LITERATURE REVIEW

Endocrinology

doi: 10.25005/2074-0581-2024-26-2-294-307
EPIDEMIOLOGY OF PRIMARY HYPERPARATHYROIDISM

N.F. NIYAZOVA, S.B. TURSUNOVA

Department of Endocrinology, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

This paper reviews epidemiological data on primary hyperparathyroidism (PHPT). PHPT is an endocrine disease caused by a tumor or hyperplastic changes in the parathyroid glands (PTG); it leads to disturbances in calcium-phosphorus homeostasis and can cause organ dysfunction. The results of epidemiological studies in various countries indicate an "epidemic" of PHPT at the end of the 20th century. Currently, PHPT ranks as the third endocrine problem in the world. Its prevalence is about 0.86-1% in people under 50 and 2% in people over 50. It was found that PHPT occurs more often in people aged 40-60 years, with an increase in the frequency of its detection after 25 years of age, especially in women after menopause. The review emphasizes the importance of PHPT, which represents a severe medical and social problem. Regular screening and the introduction of modern diagnostic methods play a vital role in the timely detection and management of PHPT, which is of great importance for improving patients' quality of life and preventing severe complications.

When compiling the literature review, we used the following databases: PubMed, Embase, Medline, ScienceDirect, Cochrane Library, eLibrary, and CyberLeninka. The literature search was carried out using the following keywords: "epidemiology of primary hyperparathyroidism", "prevalence", "incidence", "normocalcemic hyperparathyroidism", "parathyroid gland", and "parathyroid hormone". The search identified more than 1070 scientific papers, from which 48 studies were selected. These studies cover the epidemiological aspects (incidence and prevalence) of PHPT conducted in various countries. The selection was done without considering each study's specific period and volume of observations. The selection process focused on studies using automated blood calcium analyzers to evaluate the impact of regular screening on the effectiveness of detecting PHPT. Works presenting both global and regional data were also included in the analysis. Studies that did not meet the established selection criteria were excluded.

Keywords: Primary hyperparathyroidism, parathyroid hormone, hypercalcemia, menopause, epidemiology.

Download file:


