A Population-based study of the Epidemiology of Chronic Hypoparathyroidism

Thenmalar Vadiveloo (Lead / Corresponding author), Peter T. Donnan, Graham P. Leese

Research output: Contribution to journalArticle

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Abstract

There are very few reports on the epidemiology of chronic hypoparathyroidism. A population-based study was undertaken to describe the prevalence and incidence of hypoparathyroidism in Tayside, Scotland. Data on biochemistry, hospital admissions, prescribing and death records in Tayside Scotland from 1988 to 2015 were linked electronically. Patients with at least three serum albumin corrected calcium concentrations below the reference range that were taken in an out-patient setting were included in the study. Patients with severe chronic kidney disease prior to low calcium were excluded from the study. Patients with hypocalcaemia were included if they had either previous neck surgery/irradiation, a low serum PTH or were treated with Vitamin D. Patients were identified as having either a post-surgical, a non-surgical cause, or had secondary hypoparathyroidism e.g. hypomagnesaemia. Overall 18,955 patients were identified with hypocalcaemia. Of these 222 patients had primary hypoparathyroidism, 116 with post-surgical and 106 with non-surgical chronic hypoparathyroidism. In 2015 the prevalence of primary hypoparathyroidism was 40 per 100,000, with a rate of 23 and 17 per 100,000 respectively for post-surgical and non-surgical. 80% of the former and 64% of the latter were female. The mean serum calcium at diagnosis was 1.82mmol/l (SD ± 0.24) and the annual incidence varied from 1-4 per 100,000. Overall, 71% of patients were prescribed Vitamin D and/or calcium, whilst activated Vitamin D was used in 48% of post-surgical cases and 43% of non-surgical cases. Thyroxine and/or hydrocortisone were prescribed in over 90% of post-surgical and 64% of non-surgical cases. In conclusion, the prevalence of non-surgical chronic hypoparathyroidism was greater than previously reported using this population-based approach. Many had mild hypocalcaemia and did not receive any treatment. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)478-485
Number of pages8
JournalJournal of Bone and Mineral Research
Volume33
Issue number3
Early online date31 Oct 2017
DOIs
Publication statusPublished - Mar 2018

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Hypoparathyroidism
Epidemiology
Hypocalcemia
Population
Vitamin D
Calcium
Scotland
Death Certificates
Hospital Records
Incidence
Serum
Thyroxine
Chronic Renal Insufficiency
Serum Albumin
Biochemistry
Hydrocortisone
Reference Values
Outpatients
Neck

Keywords

  • EPIDEMIOLOGY
  • GENERAL POPULATION STUDY
  • HEALTH SERVICES RESEARCH
  • PARATHYROID-RELATED DISORDERS
  • STATISTICAL METHODS

Cite this

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title = "A Population-based study of the Epidemiology of Chronic Hypoparathyroidism",
abstract = "There are very few reports on the epidemiology of chronic hypoparathyroidism. A population-based study was undertaken to describe the prevalence and incidence of hypoparathyroidism in Tayside, Scotland. Data on biochemistry, hospital admissions, prescribing and death records in Tayside Scotland from 1988 to 2015 were linked electronically. Patients with at least three serum albumin corrected calcium concentrations below the reference range that were taken in an out-patient setting were included in the study. Patients with severe chronic kidney disease prior to low calcium were excluded from the study. Patients with hypocalcaemia were included if they had either previous neck surgery/irradiation, a low serum PTH or were treated with Vitamin D. Patients were identified as having either a post-surgical, a non-surgical cause, or had secondary hypoparathyroidism e.g. hypomagnesaemia. Overall 18,955 patients were identified with hypocalcaemia. Of these 222 patients had primary hypoparathyroidism, 116 with post-surgical and 106 with non-surgical chronic hypoparathyroidism. In 2015 the prevalence of primary hypoparathyroidism was 40 per 100,000, with a rate of 23 and 17 per 100,000 respectively for post-surgical and non-surgical. 80{\%} of the former and 64{\%} of the latter were female. The mean serum calcium at diagnosis was 1.82mmol/l (SD ± 0.24) and the annual incidence varied from 1-4 per 100,000. Overall, 71{\%} of patients were prescribed Vitamin D and/or calcium, whilst activated Vitamin D was used in 48{\%} of post-surgical cases and 43{\%} of non-surgical cases. Thyroxine and/or hydrocortisone were prescribed in over 90{\%} of post-surgical and 64{\%} of non-surgical cases. In conclusion, the prevalence of non-surgical chronic hypoparathyroidism was greater than previously reported using this population-based approach. Many had mild hypocalcaemia and did not receive any treatment. This article is protected by copyright. All rights reserved.",
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A Population-based study of the Epidemiology of Chronic Hypoparathyroidism. / Vadiveloo, Thenmalar (Lead / Corresponding author); Donnan, Peter T.; Leese, Graham P.

