distributed variables, and the χ2 test was used to compare enumeration data.
ResultsThe median serum parathyroid hormone and alkaline phosphatase were 144.2 (108.1, 207.0) pg/ml and 80.0 (53.7, 105.5) IU/L respectively, the average serum concentration of calcium was 2.80±0.20 mmol/L, which were significantly lower than those of the classic group (P<0.05) . The median serum 25-hydroxyvitamin D was 12.14 (7.87, 14.38) ng/ml, which was higher than that of the classic group (P<0.001) . Ten patients (33.3%) developed osteoporosis, and the incidence was lower than that of the classic group (P< 0.001) . The median tumor weight was 0.80 (0.25, 1.98) g, significantly smaller than that in the classical group (P=0.003) . There were 26 cases (86.7%, including 2 atypical parathyroid adenomas) of parathyroid adenomas and 4 cases (13.3%) of hyperplasia.
ConclusionsThe asymptomatic PHPT has the same sex ratio as the classic type, mainly female, but the average age is significantly higher than that in the classic type. Although asymptomatic PHPT in this study are all benign lesions, abnormal bone biochemical indicators, especially vitamin D deficiency, are common, which also lead to osteoporosis.
Key words:
Hyperparathyroidism; Asymptomatic primary hyperparathyroidism; Osteoporosis; Vitamin D
Contributor Information
Zuo Qingyao
Department of Endocrinology and Metabolism, Beijing Ji Shui Tan Hospital, Beijing 100035, China
Cui Aimin
Department of General Surgery, Beijing Ji Shui Tan Hospital, Beijing 100035, China
Wang Hong
Department of Endocrinology and Metabolism, Beijing Ji Shui Tan Hospital, Beijing 100035, China
Liu Baoyue
Department of Pathology, Beijing Ji Shui Tan Hospital, Beijing 100035, China
Wang Qianqian
Beijing Institute of Traumatology and Orthopaedics, Beijing Ji Shui Tan Hospital, Beijing 100035, China
Deng Wei
Department of Endocrinology and Metabolism, Beijing Ji Shui Tan Hospital, Beijing 100035, China
