The Prevalence And Clinical Characteristics Of Primary Hyperparathyroidism In Elderly Persons

Objective: To study the prevalence of hypercalcemia and primary hyperparathyroidism in middle-aged and elderly Chinese people, to investigate its clinical features and relation to the prevalence of other metabolic disorders, such as diabetes and hyperlipidemia. Methods: This research was performed in a large elderly group who came to our hospital to do health checkup. All subjects" disease histories were collected. Their blood pressure, calcium, phosphorus, creatine, as well as fasting and postprandial blood glucose were measured. Serum PTH concentration was determined in the 83 patients whose blood calcium was not less than 2.6mmol/L, while for those whose calcium was more than 2.7mmol/L and PTH level more than 50pg/ml, ultrasonography of the neck region was performed. Meanwhile, another 83 individuals were randomly chosen from those whose calcium was lower than 2.6mmo/L to investigate PTH and ALP levels as controls. Results: There are 2451 person who were under investigation, 2031 were male, 420 were female. 566 out of the total were under 60 years old. 13 out of the total 2451 people were found to have calcium level not less than 2.7mmol/L (0.57%). 83 out of the total 2451 people under investigation (3.39%) were found to have calcium level not less than 2.6mmol/L, including 5 patients with PTH>65pg/ml but without secondary factors of elevated PTH (4 had a calcium concentration between 2.7mmol/L and 1 between 2.6mmol/L and 2.7mmol/L). These patients were thought to have primary hyperparathyroidism, and the prevalence was 0.204%. Three patients out of the above five had positive findings with ultrasonography of parathyroid, but without bone pain, fracture, polydipsia or polyuria except for one with renal calculus. Compared to the controls, the prevalence of T2DM and IGT was relatively higher and FBG and triglyceride levels were also higher in high calcium level group (P<0.05). Conclusions: Theprevalence of primary hyperparathyroidism was 0.204% in the investigated elderly persons, less than data collected from western countries. Hypercalcemia was highly associated with other metabolic diseases, such as diabetes and hyperlipidemia. An overall evaluation and appropriate treatments should be given to those with hyperparathyroidism as early as possible.