Hypoparathyroidism Associated With Chronic Health Conditions, Increased Mortality

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Due to risk for complications, patients with hypoparathyroidism with persistent hypocalcemia should be referred to a specialist who can fully evaluate them for better long‐term care.
Due to risk for complications, patients with hypoparathyroidism with persistent hypocalcemia should be referred to a specialist who can fully evaluate them for better long‐term care.

Patients with hypoparathyroidism have an increased risk for several health conditions including cataracts, epilepsy, cardiovascular disease, cerebrovascular disease, infection, mental illness, and renal failure, according to study results published in Clinical Endocrinology.

Morbidities associated with hypoparathyroidism are generally related to low calcium or raised phosphate concentrations or are an indirect effect of treatment. In this study, researchers investigated whether patients with chronic hypoparathyroidism had a higher risk for other chronic conditions or death. The cohort included 280 patients from regional datasets who were identified as having chronic hypoparathyroidism. Patients were subcategorized into surgical or nonsurgical hypoparathyroidism groups and then matched with controls from the general population.

At baseline, a significantly higher percentage of patients with hypoparathyroidism had pre‐existing infections (P <.001), cardiovascular disease (P =.001), fractures (P =.004), mental health conditions (P <.001), and renal failure (P <.001) compared with the control group. Chronic hypoparathyroidism was also associated with an increased risk of developing these conditions, as well as a higher risk for death. When all patients with a serum albumin <30 g/L, a marker of chronic poor heath, were excluded in a sensitivity analysis, the adjusted mortality rate remained significant (hazard ratio 1.44; 95% CI, 1.02‐2.02; P =.037). When divided into subcategories, the postsurgical group with hypoparathyroidism had a significantly increased risk for cataract and epilepsy compared with the controls. However, nonsurgical hypoparathyroidism was also associated with increased mortality and additional morbidities compared with the reference group.

The researchers noted that limitations of the study included a small cohort due to the rarity of the condition, which may restrict the power of some end points. In addition, the study did not include data on cancer outcomes or fractures, which may occur more frequently in parathyroid disease

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“Some complications [in hypoparathyroidism] may be related to chronic [hypocalcemia], while others may relate to relative overtreatment and chronic [hypercalcemia]. All patients with persistent [hypocalcemia] should get referred to a specialist clinic where they should be fully evaluated and may get better long‐term care, and hopefully improved outcomes,” concluded the researchers.

Funding for this study was provided by Shire. Please see original source for further information about disclosures.

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Reference

Vadiveloo T, Donnan PT, Leese CJ, Abraham KJ, Leese GP. Increased mortality and morbidity in patients with chronic hypoparathyroidism: a population-based study. Clin Endocrinol (Oxf). 2018;00:1-8.

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