Regional Clinical and Biochemical Differences among Patients with

Abstract

Background: Environmental habitat may play a role in clinical disparities of primary hyperparathyroidism (pHPT) patients.

Aims: To compare preoperative clinical symptoms and associated conditions and surgical findings in patients with pHPT, living in different geographical regions from the Black Sea, Mediterranean and Anatolia regions.

Study Design: Retrospective, clinical-based multicentric study of 694 patients with pHPT.

Methods: Patients from 23 centers and 8 different geographical regions were included. Data related to baseline demographics, clinical, pathologic and treatment characteristics of 8 regions were collected and included age, gender, residential data, symptoms, history of fracture, existence of brown tumor, serum total Ca and p levels, serum parathormone (PTH) levels, serum 25-OH vitamin D levels, bone mineral density, size of the resected abnormal parathyroid gland(s), histology, as well as the presence of ectopia, presence of dual adenoma, and multiple endocrine neoplasia (MEN)- or familial-related disease.

Results: The median age was 54. Asymptomatic patient rate was 25%. The median PTH level was 232 pg/mL and serum total Ca was 11.4 mg/dL. Eighty-seven percent of patients had an adenoma and 90% of these had a single adenoma. Hyperplasia was detected in 79 patients and cancer in 9 patients. The median adenoma size was 16 mm. Significant parameters differing between regions were preoperative symptoms, serum Ca and p levels, and adenoma size. All patients from South-East Anatolia were symptomatic, while the lowest p values were reported from East Anatolia and the largest adenoma size, as well as highest Ca levels, were from Bulgaria.

Conclusion: Habitat conditions vary between geographical regions. This affects the clinicopathological features of patients with pHPT.

C1 [Makay, Ozer; Icoz, Gokhan] Ege Univ, Sch Med, Div Endocrine Surg, Dept Gen Surg, Izmir, Turkey.

[Ozcinar, Beyza; Aksakal, Nihat; Erbil, Yesim] Istanbul Univ, Istanbul Sch Med, Div Endocrine Surg, Dept Gen Surg, Istanbul, Turkey.

[Simsek, Turgay; Canturk, N. Zafer] Kocaeli Univ, Sch Med, Dept Gen Surg, Kocaeli, Turkey.

[Arici, Cumhur] Akdeniz Univ, Sch Med, Dept Gen Surg, Div Endocrine Surg, Antalya, Turkey.

[Gungor, Bulent] Ondokuz Mayis Univ, Sch Med, Dept Gen Surg, Samsun, Turkey.

[Ozbas, Serdar] Guven Hosp, Dept Gen Surg, Ankara, Turkey.

[Akca, Tamer] Mersin Univ, Dept Gen Surg, Div Endocrine Surg, Sch Med, Mersin, Turkey.

[Emre, Ali Ugur; Cakmak, Guldeniz Karadeniz] Bulent Ecevit Univ, Dept Gen Surg, Sch Med, Zonguldak, Turkey.

[Akcay, Mufide] Ataturk Univ, Dept Gen Surg, Sch Med, Erzurum, Turkey.

[Unal, Bulent] Inonu Univ, Dept Gen Surg, Sch Med, Malatya, Turkey.

[Girgin, Mustafa] Firat Univ, Dept Gen Surg, Sch Med, Elazig, Turkey.

[Girgin, Sadullah] Dicle Univ, Dept Gen Surg, Sch Med, Diyarbakir, Turkey.

[Gorgulu, Semih] Gulhane Training & Res Hosp, Dept Gen Surg, Ankara, Turkey.

[Sezer, Atakan] Trakya Univ, Dept Gen Surg, Sch Med, Edirne, Turkey.

[Karatas, Adem] Istanbul Univ, Dept Gen Surg, Cerrahpasa Med Sch, Istanbul, Turkey.

[Ozemir, Ibrahim Ali] Istanbul Medeniyet Univ, Dept Gen Surg, Sch Med, Istanbul, Turkey.

[Erel, Serap] Ankara Numune Training & Res Hosp, Dept Gen Surg, Ankara, Turkey.

[Ugurlu, M. Umit; Gulluoglu, Bahadir M.] Marmara Univ, Dept Gen Surg, Sch Med, Istanbul, Turkey.

[Filiz, Ali Ilker; Kebudi, Abut] Okan Univ, Dept Gen Surg, Sch Med, Istanbul, Turkey.

[Atalay, Can] Ankara Oncol Training Hosp, Dept Gen Surg, Ankara, Turkey.

[Uzunkoy, Ali] Harran Univ, Dept Gen Surg, Sch Med, Sanliurfa, Turkey.

[Deveci, Ugur; Kurt, Yavuz] Sultan Abdulhamid Training & Res Hosp, Dept Gen Surg, Istanbul, Turkey.

[Kotan, Cetin] Yuzuncu Yil Univ, Dept Gen Surg, Sch Med, Van, Turkey.

[Pandev, Rumen] Tsaritsa Yoanna Univ, Dept Gen Surg, Sch Med, Div Endocrine Surg, Sofia, Bulgaria.