自然史和正常血性甲状腺功能障碍症的并发症:一个回顾性队列研究
Caroline Wei Shan Hoong1,2, Stephen M Broski3, Jad G Sfeir1,4,5
1Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic Rochester, Rochester, MN 55905, United States.
JBMR plus
|September 18, 2024
概括
常态血性甲状腺功能障碍症 (NHPT) 是一种较轻的甲状腺功能障碍症形式,具有中等风险的结石和骨折. 保守的管理通常是合适的,因为进展到高血性甲状腺功能障碍症 (PHPT) 是罕见的.
科学领域:
- 内分泌学 在内分泌学.
- 代谢性骨病 代谢性骨病
背景情况:
- 常态血性甲状腺增多症 (NHPT) 缺乏明确的定义和对其并发症和自然史的理解.
- 甲状腺功能障碍症可以呈现出正常 (NHPT) 或升高 (PHPT) 的水平,影响患者的管理和结果.
研究的目的:
- 与PHPT和对照相比,描述NHPT的表型.
- 评估NHPT向PHPT进展的风险.
- 开发一个NHPT进展的预测模型.
主要方法:
- 对232名患者 (75名对照组,73名NHPT,84名PHPT) 的回顾性图表审查.
- 分析了生物化学概况,并发症率 (尿病,骨折) 和手术结果.
- 一个XGBoost模型被开发来预测进展.
主要成果:
- NHPT在对照组和PHPT之间表现出中间的生化特征.
- 与对照组相比,NHPT患者的尿病 (OR 5.34) 和脆弱性骨折 (OR 4.53) 的调整风险显著更高.
- 副甲状腺切除术的治愈率较低,并且在NHPT中没有改善BMD. 在NHPT患者中,有9%的患者在4.23年的中位数内进展到PHPT.
- 一个XGBoost模型准确地预测了进展 (AUC 1.00).
结论:
- NHPT是PHPT的轻度变体,具有中度的尿病和脆弱性骨折风险.
- 建议对大多数NHPT病例进行保守的治疗,原因是进展不频繁,手术成功率较低.
- 确定进展的风险因素对于在NHPT中指导治疗决策至关重要.
更多相关视频
07:12Establishment of a Simple and Effective Rat Model for Intraoperative Parathyroid Gland Imaging
Published on: August 17, 2022
3.3K
07:13Two Techniques to Create Hypoparathyroid Mice: Parathyroidectomy Using GFP Glands and Diphtheria-Toxin-Mediated Parathyroid Ablation
Published on: March 14, 2017
14.5K
相关概念视频
00:59The Parathyroid Glands
1.9K
The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
1.9K
01:21Skeleton and Calcium Homeostasis
4.4K
Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
4.4K
01:17Hormones and Bone Tissue
2.6K
The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
2.6K
00:51Synthesis and Functions of Calcitonin
1.7K
Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
The exact mechanisms by which calcitonin operates in calcium homeostasis remain elusive, but its significance is evident in several vital...
The exact mechanisms by which calcitonin operates in calcium homeostasis remain elusive, but its significance is evident in several vital...
1.7K
01:40Bone Remodeling
38.2K
Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
38.2K
01:29Bone Disorders
3.4K
Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
3.4K