Chronic autoimmune atrophic gastritis associated with primary hyperparathyroidism: a transversal prospective study
Chronic autoimmune atrophic gastritis associated with primary hyperparathyroidism: a transversal prospective study
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DOI：
10.1530/eje-12-1067
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发表时间：
2013-05-01
影响因子：
5.8
通讯作者：
Peracchi, Maddalena
中科院分区：
文献类型：
--
作者：
Massironi, Sara;Cavalcoli, Federica;Peracchi, Maddalena
设计：慢性自身免疫性萎缩性胃炎（CAAG）和原发性甲状旁腺功能亢进症（PHPT）的共存已被描述过，尽管其程度和潜在机制仍知之甚少。因此，我们前瞻性地评估了两组患者的这种相关性，一组患者患有CAAG，另一组患者患有散发性PHPT。方法：从2005年1月至2012年3月，连续纳入107名经组织学证实的CAAG患者和149名PHPT患者。常规实验室检测包括血清钙、甲状旁腺激素 (PTH)、血浆胃泌素和嗜铬粒蛋白 A (CgA)。在具有高 PTH 水平的 CAAG 患者中，对离子钙和 25(OH)-维生素 D 进行了评估。所有 CAAG 和高胃泌素 PHPT 患者均接受了上消化道内窥镜检查。排除标准为家族性 PHPT、MEN1 综合征、质子泵抑制剂药物治疗、幽门螺杆菌感染和肾功能衰竭。 结果：107 例 CAAG 患者中，9 例（8.4%）患有 PHPT，13 例（12.1%）患有维生素 D 缺乏引起的继发性甲状旁腺功能亢进症。在 149 名 PHPT 患者中，11 名（7.4%）患有 CAAG。患有 CAAG 患者与未患甲状旁腺功能亢进症（无论是原发性还是继发性）的患者中胃泌素和 CgA 水平相似，患有 CAAG 的 PHPT 患者与未患有 CAAG 的患者中钙和 PTH 水平相似。结论：本研究证实 PHPT 与 CAAG 之间存在非因果关联。 CAAG 患者中 PHPT 的患病率是一般人群的三倍（8.4 vs 1-3%），PHPT 患者中 CAAG 的患病率是一般人群的四倍（7.4 vs 2%）。这种关联的机制尚不清楚，但表明自身免疫具有潜在作用。欧洲内分泌学杂志 168 755-761
Design: The coexistence of chronic autoimmune atrophic gastritis (CAAG) and primary hyperparathyroidism (PHPT) has been described previously, even if its extent and underlying mechanisms remain poorly understood. We therefore prospectively evaluated this association in two series of patients, one with CAAG and the other with sporadic PHPT.Methods: From January 2005 to March 2012, 107 histologically confirmed CAAG patients and 149 PHPT patients were consecutively enrolled. Routine laboratory assays included serum calcium, parathyroid hormone (PTH), plasma gastrin and chromogranin A (CgA). In CAAG patients with high PTH levels, ionized calcium and 25(OH)-vitamin D were evaluated. All CAAG and hypergastrinemic PHPT patients received an upper gastrointestinal endoscopy. Exclusion criteria were familial PHPT, MEN1 syndrome, treatment with proton pump inhibitor drugs, Helicobacter pylori infection and renal failure.Results: Of the 107 CAAG patients, nine (8.4%) had PHPT and 13 (12.1%) had secondary hyperparathyroidism stemming from vitamin D deficiency. Among the 149 PHPT patients, 11 (7.4%) had CAAG. Gastrin and CgA levels were similar in the CAAG patients with vs those without hyperparathyroidism (either primary or secondary), and calcium and PTH levels were similar in the PHPT patients with vs those without CAAG.Conclusions: This study confirms a non-casual association between PHPT and CAAG. The prevalence of PHPT in CAAG patients is threefold that of the general population (8.4 vs 1-3%), and the prevalence of CAAG in PHPT patients is fourfold that of the general population (7.4 vs 2%). The mechanisms underlying this association remain unknown, but a potential role for autoimmunity is suggested. European Journal of Endocrinology 168 755-761