Hyperparathyroidism in men – morbidity and mortality during 21 years’ follow-up

Figures & data

Figure 1. Flowchart of 798 men included in the study on men born in 1943. S-PTH: serum parathyroid hormone (reference range 1.6 – 6.9 pmol/L); S-Ca: albumin-adjusted serum calcium (reference range 2.15 – 2.49 mmol/L); S-25(OH)D: serum 25-hydroxyvitamin D (sufficiency limit ≥ 50 nmol/L); nHPT: normocalcaemic hyperparathyroidism; pHPT: primary hyperparathyroidism; sHPT: secondary hyperparathyroidism (to hypocalcaemia).

Figure 2. Simple linear regression between albumin-adjusted serum calcium (S-Ca) and serum parathyroid hormone (S-PTH) in a random population sample of 750 men aged 50 years. The circles with cross represent individuals with vitamin D sufficiency (S-25(OH)D ≥ 50 nmol/L).

Table 1. Baseline characteristics in men aged 50 years examined in 1993 with hyperparathyroidism (HPT) (n = 70) in comparison with men with normal S-PTH independent of S-Ca or S-25(OH)D level (n = 680).

Year 1993	HPT (mean ± SD)	Normal PTH (mean ±SD)	p Value
N	70	680
Height, m	1.79 ± 0.07	1.78 ± 0.07	.82
Weight, kg	87.5 ± 10.9	83.1 ± 12.0	.002
Waist, cm	98.5 ± 9.8	94.8 ± 9.3	.004
BMI, kg/m^2	27.5 ± 3.6	26.1 ± 3.4	.003
S-Ca, mmol/L	2.29 ± 0.11	2.30 ± 0.08	.449
S-25(OH)D, nmol/L	42.5 ± 18.1	50.0 ± 18.2	.002
S-PTH, pmol/L	8.22 ± 1.02	4.55 ± 1.03	<.001
S-Creatinine, μmol/L	91.4 ± 9.7	91 ± 10	.760
S-Albumin, g/L	45.5 ± 3.0	45.0 ± 2.8	.284
S-LDL, mmol/L	3.9 ± 0.8	3.8 ± 0.9	.660
S-Cholesterol, mmol/L	6.0 ± 1.0	5.9 ± 1.0	.386
S-Triglycerides, mmol/L	1.9 ± 1.2	1.7 ± 1.1	.094
S-HDL, mmol/L	1.3 ± 0.4	1.3 ± 0.3	.896
FP-Glucose, mmol/L	5.1 ± 1.8	4.7 ± 1.4	.042
Antihypertensive treatment, n (%)	1 (1)	60 (9)	.035
Diabetes, n (%)	4 (6)	12 (2)	.054
Daily smoker, n (%)	6 (9)	214 (32)	<.001
Previous smoker, n (%)	37 (53)	243 (36)	.006
End points in 2014
Any fracture, n (%)	4 (6)	42 (6)	1.00
Myocardial infarction, n (%)	7 (10)	35 (5)	.10
Stroke, n (%)	6 (9)	35 (5)	.26
Cancer, n (%)	13 (19)	152 (22)	.55
Deceased, n (%)	10 (14)	99 (14)	1.00

Data on morbidity and mortality after 21 years are presented.

S-Ca: albumin-adjusted serum calcium (reference range 2.15–2.49 mmol/L); S-PTH: serum parathyroid hormone (reference range 1.6 – 6.9 pmol/L); S-25(OH)D: serum 25-hydroxyvitamin D (vitamin D sufficiency ≥ 50 nmol/L); FP: fasting plasma; LDL: low-density lipoprotein; HDL: high-density lipoprotein.

Table 2. Baseline characteristics in men aged 50 years examined in 1993 with normocalcaemic, vitamin D sufficient hyperparathyroidism (nHPT) (n = 21) and men with normal S-Ca, sufficient S-25(OH)D levels and normal S-PTH (n = 312).

Year 1993	nHPT (mean ± SD)	Normal S-PTH, S-Ca and S-25(OH)D (mean ± SD)	p Value
N	n = 21	n = 312
Height, m	1.80 ± 0.06	1.79 ± 0.07	.350
Weight, kg	83.2 ± 11.2	82.8 ± 10.7	.879
Waist, cm	94.1 ± 10.1	94.1 ± 8.4	.996
BMI, kg/m^2	25.7 ± 3.4	25.9 ± 2.9	.771
S-Ca, mmol/L	2.26 ± 0.07	2.30 ± 0.07	.025
S-25(OH)D, nmol/L	63.1 ± 10.4	64.4 ± 14.2	.596
S-PTH, pmol/L	8.04 ± 0.88	4.41 ± 0.97	<.001
S-Creatinine, μmol/L	89.9 ± 10.4	90.8 ± 10.7	.690
S-Albumin, g/L	45.4 ± 2.7	45.0 ± 2.6	.500
S-LDL, mmol/L	3.8 ± 0.9	3.8 ± 0.9	.960
S-Cholesterol, mmol/L	5.7 ± 1.0	5.8 ± 1.0	.580
S-Triglycerides, mmol/L	1.5 ± 0.5	1.4 ± 0.9	.558
S-HDL, mmol/L	1.4 ± 0.6	1.4 ± 0.3	.900
FP-Glucose, mmol/L	4.3 ± 0.4	4.5 ± 0.6	.063
Antihypertensive treatment, n (%)	0 (0)	21 (7)	.381
Diabetes, n (%)	0 (0)	3 (1)	1.000
Daily smoker, n (%)	1 (5)	86 (28)	.020
Previous smoker, n (%)	11 (55)	111 (36)	.160
End points in 2014
Any fracture, n (%)	1 (5)	20 (6)	1.00
Myocardial infarction, n (%)	0 (0)	21 (7)	.38
Stroke, n (%)	3 (14)	16 (5)	.11
Cancer, n (%)	2 (10)	71 (23)	.18
Deceased, n (%)	1 (5)	35 (11)	.71

Data on morbidity and mortality after 21 years are presented.

S-Ca: albumin-adjusted serum calcium (reference range 2.15–2.49 mmol/L); S-PTH: serum parathyroid hormone (reference range 1.6 – 6.9 pmol/L); S-25(OH)D: serum 25-hydroxyvitamin D (vitamin D sufficiency ≥ 50 nmol/L); FP: fasting plasma; LDL: low-density lipoprotein; HDL: high density lipoprotein.

Figure 3. Univariable analyses by steps of serum parathyroid hormone (S-PTH) and incidence of (a) fractures, (b) cancer, and (c) death during 21 years´ follow-up in 750 men aged 50 years at start.