Endocrine Abstracts

Introduction: Primary hyperparathyroidism (PHPT) is one of the most common endocrine disorders. No major epidemiological research has been previously conducted in the Russia. This served as the basis for the creation of the Russian online registry of PHPT with accessibility from various regions of the country.

Aim: Aim of this study was to estimate the clinical profile, surgical and medical therapy of the patients with different forms of PHPT.

Material and Methods: The cross-sectional, observational study was carried out at the Endocrinology Research Centre (Moscow,). The present study explored retrospective data from 6003 patients submitted to the Registry between 12.12.2016 and 25.10.2022 (http://pgpt.clin-reg.ru/) from 81 regions of the Russia.

Results: The median age was 59 [60; 66] years with a female: male ratio of 11.7:1. Symptomatic PHPT was observed in 73.5% of patients while asymptomatic form - in 26.5%. The predominant clinical manifestation was the combination of skeletal and renal complications (41.7%), while isolated disorders were noted in 35.9 and 22.4%, respectively. There was a difference between symptomatic and asymptomatic patients in age (60 [53; 67] vs 54 [45; 62] years, P<0.001). Serum iPTH, albumin adjusted and ionized Cа levels were higher in symptomatic patients (P<0.001 for all), hypophosphatemia was also more typical for the symptomatic PHPT (P<0.001). Cardiovascular disease was recorded in 48% of patients, more frequent in the symptomatic group (P<0.001). 811 patients (14%) had a suspicion for hereditary PHPT, however a genetic analysis was conducted in 183 cases revealing the mutations in MEN1, CDC73, RET genes in 107, 6 and 2 cases, respectively. As expected, the PHPT manifestation in MEN-1 group was earlier 33 [26; 48] compared to sporadic disease 59 [52; 66] years (P<0.001), average duration of disease before diagnosis was 0 [0; 4] vs 0 [0; 2] years (P=0.055). Surgical treatment has been performed in 3206 (53%) of patients with remission achievement in 87%, the relapse or persistence after surgery were recorded in 13%. Parathyroid carcinoma was verified in 101/2666 (4%) of cases, atypical adenoma in 53/2666 (2%), adenoma in 2227/2666 (84%), hyperplasia in 285/2666 (11%). Drug therapy was prescribed in 2889 (48%) of patients, with a predominance of cholecalciferol prescription.

Conclusion: The detection rate of PHPT has increased in recent years in the Russia, which is associated with start of online registration. However, the majority of patients remained symptomatic that indicates delayed diagnosis and requires further modifications of medical care.