Serum ionized calcium and the prevalence of primary hyperparathyroidism in age cohorts of 75, 80 and 85 years

Abstract

In the elderly, primary hyperparathyroidism (HPT) is often disguised as 'senility' which can, however, be alleviated or cured by parathyroid surgery. The prevalence of HPT in the non-selected 75- to 85-year-old subjects (n = 610) randomly sampled from census records was estimated by measurements of serum ionized calcium and intact parathyrin levels. The prevalence of cases that require clinical attention seems to be around 3% in women and less than 1% in men. Furthermore, this study indicates that, on average, the serum ionized calcium concentration remains stable even in the elderly.

Population based study on serum ionised calcium, serum parathyroid hormone, and blood pressure. The Tromso study

“…Although there are reports of an increase (17) as well as a decrease (18) with age, most studies (16,19,20) are in agreement with our observation. On the other hand, we did find that the serum ionised calcium levels were significantly lower in females than in males, which is in agreement with the studies by Endres et al (17) and Rudnicki et al (21), although the difference was not significant in the latter study.…”

Elevated serum parathyroid hormone predicts impaired survival prognosis in a general aged population

“…The prevalence of primary hyperparathyroidism (PHPT) is w2% in the elderly (4). However, secondary hyperparathyroidism (SHPT) is a far more common cause of elevated PTH levels and the prevalence of which has varied from 20 to 60% in different aged populations (5)(6)(7)(8).…”

“…However, secondary hyperparathyroidism (SHPT) is a far more common cause of elevated PTH levels and the prevalence of which has varied from 20 to 60% in different aged populations (5)(6)(7)(8). SHPT is the most common consequence of vitamin D deficiency, which is also associated with multiple poor outcomes in the elderly, such as the increased risk of osteoporosis and fractures as well as muscle weakness and falls (3,4). SHPT is also a common occurrence in patients with chronic renal failure, in which PTH acts as a uraemic toxin that may lead to long-term consequences including renal osteodystrophy, severe vascular and heart valve calcification, alterations in cardiovascular structure and function, immune dysfunction and renal anaemia (9).…”

Primary Hyperparathyroidism of Postmenopausal Women

“…This proportion largely complied with previous health examinations of Nordic female populations aged 360 years and 375 years (Palmer et al 1988A, Lindstedt et al 1992, Sorva et al 1992. A major discrepancy towards these studies, however, involved the currently combined use of intact serum PTH and calcium values as primary means of diagnosis, which enabled recognition of HPT accompanied by normocalcemia.…”

“…The frequency of HPT in hospitalbased materials naturally differs from that obtained by population-based screening for several reasons (Boonstra & Jackson 1970, Heath et al 1980, Mundy et al 1980, Dent et al 1987. Malignancies account for a greater proportion of cases with hypercalcemia in hospitalised individuals (Dent et al 1987, Frolich 1998), while HPT is the most common cause of an elevated serum calcium value in outpatients (Heath et al 1980, Palmer et al 1988A, Lindstedt et al 1992, Sorva et al 1992). Moreover any material on patients recruited in the clinical routine is hampered bythefact that the patient has come to medical attention for a reason.…”