Increased frequency of hypertension and coronary artery disease independent of age in primary hyperparathyroidism associated hypercalcaemia

Yıl 2023, Cilt: 4 Sayı: 4, 277 - 282, 30.08.2023

Elif Güneş , Mutlu Güneş

https://doi.org/10.47582/jompac.1324604

Öz

Aims: There are conflicting data in the literature regarding whether there is an increased frequency of coronary artery disease (CAD) in patients with primary hyperparathyroidism (PHP). In this study, we planned to investigate the frequency of CAD and hypertension (HT) in patients with PHP.
Methods: Patients with PHP aged 18 years and older who were admitted to the endocrinology clinic between September 2020 and February 2023 were included as the patient group, and age- and gender-matched individuals who presented with thyroid nodules between the same dates were included as the control group. A total of 217 patients, 114 with PHP and 103 as control group, were eligible for the study. The study was conducted as a retrospective data analysis and laboratory and demographic information of the patients and the control group were obtained from their files.
Results: Age and gender distribution of the patient group and the control group were similar (respectively; age: 55.6+12.9 years, 53.0+7.2 years, p=0.058, female/male distribution: 93/21, 80/23 p=0.48). The prevalence of HT and CAD was higher in the patient group (respectively; HT: 65.1%, 31.0%, p<0.001, CAD: 32.0%, 3.1%, p<0.001), while the prevalence of DM was similar (respectively; 18.1%, 17.3%, p=0.89). The prevalence of HT, CAD and DM was found to be the same among those with mild and severe PHP (respectively; HT: 65.6%, 64.4%, p=0.90, CAD: 38.3%, 23.3%, p=0.14, DM: 19.7%, 15.9%, p=0.62, ). Age (β=0.10, odds ratio [OR];1.11 [95% confidence interval (95% CI);1.05-1.17], p<0.001) and calcium (β=0.67, OR;1.96 [95% CI;1.10-3.51], p=0.023) levels were found to be independent effective factors on CAD.
Conclusion: Increased calcium levels in PHP constitute an age-independent risk for CAD. In addition, elevated calcium increases the frequency of HT, which is a CAD risk factor.

Anahtar Kelimeler

Primary hyperparathyroidism, hypertension, coronary artery disease, hypercalcaemia.

Destekleyen Kurum

No

Primer hiperparatiroidizmle ilişkili hiperkalsemide yaştan bağımsız olarak hipertansiyon ve koroner arter hastalığı sıklığında artış

Öz

Giriş ve amaç: Primer hiperparatiroidi (PHP)'li hastalarda koroner arter hastalığı (KAH) sıklığında artış olup olmadığı ile ilgili literatürde çelişkili veriler bulunmaktadır. Bu çalışmada PHP'li hastalarda KAH ve hipertansiyon (HT) sıklığının araştırılması planlanmıştır.
Material ve metod: Hasta grubu olarak endokrinoloji kliniğine Eylül 2020-Şubat 2023 tarihleri arasında başvuran 18 yaş ve üzeri PHP'li hastalar, kontrol grubu olarak aynı tarihler arasında yaş ve cinsiyet uyumlu tiroid nodülü nedeniyle başvuran bireyler alınmıştır. Çalışmaya uygun PHP'li 114, kontrol grubu olarak da 103 olmak üzere toplamda 217 hasta tespit edildi. Çalışma retrospektif data incelemesi şeklinde yapılmış olup hastaların ve kontrol grubunun laboratuvar ve demografik bilgileri dosyalarından elde edilmiştir.
Sonuçlar: Hasta grubu ile kontrol grubunun yaş ve cinsiyet dağılımı benzer idi (sırasıyla; yaş 55.6+12.9 yıl, 53.0+7.2 yıl, p=0.058, kadın/erkek dağlımı; 93/21, 80/23 p=0.48). HT ve KAH sıklığı hasta grubunda daha yüksek iken (sırasıyla; HT; %65.1, %31.0, p<0.001, KAH; %32.0, %3.1, p<0.001), DM sıklığı ise benzerdi (sırasıyla; %18.1, %17.3, p=0.89). Hafif ve şiddetli PHP'si olanlar arasında HT, KAH ve DM sıklıklarının aynı olduğu tespit edildi (sırasıyla; HT; %65.6%, 64.4, p=0.90, KAH; %38.3, %23.3, p=0.14, DM; %19.7, %15.9, p=0.62). KAH üzerine etkili faktörler incelendiğinde yaş (β=0.10, ods oranı [OR];1.11 [%95 güven aralığı (%95GA);1.05-1.17], p<0.001) ve kalsiyum (β=0.67, OR;1.96 [%95 GA;1.10-3.51], p=0.023) düzeylerinin bağımsız etkili faktörler olduğu saptandı.
Tartışma: PHP'de artmış kalsiyum düzeyleri yaştan bağımsız KAH için risk oluşturmaktadır. Ayrıca kalsiyum yüksekliği KAH risk faktörü olan HT sıklığını artırmaktadır.

Anahtar Kelimeler

Primer hiperparatiroidi, hipertansiyon, koroner arter hastalığı, hiperkalsemi

Kaynakça

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