Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2021) 73 AEP91 | DOI: 10.1530/endoabs.73.AEP91

ECE2021 Audio Eposter Presentations Calcium and Bone (75 abstracts)

Primary hyperparathyroidism: Differences in presentation between older and younger patients

Katarina Mlekus Kozamernik1, 2, Mojca Jensterle1, 2, Luka Ležaic´1, 3, Marko Hocˇevar1, 4, Soncka Jazbinsek1, Katarina Remec1, Andrej Janez1, 2 & Tomaž Kocjan1, 2


1University of Ljubljana, Medical faculty, Ljubljana, Slovenia; 2University Medical Centre Ljubljana, Department of Endocrinology, Diabetes and Metabolic Diseases, Ljubljana, Slovenia; 3University Medical Centre Ljubljana, Department for Nuclear Medicine, Ljubljana, Slovenia; 4Institute of Oncology Ljubljana, Department of Surgical Oncology, Ljubljana, Slovenia


Introduction

The incidence of primary hyperparathyroidism (PHPT) increases with age; however, the clinical presentation might change with aging. We aimed to compare the clinical presentation of older and younger patients with PHPT.

Methods

We retrospectively analyzed the biochemical status, renal involvement, and bone mineral density (BMD) of patients who were diagnosed with PHPT at our endocrine clinic from 2004 to 2016. Patients over 65 years of age were compared to younger patients.

Results

We included 426 adult patients (339 women and 87 men) with PHPT. There were 231 patients over 65 years with a mean age of 73.4 (SD 5.3) years and 195 younger patients with a mean age of 52.2 (10.0) years. Gender distribution was similar with 49 (21.2%) males in older group and 38 (19.5%) males in younger group (P = 0.66). Older patients had biochemically less florid disease at presentation with a lower mean serum calcium: 2.72 (0.25) mmol/l vs. 2.79 (0.29) mmol/l; P = 0.01, lower urinary calcium: 5.18 (4.0) mmol vs. 8.39 (4.6) mmol; P < 0.01 and higher phosphate: 0.84 (0.15) mmol/l vs.0.8 (0.18) mmol/l; P = 0.02, but also higher creatinine: 83.56 (31.92) µmol/l vs. 72.23 (26.32) µmol/l; P < 0.01, lower estimated glomerular filtration rate: 68.4 (18.1) ml/min vs. 79.4 (14.5) ml/min; P < 0.01 and lower 25-OH vitamin D levels: 39.63 (22.41) nmol/l vs. 43.92 (21.53) nmol/l; P = 0.02. PTH and alkaline phosphatase levels did not differ between groups. Fewer older patients had nephrolithiasis and/or nephrocalcinosis than younger patients (56 out of 231 or 24.2% vs. 78 out of 195 or 40%; P < 0.01). BMD was significantly lower in older patients than in younger patients at the total hip (0.786 (0.157) g/cm2 vs. 0.876 (0.150) g/cm2; P < 0.01), femoral neck (0.640 (0.113) g/cm2 vs. 0.717 (0.125) g/cm2; P < 0.01) and at one-third distal radius (0.564 (0.108) g/cm2 vs. 0.625 (0.100) g/cm2; P < 0.01). There were no differences in BMD at the lumbar spine. Finally, 139 out of 231 older patients (60.2%) were diagnosed with osteoporosis, which was found in only 71 out of 195 younger patients (36.4%; P < 0.01).

Conclusion

Based on our study, patients with PHPT who are older than 65 years present with biochemically less florid disease and less nephrolithiasis/nephrocalcinosis, but with more severe bone impairment than younger patients.

Volume 73

European Congress of Endocrinology 2021

Online
22 May 2021 - 26 May 2021

European Society of Endocrinology 

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