A comparative analysis of osteoporosis, nephrolithiasis, and metabolic/cardiovascular comorbidities in normocalcemic and mild primary hyperparathyroidism.

INTRODUCTION

Normocalcemic primary hyperparathyroidism (NPHPT) is thought to be an early form of hypercalcemic primary hyperparathyroidism (PHPT). However, some studies have shown that the adverse effects on bone and kidney health are similar in both conditions.

MATERIALS AND

METHODS

This is a nationwide, multicentre, retrospective study. Data from centres, including 404 patients with NPHPT and 723 patients with mild PHPT from different regions of Turkey, were included in this study. All laboratory parameters, dual-energy X-ray absorptiometry, and renal ultrasounds were performed locally at each centre. The prevalence of adverse bone and kidney outcomes and metabolic and cardiovascular comorbidities were the main outcome measures.

RESULTS

Patients with NPHPT had lower calcium and PTH levels. Skeletal outcomes revealed 29% osteoporosis and 42% osteopenia, while the prevalence of nephrolithiasis was 12.4%, which is similar to that observed in patients with mild PHPT. Hypertension was more prevalent in patients with mild PHPT than in those with NPHPT (44.4% vs. 34.9%, p = 0.002), as was diabetes mellitus (27.9% vs. 13.2%, p < 0.001). The prevalence of cardiovascular disease was similar (11.5% vs. 9.5%, p = 0.306).

CONCLUSION

Patients with NPHPT experience significant skeletal complications and nephrolithiasis but have lower rates of hypertension and diabetes.