Хронический гипопаратиреоз: клиническая картина, осложнения заболевания и влияние на качество жизни
https://doi.org/10.15829/2713-0177-2023-27
EDN: TQSOUN
Аннотация
Гипопаратиреоз — относительно редкая эндокринная патология, характеризующаяся дефицитом паратиреоидного гормона с развитием гипокальциемии и гиперфосфатемии.
По результатам анализа крупных баз данных Европы, США и стран Азии установлено, что длительное течение хронического послеоперационного и нехирургического гипопаратиреоза ассоциировано с множеством осложнений со стороны различных органов и систем. При гипопаратиреозе повышается риск патологии почек, в т.ч. почечной недостаточности, психоневрологических расстройств и инфекций. Частота и спектр осложнений гипопаратиреоза зависят от его этиологии. Так, для нехирургического гипопаратиреоза выявлены повышенные риски катаракты, сердечно-сосудистых заболеваний и переломов позвоночника, хотя патогенез развития данных нарушений остается не до конца изученным.
Обсуждаются различные параметры минерального гомеостаза в контексте тех или иных осложнений. Больше данных накоплено по структурной патологии почек (нефролитиаз, нефрокальциноз), обусловленной стойкой гиперкальциурией и приемом больших доз препаратов кальция и витамина D.
В представленном обзоре суммирована информация о клинических проявлениях и осложнениях гипопаратиреоза, а также предикторах их развития.
При поддержке: Работа выполнена в рамках государственного задания № НИОКТРАААА-А20-120011790168-2.
Об авторах
Е. В. Ковалева
ФГБУ "НМИЦ эндокринологии" Минздрава России
Россия
Россия
н.с. отдела эпидемиологии эндокринопатий, отделения патологии околощитовидных желез и нарушений минерального обмена
Москва
А. К. Еремкина
ФГБУ "НМИЦ эндокринологии" Минздрава России
Россия
Россия
к.м.н., с.н.с., зав. отделения патологии околощитовидных желез и нарушений минерального обмена
Москва
Н. Г. Мокрышева
ФГБУ "НМИЦ эндокринологии" Минздрава России
Россия
Россия
д.м.н., член-корр. РАН, профессор, директор
Москва
Список литературы
1. Lamb GD. Excitation-contraction coupling in skeletal muscle: comparisons with cardiac muscle. Clin. Exp. Pharmacol. Physiol. 2000;27(3):216-24. doi:10.1046/j.1440-1681.2000.03224.x.
2. Vered I, Vered Z, Perez JE, et al. Normal left ventricular performance documented by doppler echocardiography in patients with long-standing hypocalcemia. Am. J. Med. 1989;86(4):413-6. doi:10.1016/0002-9343(89)90338-0.
3. Newman DB, Fidahussein SS, Kashiwagi DT, et al. Reversible cardiac dysfunction associated with hypocalcemia: A systematic review and meta-analysis of individual patient data. Heart Fail. Rev. 2014;19(2):199-205. doi:10.1007/s10741-013-9371-1.
4. Válek M, Roblová L, Raška I Jr, et al. Hypocalcaemic cardiomyopathy: a description of two cases and a literature review. ESC Hear. Fail. 2020;7(3):1291-301. doi:10.1002/ehf2.12693.
5. de Oliveira Martins Duarte J, Pestana Pereira PML, Sobral ASG, et al. A rare and reversible case of heart failure-Hypocalcemia due to hypoparathyroidism. Clinical case reports. 2019;7(10):1932-4. doi:10.1002/ccr3.2397.
6. Kim SH, Rhee Y, Kim YM, et al. Prevalence and complications of nonsurgical hypoparathyroidism in Korea: A nationwide cohort study. PLoS One. 2020;15(5):e0232842. doi:10.1371/journal.pone.0232842.
7. Underbjerg L, Sikjaer T, Mosekilde L, Rejnmark L. Cardiovascular and renal complications to postsurgical hypoparathyroidism: A Danish nationwide controlled historic follow-up study. J. Bone Miner. Res. 2013;28(11):2277-85. doi:10.1002/jbmr.1979.
8. Bilezikian JP, Khan A, Potts JT Jr, et al. Hypoparathyroidism in the adult: Epidemiology, diagnosis, pathophysiology, target-organ involvement, treatment, and challenges for future research. J. Bone Miner. Res. 2011;26(10):2317-37. doi:10.1002/jbmr.483.
9. Shoback D. Clinical practice. Hypoparathyroidism. N. Engl. J. Med. United States. 2008;359(4):391-403. doi:10.1056/NEJMcp0803050.
10. Bergenfelz A, Nordenström E, Almquist M. Morbidity in patients with permanent hypoparathyroidism after total thyroidectomy. Surgery. 2020;167(1):124-8. doi:10.1016/j.surg.2019.06.056.
11. Underbjerg L, Sikjaer T, Mosekilde L, Rejnmark L. Postsurgical hypoparathyroidism-risk of fractures, Psychiatric Diseases, Cancer, Cataract, and Infections. J. Bone Miner. Res. 2014;29(11):2504-10. doi:10.1002/jbmr.2273.
