Endocrine Abstracts

Introduction: Reduced health-related quality of life (HRQoL) is common in patients with hypoparathyroidism (HypoPT) treated conventionally with calcium and active vitamin D supplements.

Aim: we studied the HRQoL in patients with chronic HypoPT estimated with the 36-Item Short-Form Health Survey (SF-36) and multidimensional fatigue inventory (MFI-20).

Methods: 64 patients with chronic HypoPT (women/men – 57/7, median age 47[36;59] years) participated in the study. The median duration of the disease was 4 years [3;9]. SF-36 is a 36-item QOL questionnaire with response alternative scores 1–6 for each item. A scoring algorithm transforms the raw score to a score from 0 to 100, where a high score indicates better HRQoL. MFI-20 has an even proportion of positively and negatively worded items that are rated on a 5-point Likert scale. Subscale scores are calculated as the sum of item ratings and a total fatigue score – as the sum of subscale scores. Higher scores indicate a higher level of fatigue.

Results: we didn’t find any associations between the SF-36 and MFI-20 scores of and serum calcium levels. However, HypoPT patients with magnesium (Mg) level under 0,7 mmol/l had significantly higher SF-36 scores such as PF (P=0.0131); BP (P=0.0034); RE (P=0.0376); PH (P=0.0042). We found a negative correlation between the number of tablets and SF-36 PF score (P=0.0133; r=−0.31). Median of tablets’ number in patients with Mg<0.7 mmol/l is 6[5;10] vs median of tablets’ number 7[5;10] in patients with Mg≥0.7 mmol/l. But the difference isn’t significant. Duration of HypoPT had a positive correlation with SF-36 scores VT(P=0.0083; r=0.33), MH(P=0.2594; r=0.04) and negative correlations with some MFI-20 scores – general fatigue (P=0.015; r=−0.31), reduced activity (P=0.0336; r=−0.27) and reduced motivation (P=0.0088; r=−0.33). These results may be related to the phenomenon of adaptation to chronic diseases such as HypoPT. In general, the presence of HypoPT complications had a positive correlation with SF-36 scores VT(P=0.0496; r=0.25), SF(P=0.0013; r=0.39) and negative correlation with reduced activity (P=0.0204; r=−0.29). These results also can be explained by better examination and thus better awareness in patients with chronic HypoPT, especially if they already have at least one complication.

Conclusion: further studies with better instruments for assessing HRQoL are required. Patients with HypoPT often can use a lot of medications and should follow the strict rules of their taking, which can significantly affect the HRQoL. Of course, doctors want to improve all mineral disturbances, but therapy should be personalized and clearly discussed with the patients.