Regional Clinical and Biochemical Differences among Patients with Primary Hyperparathyroidism

Year 2017, Volume: 34 Issue: 1, 28 - 34, 01.01.2017

Maria Stamatin Özer Makay Beyza Özçınar Turgay Şimşek Cumhur Arıcı Bülent Güngör Serdar Özbaş Tamer Akça Ali Uğur Emre Güldeniz Karadeniz Çakmak Müfide Akçay Bülent Ünal Mustafa Girgin Sadullah Girgin Semih Görgülü

Abstract

Background: Environmental habitat may play a role
in clinical disparities of primary hyperparathyroidism
(pHPT) patients.
Aims: To compare preoperative clinical symptoms and
associated conditions and surgical findings in patients
with pHPT, living in different geographical regions from
the Black Sea, Mediterranean and Anatolia regions.
Study Design: Retrospective, clinical-based multicentric
study of 694 patients with pHPT.
Methods: Patients from 23 centers and 8 different
geographical regions were included. Data related
to baseline demographics, clinical, pathologic and
treatment characteristics of 8 regions were collected and
included age, gender, residential data, symptoms, history
of fracture, existence of brown tumor, serum total Ca
and p levels, serum parathormone (PTH) levels, serum
25-OH vitamin D levels, bone mineral density, size of
the resected abnormal parathyroid gland(s), histology,
as well as the presence of ectopia, presence of dual
adenoma, and multiple endocrine neoplasia (MEN)- or
familial-related disease.
Results: The median age was 54. Asymptomatic patient
rate was 25%. The median PTH level was 232 pg/mL and
serum total Ca was 11.4 mg/dL. Eighty-seven percent of
patients had an adenoma and 90% of these had a single
adenoma. Hyperplasia was detected in 79 patients and
cancer in 9 patients. The median adenoma size was 16
mm. Significant parameters differing between regions
were preoperative symptoms, serum Ca and p levels,
and adenoma size. All patients from South-East Anatolia
were symptomatic, while the lowest p values were
reported from East Anatolia and the largest adenoma
size, as well as highest Ca levels, were from Bulgaria.
Conclusion: Habitat conditions vary between
geographical regions. This affects

Keywords

Hyperparathyroidism, clinocopathological features, regional differences, Turkey, Bulgaria

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