12. Underbjerg L, Sikjaer T, Mosekilde L, Rejnmark L. The epidemiology of nonsurgical hypoparathyroidism in Denmark: A nationwide case finding study. J. Bone Miner. Res. 2015;30(9):1738-44. doi:10.1002/jbmr.2501.
13. Vadiveloo T, Donnan PT, Leese CJ, et al. Increased mortality and morbidity in patients with chronic hypoparathyroidism: A population-based study. Clin. Endocrinol. (Oxf). 2019;90(2):285-92. doi:10.1111/cen.13895.
14. Underbjerg L, Sikjaer T, Rejnmark L. Long-Term Complications in Patients With Hypoparathyroidism Evaluated by Biochemical Findings: A Case-Control Study. J. Bone Miner. Res. 2018;33(5):822-31. doi:10.1002/jbmr.3368.
15. Gosmanova EO, Chen K, Ketteler M, et al. Risk of Cardiovascular Conditions in Patients with Chronic Hypoparathyroidism: A Retrospective Cohort Study. Adv. Ther. 2021;38(8):4246-57. doi:10.1007/s12325-021-01787-7.
16. Yamashita H, Yamazaki Y, Hasegawa H, et al. Fibroblast growth factor-23 (FGF23) in patients with transient hypoparathyroidism: its important role in serum phosphate regulation. Endocr. J. 2007;54(3):465-70. doi:10.1507/endocrj.k06-156.
17. Bolland MJ, Grey A, Avenell A, et al. Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis. BMJ. 2011;342:d2040. doi:10.1136/bmj.d2040.
18. Kaul S, Ayodele O, Sherry N, et al. Cardiovascular Events in Adult Patients With Chronic Hypoparathyroidism Treated With rhPTH(1-84) Compared With a Historical Control Cohort. J. Endocr. Soc. 2021;5(Suppl. 1):A257-A257.
19. Mitchell DM, Regan S, Cooley MR, et al. Long-term follow-up of patients with hypoparathyroidism. J. Clin. Endocrinol. Metab. 2012;97(12):4507-14. doi:10.1210/jc.2012-1808.
20. Goswami R, Sharma R, Sreenivas V, et al. Prevalence and progression of basal ganglia calcification and its pathogenic mechanism in patients with idiopathic hypoparathyroidism. Clin. Endocrinol. (Oxf). 2012;77(2):200-6. doi:10.1111/j.1365-2265.2012.04353.x.
21. Raue F, Pichl J, Dörr HG, et al. Activating mutations in the calcium-sensing receptor: genetic and clinical spectrum in 25 patients with autosomal dominant hypocalcaemia — a German survey. Clin. Endocrinol. (Oxf). England, 2011;75(6):760-5. doi:10.1111/j.1365-2265.2011.04142.x.
22. Jorens PG, Appel BJ, Hilte FA, et al. Basal ganglia calcifications in postoperative hypoparathyroidism: a case with unusual characteristics. Acta Neurol. Scand. 1991;83(2):137-40. doi:10.1111/j.1600-0404.1991.tb04663.x.
23. Shoback DM, Bilezikian JP, Costa AG, et al. Presentation of hypoparathyroidism: Etiologies and clinical features. J. Clin. Endocrinol. Metab. 2016;101(6):2300-12. doi:10.1210/jc.2015-3909.
24. Abe S, Tojo K, Ichida K, et al. A Rare Case of Idiopathic Hypoparathyroidism with Varied Neurological Manifestations. Intern. Med. 1996;35(2):129-34. doi:10.2169/internalmedicine.35.129.
25. Kalampokini S, Georgouli D, Dadouli K, et al. Fahr’s syndrome due to hypoparathyroidism revisited: A case of parkinsonism and a review of all published cases. Clin. Neurol. Neurosurg. 2021;202:106514. doi:10.1016/j.clineuro.2021.106514.
26. Aggarwal S, Kailash S, Sagar R, et al. Neuropsychological dysfunction in idiopathic hypoparathyroidism and its relationship with intracranial calcification and serum total calcium. Eur. J. Endocrinol. 2013;168(6):895-903. doi:10.1530/EJE-12-0946.
27. Taşlı NG, Akbaş EM. Ocular Findings Associated with Hypoparathyroidism. Ocul. Immunol. Inflamm. 2021;29(7-8):1287-1291. doi:10.1080/09273948.2020.1735451.
28. Kılınç Hekimsoy H, Şekeroğlu MA, Koçer AM, et al. Is there a relationship between hypoparathyroidism and retinal microcirculation? Int. Ophthalmol. 2020;40(8):2103-10. doi:10.1007/s10792-020-01387-4.
29. Cipriani C, Abraham A, Silva BC, et al. Skeletal changes after restoration of the euparathyroid state in patients with hypoparathyroidism and primary hyperparathyroidism. Endocrine. 2017;55(2):591-8. doi:10.1007/s12020-016-1101-8.
