IMPACT OF ETHNIC BACKGROUND ON CLINICAL CHARACTERISTICS AND CARDIOVASCULAR RISK FACTORS AMONG PATIENTS WITH PRIMARY HYPERPARATHYROIDISM
AACE ePoster Library. Hu S. 05/13/15; 97772; 710
Dr. Sophia Hu
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Abstract
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Objective: To compare clinical characteristics and cardiovascular risk factors (CVRF) among patients with primary hyperparathyroidism (PHPT) from different ethnic backgrounds.
Methods: In this retrospective study, 500 charts of patients with PHPT were reviewed. 46 African Americans (AA), 31 Asians (A), 19 Hispanics (H) and 404 Caucasians (C) were included. The following characteristics were compared between the four groups at initial presentation to endocrinology or surgery clinic: age, BMI, serum calcium, iPTH, 25(OH)D, 24-hr urine calcium and parathyroid adenoma weight. CVRF including BMI, DM, HTN were also used for comparison. χ2 test and ANOVA test were used for comparison.
Results: Adjusted for age and gender, AA have lower mean 25(OH)D (20.4ng/mL vs 29.7ng/mL, P<0.05) and higher iPTH (189.8pg/mL vs 158.3pg/mL, P<0.05) compared to C. AA also tended to have higher serum Ca (11.3mg/dL vs 11.1mg/dL) and lower 24-hr urine Ca (309.9mg/24hr vs 369mg/24hr) when compared to C, but these differences were not significant. The adenoma weight is heavier in AA (1.7g) compared to C and A (1g and 0.6g, P<0.05). Similar to AA, H also have lower 25(OH)D 24.7ng/mL, higher iPTH 178.6pg/mL when compared to C, but these findings were not significant. iPTH was 167.7pg/mL, serum Ca 11mg/dL, 25(OH)D 27.9ng/dL and urine Ca 344.5mg/24hr in the A group. The BMI among the groups were C: 29.6, AA: 33.8, A: 24.7 and H: 30.1 (p<0.05). HTN was more common in AA (65.2%) compared to other groups: C: 49.5%, A: 16.1% and H: 47.4% (P<0.05). AA have lower rates of renal stones (8.7%) compared to A (29%, P<0.05) and C (20.5%, P=0.06). DM is more prevalent in AA and H (19.6%, 21.1% respectively) compared to A and C (12.9%, 14.1% respectively).
Discussion: Larger parathyroid adenoma, higher serum Ca and iPTH levels, and lower 25(OH)D are associated with more severe PHPT. CVRF including obesity, DM, HTN and HLD are known to be associated with advanced PHPT. Our results suggest that AA with PHPT present with more severe PHPT on initial presentation. H also appear to have similar characteristics as AA. The underlying mechanisms for these associations remain unknown. Lower 24-hr urine Ca and lower prevalence of renal stones in AA with PHPT can often times lead to delay in consultation. Poor access to health care due to financial or social issues may also contribute to the severity of PHPT in AA at initial presentation.
Conclusion: Our study revealed that AA with PHPT present with more severe PHPT profiles, lower 24-hr urine Ca along with higher prevalence of CVRF when compared to C and A. H also appear to have similar characteristics to AA. This study underscores the need for further investigations to confirm our findings.
Methods: In this retrospective study, 500 charts of patients with PHPT were reviewed. 46 African Americans (AA), 31 Asians (A), 19 Hispanics (H) and 404 Caucasians (C) were included. The following characteristics were compared between the four groups at initial presentation to endocrinology or surgery clinic: age, BMI, serum calcium, iPTH, 25(OH)D, 24-hr urine calcium and parathyroid adenoma weight. CVRF including BMI, DM, HTN were also used for comparison. χ2 test and ANOVA test were used for comparison.
Results: Adjusted for age and gender, AA have lower mean 25(OH)D (20.4ng/mL vs 29.7ng/mL, P<0.05) and higher iPTH (189.8pg/mL vs 158.3pg/mL, P<0.05) compared to C. AA also tended to have higher serum Ca (11.3mg/dL vs 11.1mg/dL) and lower 24-hr urine Ca (309.9mg/24hr vs 369mg/24hr) when compared to C, but these differences were not significant. The adenoma weight is heavier in AA (1.7g) compared to C and A (1g and 0.6g, P<0.05). Similar to AA, H also have lower 25(OH)D 24.7ng/mL, higher iPTH 178.6pg/mL when compared to C, but these findings were not significant. iPTH was 167.7pg/mL, serum Ca 11mg/dL, 25(OH)D 27.9ng/dL and urine Ca 344.5mg/24hr in the A group. The BMI among the groups were C: 29.6, AA: 33.8, A: 24.7 and H: 30.1 (p<0.05). HTN was more common in AA (65.2%) compared to other groups: C: 49.5%, A: 16.1% and H: 47.4% (P<0.05). AA have lower rates of renal stones (8.7%) compared to A (29%, P<0.05) and C (20.5%, P=0.06). DM is more prevalent in AA and H (19.6%, 21.1% respectively) compared to A and C (12.9%, 14.1% respectively).
Discussion: Larger parathyroid adenoma, higher serum Ca and iPTH levels, and lower 25(OH)D are associated with more severe PHPT. CVRF including obesity, DM, HTN and HLD are known to be associated with advanced PHPT. Our results suggest that AA with PHPT present with more severe PHPT on initial presentation. H also appear to have similar characteristics as AA. The underlying mechanisms for these associations remain unknown. Lower 24-hr urine Ca and lower prevalence of renal stones in AA with PHPT can often times lead to delay in consultation. Poor access to health care due to financial or social issues may also contribute to the severity of PHPT in AA at initial presentation.
