Cholelithiasis in subjects with hypercalcaemia and primary hyperparathyroidism detected in a health screening.

Christensson, T.; Einarsson, Kurt

doi:10.1136/gut.18.7.543

Cited by 26 publications

(12 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However there are papers which are at variance with those of other investigators who have reported that primary hyperparthyroidism is associated with an abnormally high frequency of gallstone disease (8).…”

Section: Introductioncontrasting

confidence: 52%

Analysis of 645 Patients with Primary Hyperparathyroidism with Special References to Cholelithiasis

2005

View full text Add to dashboard Cite

Objective The clinical picture of primary hyperparathyroidism (PHPT) has changed during the past 50 years. It is currently unknown whether or not PHPT is associated with an increased risk of cholelithiasis.Patients To determine the frequency of cholelithiasis in PHPT we analyzed 645 consecutive patients seen at Prague University Hospital from 1992 through 2002 and compared them with a of normocalcaemic control group.Methods We investigated 645 patients with proven PHPT (518 female and 127 males aged 20-80 years) during a period of 10 years. To determine the frequency of cholelithiasis in normal population we analyzed 2,015 patients receiving periodic health examination at an outpatient ward from January 1998 to December 1998 (1505 females and 510 males aged 24-85 years). A detailed history, physical examination, biochemical measurements and abdominal ultrasonography were done.Results Cholelithiasis was proven in 157 of 518 women (30.3%) and in 11 of 127 men (8.66%) with PHPT. Their mean age was 59.67±12 years in women and 56.0±10 years in men. In the control group 260 of 1505 women (17.27%) and 54 of the 510 men (10.58%) had cholelithiasis. The mean age was 64.55±13.8 years in women and 61.2±12.4 in men. Only in the case of women, the difference was highly statistically significant (p<0.001). There were no significant differences between the mean values for the serum calcium level, bone alkaline phosphatase, total cholesterol, urinary hydroxyproline and body mass index in hyperparathyroid patients with and without cholelithiasis. However the hyperparathyroid women with cholelithiasis had an increased concentration of parathyroid hormone (236.1±56 pg/ml) compared with hyperparathyroid women without cholelithiasis (179.0±45 pg/ml), p<0.01.Conclusion The mechanism of PTH associated gallstone formation may involve inhibition of gallblader emptying, hepatic bile secretion and sphincter Oddi motility as well as modification of bile composition. While it might be difficult to prove it seems likely that the association of cholelithiasis with primary hyperparathyroidism in women with a high concentration of parathyroid hormone is more than merely coincidental and from our study it is obvious that a significant association exists.

show abstract

Section: Introductioncontrasting

confidence: 52%

Analysis of 645 Patients with Primary Hyperparathyroidism with Special References to Cholelithiasis

2005

View full text Add to dashboard Cite

show abstract

“…Increased body weight has also been associated with gallstone disease (46) and an increased risk of death from a variety of cancers, including those of the gastrointestinal tract, kidney, breast, and female reproductive tract (67). Cholelithiasis (68,69) and increased cancer occurrence (13,14) and mortality from cancer (12) have also been reported in association with primary hyperparathyroidism. Thus, increased body weight may contribute to the reported associations between primary hyperparathyroidism and these seemingly unrelated conditions.…”

Section: Discussionmentioning

confidence: 96%

Association between Primary Hyperparathyroidism and Increased Body Weight: A Meta-Analysis

Bolland

Grey

Gamble

et al. 2005

The Journal of Clinical Endocrinology &Amp; Metabolism

184

107

View full text Add to dashboard Cite

Although primary hyperparathyroidism is frequently asymptomatic, it has been associated with an increased prevalence of hypertension, insulin resistance, dyslipidemia, cardiovascular mortality, and cancer. Previously we reported that patients with primary hyperparathyroidism are heavier than age-matched controls. Increased body weight could contribute to the association between primary hyperparathyroidism and these extraskeletal complications. We searched MEDLINE for English language studies published between 1975 and 2003 that reported body weight or body mass index in subjects with primary hyperparathyroidism and a healthy age- and sex-comparable eucalcemic control group. Seventeen eligible studies were identified. Subjects with primary hyperparathyroidism were 3.34 kg (95% confidence interval, 1.97-4.71; P < 0.00001) heavier than controls in 13 studies reporting body weight. In four studies reporting body mass index, subjects with primary hyperparathyroidism had an increased body mass index of 1.13 kg/m(2) (-0.29 to 2.55; P = 0.12) compared with controls. Standard mean difference analysis showed that subjects with primary hyperparathyroidism had an increased weight or body mass index of 0.3 sd (0.19-0.40; P < 0.00001) compared with controls. We conclude that patients with primary hyperparathyroidism are heavier than their eucalcemic peers, and that increased body weight may contribute to the reported associations between primary hyperparathyroidism and some extraskeletal complications.

show abstract

“…One of every 500 women and one of every 2,000 men older than 40 years have primary hyperparathyroidism [5][6][7][8][9]. The disease is particularly prevalent in postmenopausal women.…”

Section: The Shifting Paradigm: a Historical Prospectivementioning

confidence: 98%

Current Indications and Decision-making Leading to Parathyroidectomy: A Surgical Viewpoint

Zarnegar¹,

Clark

2007

Clinic Rev Bone Miner Metab

View full text Add to dashboard Cite

Primary hyperparathyroidism (PHPT) is caused by a parathyroid adenoma in 85%, parathyroid hyperplasia in 15%, and parathyroid carcinoma in less than 1% of patients. This disease is classically described by the pentad of painful bones, renal stones, abdominal groans, psychic moans, and fatigue overtones. Today about 20% of patients referred for parathyroidectomy have renal stones, 30% have osteopenia or osteoporosis, and about 2% have osteitis fibrosa cystica. There are now three different presentations for PHPT: symptomatic, minimally symptomatic, and asymptomatic. PHPT is currently diagnosed by biochemical testing with an elevated serum calcium, an elevated or non-suppressed parathyroid hormone level, and the absence of hypocalciuria. Given the wide spectrum of disease that is diagnosed based on biochemical markers, the NIH made specific recommendations for the treatment of the non-classical PHPT. Many experts in this field have challenged these recommendations because numerous long-term follow-up investigations have shown the detrimental effects of hyperparathyroidism on bone density and fracture rate, renal function, cardiovascular mortality, and neuropsychiatric function. Parathyroidectomy is the only curative treatment for PHPT with a success rate of about 95%.

show abstract

Cholelithiasis in subjects with hypercalcaemia and primary hyperparathyroidism detected in a health screening.

Cited by 26 publications

References 13 publications

Analysis of 645 Patients with Primary Hyperparathyroidism with Special References to Cholelithiasis

Analysis of 645 Patients with Primary Hyperparathyroidism with Special References to Cholelithiasis

Association between Primary Hyperparathyroidism and Increased Body Weight: A Meta-Analysis

Current Indications and Decision-making Leading to Parathyroidectomy: A Surgical Viewpoint

Contact Info

Product

Resources

About