Relationship of parathyroid adenoma volume with preoperative biochemical parameters

Abstract

Aim: Primary hyperparathyroidism (PHPT) is a clinical presentation of hypercalcemia resulting from autonomous excessive parathyroid secretion from parathyroid glands. Significant correlation between serum parathyroid hormone (iPTH), calcium (Ca), phosphorus (P) and 25-OH D3 levels and adenoma volume, have a predictive value to determine the size of parathyroid adenoma resection. In this study, we examined the relation between preoperative biochemical parameters and resected parathyroid adenoma volume.

Methods: Fifty-two patients with PHPT diagnosed in the endocrinology outpatient clinic of Istanbul Haydarpaşa Numune Research Hospital, between 2011 and 2014 were included in the study. Histopathological diagnosis of solitary parathyroid adenomas was made. Correlation analysis was performed between adenoma volume and preoperative serum iPTH, corrected Ca, P, 25-OH D3 and 24 hour urinary calcium levels. The study was designed a cross-sectional study.

Results: Fifty-two patients studied, 45 were female and 7 were male. The mean age of the patients was 53.538 ± 14.996 years. The mean preoperative iPTH level was 371.423 ± 341.8 pg / dl, corrected Ca level was 11.652 ± 0.947 mg / dl, phosphorus level was 2.285 ± 0.434 mg / dl and 25-OH D3 level was 11.442 ± 6.120 ng /dl. The calculated parathyroid adenoma volume averaged 1.612 ± 2 cm3. Correlation between parathyroid adenoma volume with parathormone levels and 24 hour urine calcium levels was positive whereas 25-OH D3 levels were negatively correlated with adenoma volume.

Conclusion: The adenoma size correlates with iPTH and vitamin D levels in PHPT patients. These levels may have predictive value about adenoma volume.

Keywords

• Parathyroid adenoma volume,Biochemical parameters

Paratiroid adenom volümünün preoperatif biyokimyasal parametreler ile ilişkisi

Öz

Amaç: Primer hiperparatiroidizm (PHPT), paratiroid bezlerinden otonom olarak aşırı parathormon salgılanması sonucu oluşan, hiperkalsemi veya normokalseminin görüldüğü klinik bir tablodur. Serum paratiroid hormonu (iPTH), kalsiyum (Ca), fosfor (P) seviyeleri ve vitamin D düzeyleri (25-OH D3) ile adenom hacmi arasında anlamlı bir ilişki bulunması, paratiroid adenomunun rezeksiyonunun boyutunu belirlemek için prediktif değere sahip olabilir.Biz de bu çalışmamızda preoperatif biyokimyasal parametreler ile paratiroid adenom volümü arasındaki ilişkiyi inceledik.

Yöntemler: İstanbul Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Endokrinoloji polikliniğinde 2011-2014 yılları arasında primer hiperparatiroidi tanısıyla takip edilen, operasyon sonrasında histopatolojik olarak soliter paratiroid adenomu tanısı konmuş 52 hasta çalışmaya alındı. Adenom hacmi ile preoperatif serum parathormon (iPTH), düzeltilmiş Ca, P, 25-OH D3, 24 saatlik idrarda kalsiyum düzeyi arasında korelasyon analizi yapıldı. Çalışma cross-sectional olarak dizayn edildi.

Bulgular: Çalışmaya alınan elli iki hastanın 45’i kadın (%86,5), 7’si erkekti (%13,5). Hastaların yaş ortalaması 53,538 ± 14,996 yıldı. Hastaların ortalama preoperatif iPTH düzeyi 371,423 ± 341,857 pg/dl, ortalama düzeltilmiş Ca düzeyi 11,652 ± 0,947 mg/dl, ortalama fosfor düzeyi 2,285 ± 0,434 mg/dl, ortalama 25-OH D3 düzeyi 11,442 ± 6,120 ng/ml, 24 saatlik idrarda kalsiyum düzeyi 337,486 ± 213,658 mg/24 saat olarak bulundu. Hastaların hesaplanan paratiroid adenom volüm ortalaması 1.612 ± 2 cm3 (0,0060-11,510) idi. Paratiroid adenom volümü ile parathormon düzeyleri ve 24 saatlik idrar kalsiyum düzeyleri arasında pozitif yönde, 25-hidroksi vitamin D düzeyleri arasında negatif yönde korelasyon saptandı. 

Sonuç: PHPT hastalarda adenom boyutu parathormon ve vitamin D düzeyi ile korelasyon göstermektedir. Bu nedenle, preoperatif iPTH ve vitamin D düzeylerinin adenom boyutu hakkında prediktif değere sahip olabileceğini düşünmekteyiz.

Anahtar Kelimeler

• Paratiroid adenom volümü,Biyokimyasal parametreler

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