References
  1. Farkhutdinova LM. Pervichnyy giperparatireoz: sovremennye predstavleniya i klinicheskoe nablyudenie [Primary hyperparathyroidism: Modern concepts and clinical observation]. Arkhiv" vnutrenney meditsiny. 2020;10(2):94-101. https://doi.org/10.20514/2226-6704-2020-10-2-94-101
  2. Prokofyeva NA, Makarov IV, Galkin RA. Usovershenstvovanie diagnostiki pervichnogo giperparatireoza [Improvement in the diagnosis of primary hyperparathyroidism]. Tavricheskiy mediko-biologicheskiy vestnik. 2021;24(2):104-8. https://doi.org/10.37279/2070-8092-2021-24-2-104-108
  3. Ogorodnikov AV, Kharnas SS. Assessment of the quality of life of patients after parathyroidectomy from standard and small access. Probl Endokrinol. 2021;67(2):40-8. https://doi.org/10.14341/probl12735
  4. Mokrysheva NG, Eryomkina AK, Mirnaya SS, Krupinova YuA, Voronkova IA, Kim IV. Klinicheskie rekomendatsii po pervichnomu giperparatireozu, kratkaya versiya [Clinical guidelines for primary hyperparathyroidism, short version]. Problemy endokrinologii. 2021;67(4):94-124. https://doi.org/10.14341/probl12801
  5. Miller BS, Dimick J, Wainess R, Burney RE. Age- and sex-related incidence of surgically treated primary hyperparathyroidism. World J Surg. 2008;32(5):795- 9. https://doi.org/10.1007/s00268-007-9427-2
  6. Clarke BL, Asymptomatic primary hyperparathyroidism. Front Horm Res. 2019;51:13-22. https://doi.org/10.1159/000491035
  7. Mamedova EO, Mokrysheva NG, Rozhinskaya LYa. Osobennosti pervichnogo giperparatireoza u patsientov molodogo vozrasta [Features of primary hyperparathyroidism in young patients]. Problemy endokrinologii. 2018;64(3):163-9. https://doi.org/10.14341/probl9399
  8. Vetshev PS, Zhivotov VA, Ablitsov AYu, Drozhzhin AYu, Sudilovskaya VV. Sochetanie mnogouzlovogo toksicheskogo zoba i pervichnogo giperparatireoza s redkoy ektopiey paratireomy [Combination of multinodular toxic goiter and primary hyperparathyroidism with rare ectopic parathyroidoma]. Khirurgiya. 2020;1:89-93. https://doi.org/10.17116/hirurgia202001189
  9. Bibik EE, Eryomkina AK, Knyazeva OA, Mokrysheva NG. Sporadicheskiy pervichnyy giperparatireoz s mnozhestvennoy transformatsiey okoloshchitovidnykh zhelyoz [Sporadic primary hyperparathyroidism with multiple transformations of the parathyroid glands]. Problemy endokrinologii. 2021;67(6):31-8. https://doi.org/10.14341/probl12798
  10. Malov AA, Menkov AV, Zanozina OV. Diagnostika i lechenie manifestnogo pervichnogo giperparatireoza [Diagnosis and treatment of manifest primary hyperparathyroidism]. Meditsinskiy al'manakh. 2022;72(3):87-9.
  11. Baranova IA, Zykova TA. Normokal'tsiemicheskiy pervichnyy giperparatireoz – «novaya era» v diagnostike starogo zabolevaniya [Normocalcemic primary hyperparathyroidism – a “new era” in the diagnosis of an old disease]. Problemy endokrinologii. 2017;63(4):236-44. https://doi.org/10.14341/ probl2017634236-24
  12. Yanevskaya LG, Karonova TL, Sleptsov IV, Boriskova ME, Bakhtiyarova AR, Ivanova EV. Pervichnyy giperparatireoz: klinicheskie formy i ikh osobennosti. Rezul'taty retrospektivnogo issledovaniya [Primary hyperparathyroidism: Clinical forms and their features. Results of a retrospective study]. Klinicheskaya i eksperimental'naya tireodologiya. 2019;15(1):19-29. https://doi.org/10.14341/ ket10213
  13. Heath H 3rd, Hodgson SF, Kennedy MA. Primary hyperparathyroidism. Incidence, morbidity, and potential economic impact in a community. N Engl J Med. 1980;302:189-93
  14. Farkhutdinova LM. Pervichnyy giperparatireoz: puti resheniya problemy [Primary hyperparathyroidism: Ways to solve the problem]. Vestnik Akademii nauk Respubliki Bashkortostan. 2010;15(1):22-7.
  15. Melton LJ 3rd. The epidemiology of primary hyperparathyroidism in North America. J Bone Miner Res. 2002;17(Suppl 2):N12-N17.
  16. Griebeler ML, Kearns AE, Ryu E, Hathcock MA, Melton LJ 3rd, Wermers RA. Secular trends in the incidence of primary hyperparathyroidism over five decades (1965-2010). Bone. 2015;73:1-7. https://doi.org/10.1016/j.bone.2014.12.003
