PMID- 36929458
OWN - NLM
STAT- MEDLINE
DCOM- 20230728
LR  - 20230728
IS  - 1720-8386 (Electronic)
IS  - 0391-4097 (Linking)
VI  - 46
IP  - 9
DP  - 2023 Sep
TI  - The importance of hypophosphatemia in the clinical management of primary 
      hyperparathyroidism.
PG  - 1935-1940
LID - 10.1007/s40618-023-02064-w [doi]
AB  - AIM: The levels of serum phosphorus (P) are low or low-normal in primary 
      hyperparathyroidism (PHPT), and there is an inverse relationship between the 
      levels of parathormone (PTH) and P. However, when considering the diagnostic and 
      surgical indication criteria of PHPT, serum P levels are generally ignored. The 
      aim of this study was to retrospectively evaluate the association of serum P 
      levels with the clinical outcomes of PHPT. MATERIALS AND METHODS: A retrospective 
      evaluation was made of the data of 424 consecutive patients (370 females, 54 
      males) with PHPT who presented at our centre. RESULTS: The mean age of the study 
      population was 57 +/- 11.68 years. The mean P was 2.57 +/- 0.53 mg/dl. Asymptomatic 
      disease was determined in 199 (47%) patients. Male patients had significantly 
      lower levels of P. Symptomatic patients and patients with renal stones, vitamin 
      D < 20 microg/l, calcium level >/= 11.2 mg/dl, 24 h urinary calcium > 400 mg/day, or 
      hypomagnesemia, were seen to have significantly lower levels of P (p < 0.05). 
      Hypophosphatemia (hypoP) was found in 202 of 424 patients (47%), and these 
      patients had a higher rate of symptomatic disease (63% to 44%, p < .0001). Of the 
      61 (88%) patients with moderate hypoP, 54 (88%) had at least one of the surgical 
      criteria. A statistically significant increase in the incidence of hypoP was 
      determined in symptomatic and male patients. In the patients with hypoP, serum 
      PTH and urine calcium levels were found to be higher, and lumbar T-scores and 
      serum vitamin D levels were lower. The patients with hypoP had higher rates of 
      renal stones and osteoporosis (p < 0.05). CONCLUSIONS: The current study results 
      show that hypoP is associated with a higher risk of osteoporosis and renal stones 
      in PHPT patients. Even if patients are asymptomatic, moderate hypoP may be 
      associated with poor outcomes of PHPT. Therefore, moderate hypoP may be a new 
      criterion for parathyroidectomy, regardless of hypercalcemia level.
CI  - (c) 2023. The Author(s), under exclusive licence to Italian Society of 
      Endocrinology (SIE).
FAU - Duger, H
AU  - Duger H
AUID- ORCID: 0000-0001-5478-3192
AD  - Department of Endocrinology and Metabolism, Health Sciences University, Diskapi 
      Training and Research Hospital, Ziraat Mah. Sehit Omer Halisdemir Cad. No: 20, 
      06130, Ankara, Turkiye. hknduger@gmail.com.
FAU - Bostan, H
AU  - Bostan H
AD  - Department of Endocrinology and Metabolism, Health Sciences University, Diskapi 
      Training and Research Hospital, Ziraat Mah. Sehit Omer Halisdemir Cad. No: 20, 
      06130, Ankara, Turkiye.
FAU - Gul, U
AU  - Gul U
AD  - Department of Endocrinology and Metabolism, Health Sciences University, Diskapi 
      Training and Research Hospital, Ziraat Mah. Sehit Omer Halisdemir Cad. No: 20, 
      06130, Ankara, Turkiye.
FAU - Ucan, B
AU  - Ucan B
AD  - Department of Endocrinology and Metabolism, Health Sciences University, Diskapi 
      Training and Research Hospital, Ziraat Mah. Sehit Omer Halisdemir Cad. No: 20, 
      06130, Ankara, Turkiye.
FAU - Hepsen, S
AU  - Hepsen S
AD  - Department of Endocrinology and Metabolism, Health Sciences University, Diskapi 
      Training and Research Hospital, Ziraat Mah. Sehit Omer Halisdemir Cad. No: 20, 
      06130, Ankara, Turkiye.
FAU - Sakiz, D
AU  - Sakiz D
AD  - Department of Endocrinology and Metabolism, Health Sciences University, Diskapi 
      Training and Research Hospital, Ziraat Mah. Sehit Omer Halisdemir Cad. No: 20, 
      06130, Ankara, Turkiye.
FAU - Akhanli, P
AU  - Akhanli P
AD  - Department of Endocrinology and Metabolism, Health Sciences University, Diskapi 
      Training and Research Hospital, Ziraat Mah. Sehit Omer Halisdemir Cad. No: 20, 
      06130, Ankara, Turkiye.
FAU - Cakal, E
AU  - Cakal E
AD  - Department of Endocrinology and Metabolism, Health Sciences University, Diskapi 
      Training and Research Hospital, Ziraat Mah. Sehit Omer Halisdemir Cad. No: 20, 
      06130, Ankara, Turkiye.
FAU - Kizilgul, M
AU  - Kizilgul M
AD  - Department of Endocrinology and Metabolism, Health Sciences University, Diskapi 
      Training and Research Hospital, Ziraat Mah. Sehit Omer Halisdemir Cad. No: 20, 
      06130, Ankara, Turkiye.
LA  - eng
PT  - Journal Article
DEP - 20230316
PL  - Italy
TA  - J Endocrinol Invest
JT  - Journal of endocrinological investigation
JID - 7806594
RN  - SY7Q814VUP (Calcium)
RN  - 0 (Parathyroid Hormone)
RN  - 1406-16-2 (Vitamin D)
SB  - IM
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Aged
MH  - Retrospective Studies
MH  - Calcium
MH  - *Hyperparathyroidism, Primary/complications/diagnosis/surgery
MH  - *Hypophosphatemia/diagnosis/epidemiology/etiology
MH  - Parathyroid Hormone
MH  - *Osteoporosis/complications
MH  - *Nephrolithiasis
MH  - Vitamin D
MH  - Parathyroidectomy
OTO - NOTNLM
OT  - Hypophosphatemia
OT  - Primary hyperparathyroidism
OT  - Surgery
OT  - Symptomatic
EDAT- 2023/03/18 06:00
MHDA- 2023/07/28 06:43
CRDT- 2023/03/17 10:08
PHST- 2022/09/13 00:00 [received]
PHST- 2023/03/08 00:00 [accepted]
PHST- 2023/07/28 06:43 [medline]
PHST- 2023/03/18 06:00 [pubmed]
PHST- 2023/03/17 10:08 [entrez]
AID - 10.1007/s40618-023-02064-w [pii]
AID - 10.1007/s40618-023-02064-w [doi]
PST - ppublish
SO  - J Endocrinol Invest. 2023 Sep;46(9):1935-1940. doi: 10.1007/s40618-023-02064-w. 
      Epub 2023 Mar 16.