Incident comorbidities in patients with chronic hypoparathyroidism after thyroidectomy: a multicenter nationwide study.

Journal: Frontiers in endocrinology

Volume: 15

Issue: 

Year of Publication: 2024

Affiliated Institutions:  Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Majadahonda, Spain. Department of Endocrinology, Hospital Universitario de Navarra, Pamplona, Spain. Department of Endocrinology, Complejo Asistencial Universitario de León, León, Spain. Department of Endocrinology, Hospital Universitario de Basurto, Universidad del País Vasco (UPV/EHU), Bilbao, Spain. Department of Endocrinology, Hospital Severo Ochoa, Leganés, Spain. Department of Endocrinology, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain. Department of Endocrinology and Nutrition, Hospital Clínic, Barcelona, Spain. Department of Endocrinology, Hospital Universitario Virgen del Rocío, Sevilla, Spain. Department of Endocrinology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. Department of Endocrinology, Hospital Universitario de Canarias, Tenerife, Spain. Department of Endocrinology, Hospital Universitario Reina Sofía, Córdoba, Spain. Department of Endocrinology, Hospital Universitario de Cruces, Bilbao, Spain. Department of Endocrinology, Hospital Universitario de Burgos, Burgos, Spain. Department of Endocrinology, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga, Universidad de Málaga, Málaga, Spain. Department of Endocrinology, Hospital Universitario Virgen Macarena, Sevilla, Spain. Department of Endocrinology, Hospital Universitario de Toledo, Toledo, Spain.

Abstract summary 

Population-based and registry studies have shown that chronic hypoparathyroidism is accompanied by long-term complications. We aimed to evaluate the risk of incident comorbidity among patients with chronic postsurgical hypoparathyroidism in real-life clinical practice in Spain.We performed a multicenter, retrospective cohort study including patients with chronic postsurgical hypoparathyroidism lasting ≥3 years with at least a follow-up visit between January 1, 2022 and September 15, 2023 (group H). The prevalence and incidence of chronic complications including chronic kidney disease, nephrolithiasis/nephrocalcinosis, hypertension, dyslipidemia, diabetes, cardiovascular disease, central nervous system disease, mental health disorders, eye disorders, bone mineral density alterations, fracture and cancer were evaluated. Patient data were compared with a group of patients who did not develop hypoparathyroidism, matched by gender, age, and follow-up time after thyroidectomy (group NH).We included 337 patients in group H (median [IQR] age, 45 [36-56] years; median time of follow-up, 8.9 [6.0-13.0] years; women, 84.3%) and 669 in group NH (median age, 47 [37-55] years; median time of follow-up, 8.0 [5.3-12.0] years; women, 84.9%). No significant differences were found in the prevalence of comorbidities at the time of thyroidectomy between both groups. In multivariable adjusted analysis, patients with chronic hypoparathyroidism had significantly higher risk of incident chronic kidney disease (OR, 3.45; 95% CI, 1.72-6.91; P<0.001), nephrolithiasis (OR, 3.34; 95% CI, 1.55-7.22; P=0.002), and cardiovascular disease (OR, 2.03; 95% CI, 1.14-3.60; P=0.016), compared with patients without hypoparathyroidism. On the contrary, the risk of fracture was decreased in patients with hypoparathyroidism (OR, 0.09; 95% CI, 0.01-0.70; P=0.021).This study demonstrates that, in the clinical practice of Spanish endocrinologists, a significant increase in the risk of chronic kidney disease, nephrolithiasis and cardiovascular disease, as well as a reduction in the risk of fractures is detected. These results are of interest for the development of new clinical guidelines and monitoring protocols for patients with hypoparathyroidism.

Authors & Co-authors:  Díez Anda Pérez-Corral Paja Alcázar Sánchez-Ragnarsson Orois Romero-Lluch Sambo Oleaga Caballero Alhambra Urquijo Delgado-Lucio Fernández-García Kishore-Doulatram Dueñas-Disotuar Martín Peinado Sastre

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Mannstadt M, Bilezikian JP, Thakker RV, Hannan FM, Clarke BL, Rejnmark L, et al. . Hypoparathyroidism. Nat Rev Dis Primers (2017) 3:17080. doi: 10.1038/nrdp.2017.80
Authors :  20
Identifiers
Doi : 1348971
SSN : 1664-2392
Study Population
Female
Mesh Terms
Female
Other Terms
comorbidity;incidence;postsurgical hypoparathyroidism;prevalence;thyroidectomy
Study Design
Cohort Study
Study Approach
Country of Study
Publication Country
Switzerland