PMID- 37638278
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230829
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 8
DP  - 2023 Aug
TI  - The Impact of Moderate Hypophosphatemia on the Clinical Management of Primary 
      Hyperparathyroidism.
PG  - e44115
LID - 10.7759/cureus.44115 [doi]
LID - e44115
AB  - Background and objective The impact of moderate hypophosphatemia (hypoP) on 
      primary hyperparathyroidism (PHPT) and its use as an independent surgical 
      criterion has not been adequately evaluated in the literature. In light of this, 
      we conducted this study to address the scarcity of data on this topic. Methods We 
      conducted a retrospective evaluation of data related to 164 (133 females and 31 
      males) patients with PHPT who met the criteria for inclusion in the study. HypoP, 
      which is indicated by phosphorus (P) levels lower than 2.5 mg/dL, was found in 78 
      (47.5%) patients, and moderate hypoP (1-1.99 mg/dL) was found in 25 patients 
      (15.2%). Results PHPT severity was worse in hypoP patients than non-hypoP 
      patients, as evidenced by higher levels of mean serum calcium (12.9 +/-1.0 mg/dL 
      vs. 11.1 +/-0.3 mg/dL respectively, p<0.001), parathormone (PTH) [median 
      (interquartile range, IQR): 455.3 (455.3) ng/L vs. 124.0 (84.0) ng/L 
      respectively, p<0.001] and mean 24-hour urinary calcium (414.6 +/-168.5 mg/day vs. 
      291.5 +/-161.4 mg/day respectively, p=0.026) as well as lower levels of mean BMI 
      (25.6 +/-3.9 kg/m(2) vs. 29.0 +/-4.0 kg/m(2) respectively, p=0.18) and mean 
      25-hydroxy vitamin D3 (13.8 +/-7.3 microg/L vs. 18.2 +/-7.8 microg/L respectively, p=0.001). 
      Among the whole study population as well as among patients with Ca levels <1.0 
      mg/dL according to the upper limit of normal, P level was determined to be an 
      independent factor affecting the indication for surgical treatment [beta: 
      -1.96,p=0.038, odds ratio (OR): 0.14, 95% confidence interval (CI): 0.02-0.89 and 
      beta: -2.3, p=0.034, OR: 0.10, 95% CI: 0.12-0.84 respectively]. Conclusion We found 
      a strong correlation between moderate hypoP and the severity of the biochemical 
      manifestations of PHPT. In asymptomatic PHPT patients, moderate hypoP was 
      predictive of surgical indication, independent of age and level of hypercalcemia.
CI  - Copyright (c) 2023, Gunes et al.
FAU - Gunes, Elif
AU  - Gunes E
AD  - Department of Endocrinology, Metabolism and Diabetes, Health Sciences University, 
      Bursa State Hospital, Bursa, TUR.
FAU - Gunes, Mutlu
AU  - Gunes M
AD  - Department of Endocrinology, Metabolism and Diabetes, Health Sciences University, 
      Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, TUR.
LA  - eng
PT  - Journal Article
DEP - 20230825
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10455043
OTO - NOTNLM
OT  - hypercalcaemia
OT  - hypophosphataemia
OT  - parathormone
OT  - primary hyperparathyroidism
OT  - urinary calcium
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/08/28 06:43
MHDA- 2023/08/28 06:44
PMCR- 2023/08/25
CRDT- 2023/08/28 05:02
PHST- 2023/08/25 00:00 [accepted]
PHST- 2023/08/28 06:44 [medline]
PHST- 2023/08/28 06:43 [pubmed]
PHST- 2023/08/28 05:02 [entrez]
PHST- 2023/08/25 00:00 [pmc-release]
AID - 10.7759/cureus.44115 [doi]
PST - epublish
SO  - Cureus. 2023 Aug 25;15(8):e44115. doi: 10.7759/cureus.44115. eCollection 2023 
      Aug.