title: Postsurgical hypoparathyroidism--risk of fractures, psychiatric diseases, cancer, cataract, and infections.
abstract: Data on co-morbidity in patients with postsurgical hypoparathyroidism (HypoPT) are sparse. We aimed to assess risk of fractures, spinal stenosis, cataract, neuropsychiatric diseases, cancer, and infections within the historic cohort of patients with postsurgical HypoPT due to non-malignant causes that we previously have characterized. Patients were identified through the Danish National Patient Registry and regional prescription databases, with subsequent validation of their individual hospital records. Identified cases were matched with three age- (± 2 yr) and gender-matched controls from the general background population. Compared with controls, patients did not have an increased risk of cataract (p = 0.52), spinal stenosis (p = 0.59), or any fracture (p = 0.98). However, the risk of fractures at the upper extremities was significantly decreased in patients (HR 0.69, 95% CI 0.49-0.97). Compared with controls, patients had a significantly increased risk of hospitalization due to infections (HR 1.42, 95% CI 1.20-1.67) and depression/bipolar affective disorders (HR 1.99, 95% CI 1.14-3.46). The risk of malignant diseases did not differ between groups although the risk of gastrointestinal cancers was significantly lower in patients compared with controls (HR 0.63, 95% CI 0.44-0.93). In conclusion, HypoPT is associated with an increased risk of depression and other types of neuropsychiatric diseases as well as infections, whereas patients seem to be protected against fractures at the upper extremities and gastrointestinal malignancies.
authors.affiliation: Department of Endocrinology and Internal Medicine, THG, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Line
authors.initials: L
authors.lastname: Underbjerg
authors.forename: Tanja
authors.initials: T
authors.lastname: Sikjaer
authors.forename: Leif
authors.initials: L
authors.lastname: Mosekilde
authors.forename: Lars
authors.initials: L
authors.lastname: Rejnmark
mesh_terms: D002386:Cataract / Q000453:epidemiology* / Q000209:etiology; D003718:Denmark / Q000453:epidemiology; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007011:Hypoparathyroidism / Q000453:epidemiology* / Q000209:etiology; D007239:Infections / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D009333:Neck / Q000601:surgery; D009369:Neoplasms / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012042:Registries; D012307:Risk Factors
keywords: EPIDEMIOLOGY; OTHER THERAPEUTICS; PARATHYROID-RELATED DISORDERS