Residual risks of comorbidities after parathyroidectomy in a nationwide cohort of patients with primary hyperparathyroidism

Abstract

Purpose: Primary hyperparathyroidism (PHPT) is a common endocrine disorder with increasing incidence, while epidemiologic data in Asian population has been lacking. Therefore, we aimed to identify the incidence, prognosis, and prognostic factors of PHPT patients who underwent parathyroidectomy in Korea.Methods: In this retrospective nationwide cohort, patients with PHPT were de ned as those with diagnostic codes of PHPT and procedural codes for parathyroidectomy, excluding chronic renal failure or secondary hyperparathyroidism based on National Health Insurance Services database in Korea in 2002-2018. Main primary outcomes were all-cause mortality, cardiovascular, and cerebrovascular events.Results: A total of 5,561 patients were diagnosed with PHPT and had parathyroidectomy. The mean age was 54.5 years, and 71.8% were women. The age-standardized incidence was 10.1/ 100,000 person-year in 2018, rising from 1.7/100,000 person-year in 2002. During a mean of 5.9 years, history of cardiovascular disease, mood disorder, and genitourinary stone had increased risks of mortality with hazard ratios (HRs) of 1.59 (95% con dence interval [

Is cardiovascular evaluation necessary for elderly patients with primary hyperparathyroidism?

“…However, the authors pointed out an interesting trend: in cases where patients with hypertension underwent parathyroidectomy, there was a suggestion of reduced risk of major cerebrovascular events compared to the comparison subjects who did not undergo parathyroidectomy (hazard ratio of 0.87; 95% confidence interval: 0.75–1.01) ( 11 ). In conjunction with the study by Grant et al , we recently reported that patients who had parathyroidectomy with complications, notably mood disorders, faced heightened risks of cardiovascular and cerebrovascular events, as well as mortality ( 3 ). While both studies draw from nationally representative datasets, it is important to note a crucial distinction in the racial composition of the patient populations that our study included only Asians and the study by Grant et al included mostly Caucasians.…”

“…Primary hyperparathyroidism (PHPT) is an increasingly prevalent endocrine disorder, with an incidence ranging from 1.3 to 50 cases per 100,000 person-years according to previous reports ( 1 - 3 ). Characterized by the excessive secretion of parathyroid hormone and subsequent hypercalcemia, PHPT can show non-classical manifestation of cardiovascular and psychological systems as well as classical manifestation targeted the skeletal and renal systems ( 4 - 6 ).…”

“…While parathyroidectomy can be considered as a potential intervention to mitigate cardiovascular and cerebrovascular risks in PHPT patients, it is paramount to recognize that hypertension often coexists with PHPT both before and after surgery ( 3 , 12 ). Although there has been studies that report the improvement of hypertension control after parathyroidectomy ( 13 , 14 ), several studies underscore that despite successful parathyroidectomy, hypertension may persist or even emerge de novo in a subset of patients ( 9 , 15 ).…”

Big Data Research in the Field of Endocrine Diseases Using the Korean National Health Information Database

“…(2) a procedure code for parathyroidectomy (P4541, P4542, or P4543); and (3) a history of admission [78]. In a retrospective cohort study estimating the prevalence of nonsurgical hypoparathyroidism and the risk of complications, nonsurgical hypoparathyroidism was defined as the presence of the ICD-10 codes (D82.1, E20.0, E20.8, E20.9, E31.0, E31.8, or E31.9) and at least two prescriptions for active vitamin D analogs.…”

Protein Signatures of Parathyroid Adenoma according to Tumor Volume and Functionality

“…Primary hyperparathyroidism (PHPT) is a common endocrine disorder with a globally increasing incidence [1,2]. It is the primary cause of outpatient hypercalcemia and presents with a wide spectrum of symptoms impacting the renal, skeletal, neurological, cardiovascular, and gastrointestinal systems [3].…”