To assess vascular calcification in the patients of hypoparathyroidism using multidetector computed tomography scan
Pooja Agarwal1, Mahesh Prakash1, Manphool Singhal1
1Department of Radiodiagnosis, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Patients with sporadic idiopathic hypoparathyroidism (SIH) show increased vascular risk, evidenced by coronary artery calcification. Low serum calcium levels may contribute to this heightened cardiovascular risk in SIH patients.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Radiology
Background:
- Sporadic idiopathic hypoparathyroidism (SIH) is associated with increased intima media thickness.
- Altered calcium, phosphate, and parathyroid hormone (PTH) homeostasis in SIH may increase cardiovascular risk.
- Objective data on cardiovascular risk in SIH patients is limited.
Purpose of the Study:
- To evaluate the impact of SIH-related mineral and hormonal imbalances on coronary calcium score.
- To assess coronary artery calcification (CAC) as a marker of vascular risk in SIH patients using multidetector computed tomography (MDCT).
Main Methods:
- A case-control study involving 30 SIH patients and 40 age/sex-matched healthy controls.
- Coronary calcium score was measured using MDCT.
- Correlation between CAC and biochemical parameters (serum calcium, phosphate, PTH) was analyzed.
Main Results:
- Coronary artery calcification (CAC) was detected in 10% of SIH patients, compared to 0% in controls (P=0.07).
- SIH patients with CAC exhibited significantly lower serum calcium levels (albumin-corrected).
- An inverse correlation was observed between CAC and serum calcium levels; no correlation with other parameters.
Conclusions:
- MDCT-assessed coronary calcium score indicates increased vascular risk in SIH patients.
- Low serum calcium levels appear to be a potential predisposing factor for elevated vascular risk in SIH.
Background:
Our pilot data showed an increased intima media thickness in the patients with sporadic idiopathic hypoparathyroidism (SIH). Alteration in homeostasis of calcium, phosphate, and parathyroid hormone (PTH) may predispose to increase the risk of cardiovascular morbidity and mortality. The data on objective assessment of this increased risk is however lacking.
Objective:
To assess the effect of altered calcium, phosphate, and PTH homeostasis in the patients with SIH on coronary calcium score (a marker of increase vascular risk) by multidetector computed tomography scan (MDCT).
Methods:
In this case-control study, we measured coronary CT calcium score in 30 patients of SIH and compared with 40 age and sex matched healthy subjects. Correlation of coronary calcium score with biochemical parameters was evaluated.
Results:
Three of the 30 cases (10%) with SIH were found to have coronary artery calcification (CAC) of varying degree, whereas none of the control showed CAC (P = 0.07). The patients with CAC had significantly lower serum calcium levels (albumin corrected), as compared to the patients without CAC. Inverse correlation of CAC was found with serum calcium levels. No correlation was found with other biochemical parameters.
Conclusion:
The vascular risk is increased in the patients with SIH as assessed by coronary calcium score measured by MDCT. Low serum calcium levels might be a predisposing factor for this increased risk.
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