Population-based screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in menopausal women.

摘要: Abstract Background. Population-based screenings for primary hyperparathyroidism have failed to systematically use intact parathyroid hormone (PTH) values diagnosis, explore prevalence and diagnostic criteria of normocalcemic hyperparathyroidism, attempt surgical verification the disorder. Methods. A total 5202 women (ages, 55 75 years) attending a population-based mammography screening were investigated hyperparathyroidism. In lacking family history hypercalcemia, significant renal impairment, or low urinary calcium excretion was diagnosed on basis predetermined encompassing lower serum PTH levels in hypercalcemia (serum 25 ng/L greater; reference range, 12 ng/L) than two intervals normocalcemia 35 greater, greater ng/L). Results. Prevalence 2.1% (n = 109). At diagnosis 2.32 3.19 mmol/L 34 300 ng/L, respectively, 66% exhibited normocalcemia. Repeated examination showed persistent 30 patients, all but them had normal ionized plasma levels. Significantly higher calcium, PTH, urine calcium—but not creatinine—levels found patients with compared matched control subjects from screened population. Within an ongoing stratified treatment program, 59 60 who underwent operation pathologic tissue (mean weight, 591 mg). Conclusions. Substantial sporadic is demonstrated risk group. Although recognition included truly mild biochemical derangement, operative findings suggested underdiagnosis