In: Journal of Bone and Mineral Research, Vol. 33, No. 3, 03.2018, p. 478-485.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A Population-based study of the Epidemiology of Chronic Hypoparathyroidism

AU - Vadiveloo, Thenmalar

AU - Donnan, Peter T.

AU - Leese, Graham P.

N1 - This article is protected by copyright. All rights reserved.

PY - 2018/3

Y1 - 2018/3

N2 - There are very few reports on the epidemiology of chronic hypoparathyroidism. A population-based study was undertaken to describe the prevalence and incidence of hypoparathyroidism in Tayside, Scotland. Data on biochemistry, hospital admissions, prescribing and death records in Tayside Scotland from 1988 to 2015 were linked electronically. Patients with at least three serum albumin corrected calcium concentrations below the reference range that were taken in an out-patient setting were included in the study. Patients with severe chronic kidney disease prior to low calcium were excluded from the study. Patients with hypocalcaemia were included if they had either previous neck surgery/irradiation, a low serum PTH or were treated with Vitamin D. Patients were identified as having either a post-surgical, a non-surgical cause, or had secondary hypoparathyroidism e.g. hypomagnesaemia. Overall 18,955 patients were identified with hypocalcaemia. Of these 222 patients had primary hypoparathyroidism, 116 with post-surgical and 106 with non-surgical chronic hypoparathyroidism. In 2015 the prevalence of primary hypoparathyroidism was 40 per 100,000, with a rate of 23 and 17 per 100,000 respectively for post-surgical and non-surgical. 80% of the former and 64% of the latter were female. The mean serum calcium at diagnosis was 1.82mmol/l (SD ± 0.24) and the annual incidence varied from 1-4 per 100,000. Overall, 71% of patients were prescribed Vitamin D and/or calcium, whilst activated Vitamin D was used in 48% of post-surgical cases and 43% of non-surgical cases. Thyroxine and/or hydrocortisone were prescribed in over 90% of post-surgical and 64% of non-surgical cases. In conclusion, the prevalence of non-surgical chronic hypoparathyroidism was greater than previously reported using this population-based approach. Many had mild hypocalcaemia and did not receive any treatment. This article is protected by copyright. All rights reserved.

AB - There are very few reports on the epidemiology of chronic hypoparathyroidism. A population-based study was undertaken to describe the prevalence and incidence of hypoparathyroidism in Tayside, Scotland. Data on biochemistry, hospital admissions, prescribing and death records in Tayside Scotland from 1988 to 2015 were linked electronically. Patients with at least three serum albumin corrected calcium concentrations below the reference range that were taken in an out-patient setting were included in the study. Patients with severe chronic kidney disease prior to low calcium were excluded from the study. Patients with hypocalcaemia were included if they had either previous neck surgery/irradiation, a low serum PTH or were treated with Vitamin D. Patients were identified as having either a post-surgical, a non-surgical cause, or had secondary hypoparathyroidism e.g. hypomagnesaemia. Overall 18,955 patients were identified with hypocalcaemia. Of these 222 patients had primary hypoparathyroidism, 116 with post-surgical and 106 with non-surgical chronic hypoparathyroidism. In 2015 the prevalence of primary hypoparathyroidism was 40 per 100,000, with a rate of 23 and 17 per 100,000 respectively for post-surgical and non-surgical. 80% of the former and 64% of the latter were female. The mean serum calcium at diagnosis was 1.82mmol/l (SD ± 0.24) and the annual incidence varied from 1-4 per 100,000. Overall, 71% of patients were prescribed Vitamin D and/or calcium, whilst activated Vitamin D was used in 48% of post-surgical cases and 43% of non-surgical cases. Thyroxine and/or hydrocortisone were prescribed in over 90% of post-surgical and 64% of non-surgical cases. In conclusion, the prevalence of non-surgical chronic hypoparathyroidism was greater than previously reported using this population-based approach. Many had mild hypocalcaemia and did not receive any treatment. This article is protected by copyright. All rights reserved.

KW - EPIDEMIOLOGY

KW - GENERAL POPULATION STUDY

KW - HEALTH SERVICES RESEARCH

KW - PARATHYROID-RELATED DISORDERS

KW - STATISTICAL METHODS

U2 - 10.1002/jbmr.3329

DO - 10.1002/jbmr.3329

M3 - Article

VL - 33

SP - 478

EP - 485

JO - Journal of Bone and Mineral Research

JF - Journal of Bone and Mineral Research

SN - 0884-0431

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ER -