Disturbances of calcium homeostasis consistent with mild primary hyperparathyroidism in premenopausal women and associated morbidity.
BACKGROUND
Primary hyperparathyroidism (PHPT) and associated morbidity are comprehensively assessed in elderly females; however, less is known of the disease in younger women.


OBJECTIVE
Our objectives were to estimate the prevalence of mild disturbances in calcium homeostasis, which could be analogous with early PHPT, in a premenopausal population, and determine the potential presence of associated morbidity.


METHODS
Initial results from this longitudinal study are from 2002-2004.


METHODS
We conducted a population-based screening of serum (s)-calcium in conjunction with routine mammography.


METHODS
Participants included premenopausal women, 40-50 yr of age (n = 1900). Cases fulfilling previously evaluated biochemical criteria for PHPT (n=214) were matched to controls (n = 214).


METHODS
All participants underwent investigation, including screening of parameters of calcium homeostasis, dual x-ray absorptiometry, and body mass index assessment, and filled out extensive health and quality of life (SF-36) questionnaires. Participants were divided into four groups depending on the relation between s-calcium/intact PTH. Statistical comparisons between cases and controls as well as among the four groups were performed to evaluate morbidity.


RESULTS
The prevalence of assumed mild PHPT, i.e. inappropriate intact PTH value in relation to total s-calcium, was estimated to be 5.1% (n = 96). Women with mild disturbances in calcium homeostasis had statistically significant lower bone mineral density in the proximal femur and femoral neck, higher body mass index, and lower scores for vitality and general health in the analysis of SF-36.


CONCLUSIONS
Mild disturbances in calcium homeostasis in premenopausal women were more prevalent than previously thought and were associated with obesity, lower bone mineral density, and decreased quality of life.
Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden. helene.siilin@bredband.net
Helene
H
Siilin
Jonas
J
Rastad
Osten
O
Ljunggren
Ewa
E
Lundgren
D015502:Absorptiometry, Photon; D000328:Adult; D001774:Blood Chemical Analysis; D015519:Bone Density / Q000502:physiology; D002118:Calcium / Q000097:blood*; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood*; D008137:Longitudinal Studies; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D017697:Premenopause / Q000097:blood; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D003404:Creatinine; D002118:Calcium