Regional Clinical and Biochemical Differences among Patients with Primary Hyperparathyroidism
Makaleler > Tam Makale · 2017
Yazarlar: Özer MAKAY, Beyza Ozcinar, TURGAY ŞİMŞEK, CUMHUR ARICI, Bulent Gungor, Serdar OZBAS, Tamer Akca, Ali Ugur Emre, Guldeniz Karadeniz Cakmak, Mufide Akcay, Bulent Unal, Mustafa Girgin, Sadullah Girgin, Semih GORGULU, Atakan Sezer, Adem Karatas, Ibrahim Ali Ozemir, Nihat Aksakal, Serap EREL, M. Umit Ugurlu, Ali Ilker Filiz, Can ATALAY, Ali Uzunkoy, Ugur DEVECI, Cetin Kotan, Recep Gökhan İÇÖZ, Yavuz KURT, Abut Kebudi, N. Zafer Canturk, Yesim Erbil, Rumen PANDEV, Bahadir M. Gulluoglu
Balkan Medical Journal, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Wos, 2017, cilt 34, ss 28-34
DOI: 10.4274/balkanmedj.2015.0865
Özet
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 multi-centric 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 the clinicopathological features of patients with pHPT.