Morbidity associated with primary hyperparathyroidism: A population-based study with a sub-analysis on Vitamin D

TY - JOUR

T1 - Morbidity associated with primary hyperparathyroidism

T2 - A population-based study with a sub-analysis on Vitamin D

AU - Soto-Pedre, Enrique

AU - Lin, Yeun Yi

AU - Soto-Hernaez, Jimena

AU - Newey, Paul J.

AU - Leese, Graham P.

N1 - Funding Information: The study was supported by the NHS Tayside Research Endowments. Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society.

PY - 2023/9

Y1 - 2023/9

N2 - CONTEXT: Primary hyperparathyroidism (PHPT) is associated with increased risk of morbidity and death, and vitamin D levels are a potentially confounding variable. OBJECTIVE: The aim of this study was to assess morbidity and mortality associated with primary hyperparathyroidism (PHPT). METHODS: In this population-based retrospective matched cohort study, data linkage of biochemistry, hospital admissions, prescribing, imaging, pathology, and deaths was used to identify patients across the region of Tayside, Scotland, who had PHPT from 1997 to 2019. Cox proportional hazards models and hazards ratios (HR) were used to explore the relationship between exposure to PHPT and several clinical outcomes. Comparisons were made with an age- and gender-matched cohort. RESULTS: In 11 616 people with PHPT (66.8% female), with a mean follow-up period of 8.8 years, there was an adjusted HR of death of 2.05 (95% CI, 1.97-2.13) for those exposed to PHPT. There was also an increased risk of cardiovascular disease (HR = 1.34; 95% CI, 1.24-1.45), cerebrovascular disease (HR = 1.29; 95% CI, 1.15-1.45), diabetes (HR = 1.39; 95% CI, 1.26-1.54), renal stones (HR = 3.02; 95% CI, 2.19-4.17) and osteoporosis (HR = 1.31; 95% CI, 1.16-1.49). Following adjustment for serum vitamin D concentrations (n = 2748), increased risks for death, diabetes, renal stones, and osteoporosis persisted, but not for cardiovascular or cerebrovascular disease. CONCLUSION: In a large population-based study, PHPT was associated with death, diabetes, renal stones, and osteoporosis, independent of serum vitamin D concentration.

AB - CONTEXT: Primary hyperparathyroidism (PHPT) is associated with increased risk of morbidity and death, and vitamin D levels are a potentially confounding variable. OBJECTIVE: The aim of this study was to assess morbidity and mortality associated with primary hyperparathyroidism (PHPT). METHODS: In this population-based retrospective matched cohort study, data linkage of biochemistry, hospital admissions, prescribing, imaging, pathology, and deaths was used to identify patients across the region of Tayside, Scotland, who had PHPT from 1997 to 2019. Cox proportional hazards models and hazards ratios (HR) were used to explore the relationship between exposure to PHPT and several clinical outcomes. Comparisons were made with an age- and gender-matched cohort. RESULTS: In 11 616 people with PHPT (66.8% female), with a mean follow-up period of 8.8 years, there was an adjusted HR of death of 2.05 (95% CI, 1.97-2.13) for those exposed to PHPT. There was also an increased risk of cardiovascular disease (HR = 1.34; 95% CI, 1.24-1.45), cerebrovascular disease (HR = 1.29; 95% CI, 1.15-1.45), diabetes (HR = 1.39; 95% CI, 1.26-1.54), renal stones (HR = 3.02; 95% CI, 2.19-4.17) and osteoporosis (HR = 1.31; 95% CI, 1.16-1.49). Following adjustment for serum vitamin D concentrations (n = 2748), increased risks for death, diabetes, renal stones, and osteoporosis persisted, but not for cardiovascular or cerebrovascular disease. CONCLUSION: In a large population-based study, PHPT was associated with death, diabetes, renal stones, and osteoporosis, independent of serum vitamin D concentration.

KW - Primary hyperparathyroidism

KW - Vitamin D

KW - calcium

KW - mortality

KW - vitamin D

KW - primary hyperparathyroidism

UR - https://www.scopus.com/pages/publications/85168315809

U2 - 10.1210/clinem/dgad103

DO - 10.1210/clinem/dgad103

M3 - Article

C2 - 36810667

SN - 0021-972X

VL - 108

SP - e842–e849

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

IS - 9

ER -