Incidence and Prevalence of Primary Hyperparathyroidism in a Racially Mixed Population
Incidence and Prevalence of Primary Hyperparathyroidism in a Racially Mixed Population
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DOI：
10.1210/jc.2012-4022
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发表时间：
2013-03-01
影响因子：
5.8
通讯作者：
Adams, Annette L.
中科院分区：
文献类型：
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作者：
Yeh, Michael W.;Ituarte, Philip H. G.;Adams, Annette L.
背景：高加索人群中的原发性甲状旁腺功能亢进症(PHPT)的流行病学研究。目的：调查种族混合人群中PHPT的发病率和患病率。设计：进行描述性流行病学研究。患者/地点：研究人群包括南加州凯撒永久医院的350万名登记患者。方法：纳入1995年至2010年间血清钙水平至少升高一次的所有患者(>；10.5 mg/dL，2.6 mmol/L)。排除继发性甲状旁腺功能亢进症、肾脏甲状旁腺功能亢进症和三级甲状旁腺功能亢进症的病例后，通过生化指标对实验室数据进行电子查询来确定PHPT病例。根据性别、种族、年龄组和年份计算PHPT的发病率和患病率。结果：初步病例发现有15,234名慢性高钙血症患者，其中13,327人(87%)患有PHPT，其定义为甲状旁腺激素水平升高或异常正常。女性的PHPT发病率为每10万人年34至120人(平均66人)，男性为13至36人(平均25人)。随着年龄的增长，发病率增加，性别差异明显(50岁以下男女发病率为12-24/10万；50-59岁男女发病率分别为80/10万和36/10万；70-79岁男女发病率分别为196/10万和95/10万)。黑人的PHPT发病率最高(92名女性，46名男性，P<；.0001)，其次是白人(81名女性，29名男性)，亚洲人(52名女性，28名男性)、西班牙裔(49名女性，17名男性)和其他种族(25名女性，6名男性)的发病率低于白人(P<；.0001)。在研究期间，PHPT的患病率增加了两倍，从每10万名妇女中的76人增加到233人，从每10万人中的30人增加到85人。患病率的种族差异反映了发病率的差异。结论：PHPT是高钙血症的主要原因，并日益流行。不同种族之间PHPT的发病率和患病率有很大差异。(临床内分泌代谢酶98：1122-1129,2013)
Context: The epidemiology of primary hyperparathyroidism (PHPT) has generally been studied in Caucasian populations.Objective: The aim was to examine the incidence and prevalence of PHPT within a racially mixed population.Design: A descriptive epidemiologic study was performed.Patients/Setting: The study population included 3.5 million enrollees within Kaiser Permanente Southern California.Methods: All patients with at least one elevated serum calcium level (> 10.5 mg/dL, 2.6 mmol/L) between 1995 and 2010 were included. Cases of PHPT were identified by electronic query of laboratory values using biochemical criteria, after exclusion of secondary or renal and tertiary hyperparathyroidism cases. The incidence and prevalence rates of PHPT were calculated according to sex, race, age group by decade, and year.Results: Initial case finding identified 15,234 patients with chronic hypercalcemia, 13,327 (87%) of which had PHPT as defined by elevated or inappropriately normal parathyroid hormone levels. The incidence of PHPT fluctuated from 34 to 120 per 100 000 person-years (mean 66) among women, and from 13 to 36 (mean 25) among men. With advancing age, incidence increased and sex differences became pronounced (incidence 12-24 per 100 000 for both sexes younger than 50 y; 80 and 36 per 100 000 for women and men aged 50-59 y, respectively; and 196 and 95 for women and men aged 70-79 y, respectively). The incidence of PHPT was highest among blacks (92 women; 46 men, P < .0001), followed by whites (81 women; 29 men), with rates for Asians (52 women, 28 men), Hispanics (49 women, 17 men), and other races (25 women, 6 men) being lower than that for whites (P < .0001). The prevalence of PHPT tripled during the study period, increasing from 76 to 233 per 100 000 women and from 30 to 85 per 100 000 men. Racial differences in prevalence mirrored those found in incidence.Conclusions: PHPT is the predominant cause of hypercalcemia and is increasingly prevalent. Substantial differences are found in the incidence and prevalence of PHPT between races. (J Clin Endocrinol Metab 98: 1122-1129, 2013)