Cribado y caracterización bioquímica del hiperparatiroidismo primario en Guayaquil (Ecuador)

Abstract

Objectives: To determine the prevalence of primary hyperparathyroidism (HPTP) using PTH and Ionic calcium screening in a population sample of Guayaquil (Ecuador). Materials and methods: Prospective, cross-sectional study carried out between January 1, 2009 and November 30, 2014 of 13,860 people who attended routine control tests. All were tested in serum parathyroid hormone (PTH), ionic calcium, serum creatinine and the 25 (OH) total vitamin D (total VD). The diagnosis of HPTP was confirmed if PTH or Ionic calcium levels remained high at least in two different occasions. We excluded patients with raised serum creatinine, vitamin D insufficiency, malabsorption, chronic liver disease, or those receiving treatments that alter phosphocalcic metabolism. Results: 61 cases were found with raised PTH on at least two different occasions. Among these, 34 presented vitamin D insufficiency and were excluded from the analysis. In 27 cases (4 men and 23 women) the diagnosis of HPTP was confirmed. The average age for women was 64.5±15.4 years and men of 71.3±12.8 years; average PTH values were 115±24.2 pg/ml; Ionic calcium, 5.15±0.4 mg/dl; total VD, 47.1±20.2 ng/ml; and serum creatinine 0.84±0.2 mg/ml; prevalence of HPTP corresponds to 2 cases per thousand adults (95% CI: 1.71-2.18). The greatest increase in prevalence occurred in women aged 60 years. Conclusion: PTH prevalence in this sample is low compared to that reported in international series, being higher in advanced ages and in women. With the proposed screening for PTH and ionic calcium, we detected the normocalcemic form of HPTP in most cases.

Niveles de Vitamina D en pacientes con y sin Enfermedad Renal Crónica, perfil clínico y epidemiológico: un análisis preeliminiar en un hospital de segundo nivel en quito, Ecuador.

“…Encontramos que la edad presentó diferencias significativas en cuanto a los niveles de vitamina D, siendo mayor el déficit en la población de los adultos mayores con una media de edad de 70 años y el déficit de vitamina D se presentó en el 63.8% de este grupo. En otro estudio realizado en Ecuador la prevalencia de vitamina d menor a 40 nmol/L (16 ng/ml) entre los ancianos oscilan entre el 9 al 19% 17 .Entre los factores que determinan menores niveles séricos de vitamina D en ancianos se encuentran la menor ingesta en la dieta y la capacidad disminuida de la piel de producir vitamina D disminuyendo un 25% en los 75 años, adicionalmente en un metanálisis se observó mayores niveles de deficiencia en los ancianos que viven solos o están institucionalizados 18,19 .…”

La fractura de cadera en Latinoamérica. ¿Se está aproximando a la experiencia europea de los últimos años?

“…Given HF's peculiarities in our environment, it is interesting to observe its behavior in other populations, its similarities and differences with Spain, as in the case of Latin America. In this issue, López Gavilánez et al 15 publish data on HF epidemiology in Ecuador, after collecting cases of this fracture after a thorough search. Their data are similar to those published in Spain a few years ago.…”