The Prevalence of Hyperparathyroidism in the Bulgarian Population – Analysis of an Epidemiological Study by the Bulgarian Society of Endocrinology (BSE) – 2012
Author: Borissova, Anna-Maria I.1, Vlahov, Jordan D.1, Krivoshiev, Stefan G.2, Dakovska, Lilia N.1, Popov, Alexander G.2, Mihailov, Georgy K.2, Shinkov, Alexander D.2
2. University Hospital of Endocrinology, Medical University-Sofia
Abstract: The prevalence and characteristics of hyperparathyroidism (HPT) in the Bulgarian population have not been investigated.
Aim: To perform a cross-sectional epidemiological study on the prevalence of HPT in the Bulgarian population and its relation to vitamin D deficiency and renal function.
Material and methods: In 2012 the Bulgarian Society of Endocrinology (BSE) performed a nested epidemiological study on 2032 individuals from 58 nests in Bulgaria, divided into three age groups: young (20-44 years), middle-aged (45-59 years) and advanced age (>60 years). The following parameters were investigated: parathyroid hormone (PTH), creatinine, calcium, phosphate, total protein (TP), 25(OH) vitamin D.
Results: The prevalence of HPT among the investigated individuals (2032) was 3,59% with a marked increase with age – from 1,9% in the young group to 6,8% among individuals in the advanced age group (>60 years). In individuals >60 years of age (women and men) HPT was significantly more prevalent compared to that in young women (8,3% vs. 2%, p<0,01), and to that of the men >60 years of age (8,3% vs. 4,7%, p<0,05). In individuals with normal kidney function (eGFR >60 ml/min) the prevalence of HPT was much higher among individuals >60 years of age compared to that from the middle-age and young age groups (5,3% vs. 2,5% vs. 1,6%, respectively, p<0,001). In individuals with eGFR <60 ml/min, the prevalence of HPT was much higher (5,5% in the middle-age group and almost three times higher – 14,1% among patients >60 years of age, р<0,001). The levels of vitamin D significantly affected the prevalence of HPT both in individuals with normal and with impaired renal function (eGFR>60 ml/min (n=1920) – 7,3% in vitamin D deficiency compared to1,3% in the vitamin D sufficiency group, p<0,001; eGFR<60 ml/min (n=110) – 29,6% vs. 3,0%, respectively, p<0,01). Conclusion: The prevalence of HPT in the Bulgarian population is not low. The complex evaluation of PTH levels should include vitamin D levels and renal function.
Key words: hyperparathyroidism, renal function, vitamin D levels.