  17. Yeh MW, Ituarte PH, Zhou HC. Incidence and prevalence of primary hyperparathyroidism in a racially mixed population. J Clin Endocrinol Metab. 2013;98(3):1122-9. https://doi.org/ 10.1210/jc.2012-4022
  18. Wermers RA, Khosla S, Atkinson EJ, Achenbach SJ, Oberg AL, Grant CS, et al. Incidence of primary hyperparathyroidism in Rochester, Minnesota, 1993-2001: an update on the changing epidemiology of the disease. J Bone Miner Res. 2006;21(1):171-7. https://doi.org/10.1359/JBMR.050910
  19. Ohe MN, Santos RO, Barros ER. Changes in clinical and laboratory findings at the time of diagnosis of primary hyperparathyroidism in a University Hospital in Sao Paulo from 1985 to 2002. Braz J Med Biol Res. 2005;38(9):1383-7. https://doi.org/10.1590/s0100-879x2005000900013
  20. Eufrazino C, Veras A, Bandeira F. Epidemiology of primary hyperparathyroidism and its non-classical manifestations in the City of Recife, Brazil. Clin Med Insights Endocrinol Diabetes. 2013;6:69-74. https://doi.org/10.4137/CMED. S13147
  21. Blichert-Toft M, Mollerup CL, Feldt-Rasmussen UF, Daugaard H, Engel UH. Primaer hyperparatyreoidisme. En underdiagnosticeret sygdom i Danmark? [Primary hyperparathyroidism. An underdiagnosed disease in Denmark?]. Ugeskr Laeger. 1993;155(11):765-9.
  22. Abood A, Vestergaard P. Increasing incidence of primary hyperparathyroidism in Denmark. Dan Med J. 2013;60(2):A4567.
  23. Darba J, Marsa A. Epidemiology and management of parathyroid gland disorders in Spain over 15 years: A retrospective multicentre analysis. PLoS One. 2020;15(3):e0230130. https://doi.org/10.1371/journal.pone.0230130
  24. Lundgren E, Hagström EG, Lundin J, Winnerbäck K, Roos J, Ljunghall S, et al. Primary hyperparathyroidism revisited in menopausal women with serum calcium in the upper normal range at population-based screening 8 years ago. World J Surg. 2002;26(8):931-6. https://doi.org/ 10.1007/s00268-002-6621-0
  25. Yu N, Donnan PT, Murphy MJ, Leese GP. Epidemiology of primary hyperparathyroidism in Tayside, Scotland, UK. Clin Endocrinol (Oxf). 2009;71(4):485-93. https://doi.org/10.1111/j.1365-2265.2008.03520.x
  26. Cipriani C, Carnevale V, Biamonte F. Hospital care for primary hyperparathyroidism in Italy: A 6-year register-based study. Eur J Endocrinol. 2014;171(4):481-7. https://doi.org/10.1530/EJE-14-0493
  27. Evans LM, Owens D, Scott-Coombes DM, Stechman MJ. A decade of change in the uptake of parathyroidectomy in England and Wales. Ann R Coll Surg Engl. 2014;96(5):339-42. https://doi.org/10.1308/003588414X13946184900327
  28. Broulik P, Adamek S, Libansky P, Kubinyi J. Changes in the pattern of primary hyperparathyroidism in Czech Republic. Prague Med Rep. 2015;116(2):112-21. https://doi.org/10.14712/23362936.2015.50
  29. Ignjatovic VD, Matovic MD, Vukomanovic VR, Jankovic SM, Dzodic RR. Is there a link between Hashimoto’s thyroiditis and primary hyperparathyroidism? A study of serum parathormone and anti-TPO antibodies in 2267 patients. Hell J Nucl Med. 2013;16(2):86-90.
  30. Misiorowski W, Zgliczynski W. Prevalence of primary hyperparathyroidism among patients with low bone mass. Adv Med Sci. 2012;57(2):308-13. https:// doi.org/10.2478/v10039-012-0062-2
  31. Ghervan C, Silaghi A, Nemes C. Parathyroid incidentaloma detected during thyroid sonography – prevalence and significance beyond images. Med Ultrason. 2012;14(3):187-91.
  32. Toke J, Patocs A, Balogh K, Gergics P, Stenczer B, Rácz K. Parathyroid hormone-dependent hypercalcemia. Wien Klin Wochenschr. 2009;121(7-8):236- 45. https://doi.org/10.1007/s00508-009-1149-z
  33. Paunovic I, Zivaljevic V, Stojanic R, Kalezic N, Kazic M, Diklic A. Primary hyperparathyroidism in children and young adults: A single institution experience. Acta Chir Belg. 2013;113(1):35-9. https://doi.org/10.1080/00015458.2013.11 680882
  34. Libansky P, Adamek S, Broulik P, Fialová M, Kubinyi J, Lischke R. Parathyroid carcinoma in patients that have undergone surgery for primary hyperparathyroidism. In Vivo. 2017;31(5):925. https://doi.org/10.21873/invivo.11148
  35. Ozolins A, Narbuts Z, Vanags A, Simtniece Z, Visnevska Z, Akca A. Evaluation of malignant parathyroid tumours in two European cohorts of patients with sporadic primary hyperparathyroidism. Langenbecks Arch Surg. 2016;401(7):943- 51. https://doi.org/10.1007/s00423-015-1361-4
