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Endocrine Abstracts (2024) 99 OC2.5 | DOI: 10.1530/endoabs.99.OC2.5

1APHP-Hopital Pitié Slapétrière, Paris, France; 2Hypoparathyroidisme France, Annecy-le-Vieux, France; 3APHP-Hopital du Kremlin Bicetre, Le Kremlin-Bicêtre, France; 4CHU de Lille, Lille, France; 5APHP Hopital Européen Georges Pompidou, Paris, France; 6APHP Hopital Cochin, Paris, France; 7Amolyt Pharma, Ecully, France


Introduction: In Chronic hypoparathyroidism (cHP), secretion of parathyroid hormone (PTH) is insufficient to maintain blood calcium concentration (PCa) steady. More than 70% of cases result from neck surgery and therefore in insufficient secretion of PTH as in mutations of genes involved in PTH synthesis, while mutations of the calcium-sensing receptor (CaSR) and its signaling pathway may result in a remaining secretion of PTH. cHP can exert nephrocalcinosis and/or nephrolithiasis in which calciuria (CaU) may play a key role. If the relationship between PCa and CaU has been studied, very few is known about the determinants of CaU during cHP. Taking advantage of the prospective cohort Epi-Hypo, we designed a study to analyze the determinants of CaU during cHP.

Methods: Epi-Hypo started in 2016 in France and is still actively recruiting. Inclusion criteria are i) chronic (i.e. ≥6 months) hypoPT, ii) followed in France, and iii) agreement to participate. Exclusion criteria are i) transient hypoPT and ii) pseudo-hypoparathyroidism. Both pediatric and adult participants are recruited. Data collected online through a secure digital platform refer to: demographics, circumstances of diagnosis, and follow-up including biology (PCa, CaU, and PTH as its ratio (PTHr) to the upper level of the normal laboratory range).

Results: The database was frozen on March 1st, 2023. At that time, 1,249 patients were included: 893 (71%) were female with median[IQR] age at diagnosis 43[31;56] years. In 937 (73%) patients, the cause was surgery. Nephrolithiasis and/or nephrocalcinosis was diagnosed in 198 (15%) patients over a mean±SD period of 12±10 years of follow-up. We gathered a subpopulation of 768 patients in whom both PCa and CaU (collected in 24-h urine collection) were available at least once. Mean±SD PCa and CaU values were 2.08±0.28 mM and 5.5±4.2 mmol/day, respectively, 33% patients exhibiting hypercalciuria. A positive correlation between PCa and CaU (r2=0.29, P<0.001) and a negative correlation between blood PTH level and CaU (r2=-0.30, P<0.001) were identified. Neither age, gender, or etiology of hypoparathyroidism were significantly different among patients with or without a remaining secretion of PTHr (ie PTHr ≥0.10).

Discussion/Conclusion: Controlling CaU during cHP is a challenging task. For the first time in a large cohort of patients, we report that a remaining secretion of PTH is linked to a lower CaU. Further studies are required to decipher whether this secretion is stable over time and whether it has to be taken into account when treating patients suffering from cHP.

Volume 99

26th European Congress of Endocrinology

Stockholm, Sweden
11 May 2024 - 14 May 2024

European Society of Endocrinology 

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