Conclusion: Our study revealed that AA with PHPT present with more severe PHPT profiles, lower 24-hr urine Ca along with higher prevalence of CVRF when compared to C and A. H also appear to have similar characteristics to AA. This study underscores the need for further investigations to confirm our findings.
Objective: To compare clinical characteristics and cardiovascular risk factors (CVRF) among patients with primary hyperparathyroidism (PHPT) from different ethnic backgrounds.
Methods: In this retrospective study, 500 charts of patients with PHPT were reviewed. 46 African Americans (AA), 31 Asians (A), 19 Hispanics (H) and 404 Caucasians (C) were included. The following characteristics were compared between the four groups at initial presentation to endocrinology or surgery clinic: age, BMI, serum calcium, iPTH, 25(OH)D, 24-hr urine calcium and parathyroid adenoma weight. CVRF including BMI, DM, HTN were also used for comparison. χ2 test and ANOVA test were used for comparison.
Results: Adjusted for age and gender, AA have lower mean 25(OH)D (20.4ng/mL vs 29.7ng/mL, P<0.05) and higher iPTH (189.8pg/mL vs 158.3pg/mL, P<0.05) compared to C. AA also tended to have higher serum Ca (11.3mg/dL vs 11.1mg/dL) and lower 24-hr urine Ca (309.9mg/24hr vs 369mg/24hr) when compared to C, but these differences were not significant. The adenoma weight is heavier in AA (1.7g) compared to C and A (1g and 0.6g, P<0.05). Similar to AA, H also have lower 25(OH)D 24.7ng/mL, higher iPTH 178.6pg/mL when compared to C, but these findings were not significant. iPTH was 167.7pg/mL, serum Ca 11mg/dL, 25(OH)D 27.9ng/dL and urine Ca 344.5mg/24hr in the A group. The BMI among the groups were C: 29.6, AA: 33.8, A: 24.7 and H: 30.1 (p<0.05). HTN was more common in AA (65.2%) compared to other groups: C: 49.5%, A: 16.1% and H: 47.4% (P<0.05). AA have lower rates of renal stones (8.7%) compared to A (29%, P<0.05) and C (20.5%, P=0.06). DM is more prevalent in AA and H (19.6%, 21.1% respectively) compared to A and C (12.9%, 14.1% respectively).
Discussion: Larger parathyroid adenoma, higher serum Ca and iPTH levels, and lower 25(OH)D are associated with more severe PHPT. CVRF including obesity, DM, HTN and HLD are known to be associated with advanced PHPT. Our results suggest that AA with PHPT present with more severe PHPT on initial presentation. H also appear to have similar characteristics as AA. The underlying mechanisms for these associations remain unknown. Lower 24-hr urine Ca and lower prevalence of renal stones in AA with PHPT can often times lead to delay in consultation. Poor access to health care due to financial or social issues may also contribute to the severity of PHPT in AA at initial presentation.
Conclusion: Our study revealed that AA with PHPT present with more severe PHPT profiles, lower 24-hr urine Ca along with higher prevalence of CVRF when compared to C and A. H also appear to have similar characteristics to AA. This study underscores the need for further investigations to confirm our findings.
Methods: In this retrospective study, 500 charts of patients with PHPT were reviewed. 46 African Americans (AA), 31 Asians (A), 19 Hispanics (H) and 404 Caucasians (C) were included. The following characteristics were compared between the four groups at initial presentation to endocrinology or surgery clinic: age, BMI, serum calcium, iPTH, 25(OH)D, 24-hr urine calcium and parathyroid adenoma weight. CVRF including BMI, DM, HTN were also used for comparison. χ2 test and ANOVA test were used for comparison.
Results: Adjusted for age and gender, AA have lower mean 25(OH)D (20.4ng/mL vs 29.7ng/mL, P<0.05) and higher iPTH (189.8pg/mL vs 158.3pg/mL, P<0.05) compared to C. AA also tended to have higher serum Ca (11.3mg/dL vs 11.1mg/dL) and lower 24-hr urine Ca (309.9mg/24hr vs 369mg/24hr) when compared to C, but these differences were not significant. The adenoma weight is heavier in AA (1.7g) compared to C and A (1g and 0.6g, P<0.05). Similar to AA, H also have lower 25(OH)D 24.7ng/mL, higher iPTH 178.6pg/mL when compared to C, but these findings were not significant. iPTH was 167.7pg/mL, serum Ca 11mg/dL, 25(OH)D 27.9ng/dL and urine Ca 344.5mg/24hr in the A group. The BMI among the groups were C: 29.6, AA: 33.8, A: 24.7 and H: 30.1 (p<0.05). HTN was more common in AA (65.2%) compared to other groups: C: 49.5%, A: 16.1% and H: 47.4% (P<0.05). AA have lower rates of renal stones (8.7%) compared to A (29%, P<0.05) and C (20.5%, P=0.06). DM is more prevalent in AA and H (19.6%, 21.1% respectively) compared to A and C (12.9%, 14.1% respectively).
Discussion: Larger parathyroid adenoma, higher serum Ca and iPTH levels, and lower 25(OH)D are associated with more severe PHPT. CVRF including obesity, DM, HTN and HLD are known to be associated with advanced PHPT. Our results suggest that AA with PHPT present with more severe PHPT on initial presentation. H also appear to have similar characteristics as AA. The underlying mechanisms for these associations remain unknown. Lower 24-hr urine Ca and lower prevalence of renal stones in AA with PHPT can often times lead to delay in consultation. Poor access to health care due to financial or social issues may also contribute to the severity of PHPT in AA at initial presentation.
Conclusion: Our study revealed that AA with PHPT present with more severe PHPT profiles, lower 24-hr urine Ca along with higher prevalence of CVRF when compared to C and A. H also appear to have similar characteristics to AA. This study underscores the need for further investigations to confirm our findings.
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