  36. Al Saleh Y, Al Sohaim A, Al Amoudi R. Primary hyperparathyroidism in Saudi Arabia revisited: A multi centre observational study. BMC Endocrine Disorders. 2022;22:155. https://doi.org/10.1186/s12902-022-01059-7
  37. Arya AK, Kumari P, Bhadada SK, Agrawal K, Singh P, Mukherjee S, et al. Progressive rise in the prevalence of asymptomatic primary hyperparathyroidism in India: Data from PHPT registry. J Bone Miner Metab. 2021;39(2):253-9. https:// doi.org/10.1007/s00774-020-01142-w
  38. Abdulla J, Suwaif YM. Prevalence and incidence of primary hyperparathyroidism in Bahrain: A retrospective study from one medical center. Neuro Endocrinol Lett. 2021;42(4):257-64.
  39. Marzouki HZ, Chavannes M, Tamilia M, Hier MP, Black MJ, Levental M, Payne RJ. Location of parathyroid adenomas: 7-year experience. J Otolaryngol Head Neck Surg. 2010;39(5):551-4.
  40. Filser B, Uslar V, Weyhe D, Tabriz N. Predictors of adenoma size and location in primary hyperparathyroidism. Langenbecks Arch Surg. 2021;406(5):1607-14. https://doi.org/10.1007/s00423-021-02179-9
  41. Bhadada SK, Arya AK, Mukhopadhyay S. Primary hyperparathyroidism: insights from the Indian PHPT registry. J Bone Miner Metab. 2018;36(2):238-45. https://doi.org/10.1007/s00774-017-0833-8.
  42. Yadav SK, Johri G, Bichoo RA, Jha CK, Kintu-Luwaga R, Mishra SK. Primary hyperparathyroidism in developing world: A systematic review on the changing clinical profile of the disease. Arch Endocrinol Metab. 2020;64(2):105-10. https://doi.org/10.20945/2359-3997000000211
  43. Zhao L, Liu JM, He XY, Zhao YH, Sun HL, Tao B. The changing clinical patterns of primary hyperparathyroidism in Chinese patients: Data from 2000 to 2010 in a single clinical center. J Clin Endocrinol Metab. 2013;98(2):721-8. https://doi. org/10.1210/jc.2012-2914
  44. Yao XA, Wei BJ, Jiang T, Chang H. The characteristics of clinical changes in primary hyperparathyroidism in Chinese patients. J Bone Miner Metab. 2019;37(2):336-41. https://doi.org/10.1007/s00774-018-0922-3
  45. Minisola S, Arnold A, Belaya Z, Luisa M, Clarke B, Hannan F, Hofbauer L. Epidemiology, pathophysiology, and genetics of primary hyperparathyroidism. Journal of Bone and Mineral Research. 2022;37(11):2315-29. https://doi. org/10.1002/jbmr.4665
  46. Rozhinskaya LYa, Rostomyan LG, Mokrysheva NG, Mirnaya SS, Kirdyankina NO. Epidemiologiya pervichnogo giperparatireoza [Epidemiology of primary hyperparathyroidism]. Lechashchiy vrach. 2010;11:25-8.
  47. Avdeeva VA, Suplotova LA, Tarasenko VV, Nikulin MO. Kliniko-laboratornye osobennosti pervichnogo giperparatireoza v Tyumenskoy oblasti: retrospektivnye dannye tryokhletnego nablyudeniya [Clinical and laboratory features of primary hyperparathyroidism in the Tyumen region: Retrospective data from a three-year observation]. Osteoporoz i osteopatii. 2023;26(1):24-30. https:// doi.org/10.14341/osteo13124
  48. Mokrysheva NG, Eremkina AK, Elfimova AR, Kovaleva EV, Miliutina AP, Bibik EE, et al. The Russian registry of primary hyperparathyroidism, latest update. Front Endocrinol. 2023;14:1203437. https://doi.org/10.3389/fendo.2023.1203437

Authors' information:


Niyazova Nargis Fazlikhudoevna,
Candidate of Medical Sciences, Associate Professor, Head of the Department of Endocrinology, Avicenna Tajik State Medical University
ORCID ID: 0000-0003-4344-8318
SPIN: 9749-5620
Author ID: 915628
E-mail: nargis_7373@mail.ru

Tursunova Saodatkhon Bakhtiyorovna,
Assistant of the Department of Endocrinology, Avicenna Tajik State Medical University
ORCID ID: 0009-0002-5764-5769
SPIN: 3655-0530
Author ID: 1130525
E-mail: saodatkhon.tursunova@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:


Niyazova Nargis Fazlikhudoevna
Candidate of Medical Sciences, Associate Professor, Head of the Department of Endocrinology, Avicenna Tajik State Medical University

734026, Republic of Tajikistan, Dushanbe, Sino, str., 29-31

Tel.: +992 (883) 309999

E-mail: nargis_7373@mail.ru

Materials on the topic: