Warning: fopen(/home/virtual/enm-kes/journal/upload/ip_log/ip_log_2025-06.txt): failed to open stream: Permission denied in /home/virtual/lib/view_data.php on line 100 Warning: fwrite() expects parameter 1 to be resource, boolean given in /home/virtual/lib/view_data.php on line 101
1Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
2Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA
Copyright © 2021 Korean Endocrine Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST
No potential conflict of interest relevant to this article was reported.
Total calcium | Albumin-adjusted calcium | Albumin-adjusted and ionized calcium | Total calcium and ionized calcium | |
---|---|---|---|---|
Osteoporosis, fractures, or bone loss | Amaral et al. [20] (15%) | Tordjman et al. [22] (38%) | Palermo et al. [30] (28%) | Maruani et al. [21] (18%) |
Cakir et al. [28] (47%) | Lowe et al. [24] (57%) | Silverberg et al. [23] (45%) | Wade et al. [25] (25%) | |
Siprova et al. [29] (42%) | Koumakis et al. [26] (92%) | |||
Marques et al. [27] (36%) | ||||
|
||||
Nephrolithiasis | Amaral et al. [20] (18%) | Tordjman et al. [22] (9%) | Palermo et al. [30] (13%) | Maruani et al. [21] (35%) |
Siprova et al. [29] (4%) | Lowe et al. [24] (14%) | Silverberg et al. [23] (14%) | Wade et al. [25] (25%) | |
Marques et al. [27] (29%) | Koumakis et al. [26] (18%) | |||
Lemos et al. [31] (20%) |
Total calcium | Albumin-adjusted calcium | Albumin-adjusted and ionized calcium | Total calcium and ionized calcium | |
---|---|---|---|---|
Osteoporosis, fractures, or bone loss | Amaral et al. [20] (15%) | Tordjman et al. [22] (38%) | Palermo et al. [30] (28%) | Maruani et al. [21] (18%) |
Cakir et al. [28] (47%) | Lowe et al. [24] (57%) | Silverberg et al. [23] (45%) | Wade et al. [25] (25%) | |
Siprova et al. [29] (42%) | Koumakis et al. [26] (92%) | |||
Marques et al. [27] (36%) | ||||
| ||||
Nephrolithiasis | Amaral et al. [20] (18%) | Tordjman et al. [22] (9%) | Palermo et al. [30] (13%) | Maruani et al. [21] (35%) |
Siprova et al. [29] (4%) | Lowe et al. [24] (14%) | Silverberg et al. [23] (14%) | Wade et al. [25] (25%) | |
Marques et al. [27] (29%) | Koumakis et al. [26] (18%) | |||
Lemos et al. [31] (20%) |
Explanation | |
---|---|
Hypertension | PTH1R receptors on vascular cells may increase vascular tone, and, therefore resistance, leading to increased arterial blood pressure. |
Aldosterone excess | PTH levels correlate with aldosterone levels, with direct PTH stimulation of the adrenal glands. |
Cardiovascular morbidity | Increased PTH levels have been associated with cardiovascular comorbidities. However, parathyroidectomy has not yet been shown to reduce cardiovascular comorbidity. |
Hyperglycemia | Increased PTH levels have been associated with insulin resistance and hyperglycemia. Parathyroidectomy has not yet been shown to improve HbA1c, but may improve blood glucose levels. |
Quality of life (QoL) | Quality of life may be reduced in NHPT. Serum calcium levels may directly affect QoL, because surgery improves a number of domains of QoL if patients have preexisting mild hypercalcemia due to PHPT, compared to patients with normal serum calcium due to NHPT. |
Muscle function | Muscle strength and function are impaired in patients with NHPT compared to healthy controls. |
Immune function and gut microbiota | Immune function and gut microbiota may play a role in PHPT and NHPT as they may affect the severity of bone complications. This requires further investigation. |
NHPT, normocalcemic primary hyperparathyroidism; PTH1R, parathyroid hormone 1 receptor; PTH, parathyroid hormone; HbA1c, glycated hemoglobin; PHPT, primary hyperparathyroidism.