30. Mendonça ML, Pereira FA, Nogueira-Barbosa MH. Increased vertebral morphometric fracture in patients with postsurgical hypoparathyroidism despite normal bone mineral density. BMC Endocr Disord. 2013;13:1. doi:10.1186/1472-6823-13-1.
31. Pal R, Bhadada SK, Mukherjee S, et al. Fracture risk in hypoparathyroidism: a systematic review and meta-analysis. Osteoporos. Int. 2021;32(11):2145-53. doi:10.1007/s00198-021-05966-8.
32. Astor MC, Løvås K, Debowska A, et al. Epidemiology and health-related quality of life in hypoparathyroidism in Norway. J. Clin. Endocrinol. Metab. 2016;101(8):3045-53. doi:10.1210/jc.2016-1477.
33. Arlt W, Fremerey C, Callies F, et al. Well-being, mood and calcium homeostasis in patients with hypoparathyroidism receiving standard treatment with calcium and vitamin D. Eur. J. Endocrinol. 2002;146(2):215-22. doi:10.1530/eje.0.1460215.
34. Sikjaer T, Rolighed L, Hess A, et al. Effects of PTH(1-84) therapy on muscle function and quality of life in hypoparathyroidism: results from a randomized controlled trial. Osteoporos. Int. 2014;25(6):1717-26. doi:10.1007/s00198-014-2677-6.
35. Cho NL, Moalem J, Chen L, et al. Surgeons and patients disagree on the potential consequences from hypoparathyroidism. Endocr. Pract. 2014;20(5):427-46. doi:10.4158/EP13321.OR.
36. Sikjaer T, Moser E, Rolighed L, et al. Concurrent Hypoparathyroidism Is Associated With Impaired Physical Function and Quality of Life in Hypothyroidism. J. bone Miner. Res. 2016;31(7):1440-8. doi:10.1002/jbmr.2812.
37. Underbjerg L, Sikjaer T, Rejnmark L. Health-related quality of life in patients with nonsurgical hypoparathyroidism and pseudohypoparathyroidism. Clin. Endocrinol. (Oxf). 2018;88(6):838-47. doi:10.1111/cen.13593.
38. Failde II, Soto MM. Changes in Health Related Quality of Life 3 months after an acute coronary syndrome. BMC Public Health. 2006;6:18. doi:10.1186/1471-2458-6-18.
39. Hopman WM, Harrison MB, Coo H, et al. Associations between chronic disease, age and physical and mental health status. Chronic Dis. Can. 2009;29(3):108-16.
40. Zuluaga MC, Guallar-Castillón P, López-García E, et al. Generic and disease-specific quality of life as a predictor of long-term mortality in heart failure. Eur. J. Heart Fail. 2010;12(12):1372-8. doi:10.1093/eurjhf/hfq163.
41. Porter J, Bowden DK, Economou M, et al. Health-Related Quality of Life, Treatment Satisfaction, Adherence and Persistence in β-Thalassemia and Myelodysplastic Syndrome Patients with Iron Overload Receiving Deferasirox: Results from the EPIC Clinical Trial. Anemia. 2012;2012:297641. doi:10.1155/2012/297641.
42. de Wee EM, Mauser-Bunschoten EP, Van Der Bom JG, et al. Health-related quality of life among adult patients with moderate and severe von Willebrand disease. J. Thromb. Haemost. 2010;8(7):1492-9. doi:10.1111/j.1538-7836.2010.03864.x.
43. Kuznetsov L, Long GH, Griffin SJ, Simmons RK. Are changes in glycaemic control associated with diabetes-specific quality of life and health status in screen-detected type 2 diabetes patients? Four-year follow up of the ADDITION-Cambridge cohort. Diabetes. Metab. Res. Rev. 2015;31(1):69-75. doi:10.1002/dmrr.2559..
44. Jiang Z, Butler-Bowen H, Rodriguez T, et al. Role of methylphenidate in the treatment of fatigue in advanced pancreatic cancer population. Ann. Gastroenterol. 2016;29(4):536-43. doi:10.20524/aog.2016.0065.
45. Xiao C, Miller AH, Felger J, et al. A prospective study of quality of life in breast cancer patients undergoing radiation therapy. Adv. Radiat. Oncol. 2016;1(1):10-6. doi:10.1016/j.adro.2016.01.003.
46. Siggelkow H, Clarke BL, Germak J, et al. Burden of illness in not adequately controlled chronic hypoparathyroidism: Findings from a 13-country patient and caregiver survey. Clin. Endocrinol. (Oxf). 2020;92(2):159-68. doi:10.1111/cen.14128.
Рецензия
Для цитирования:
Ковалева Е.В., Еремкина А.К., Мокрышева Н.Г. Хронический гипопаратиреоз: клиническая картина, осложнения заболевания и влияние на качество жизни. FOCUS Эндокринология. 2023;4(1):78-83. https://doi.org/10.15829/2713-0177-2023-27. EDN: TQSOUN
For citation:
Kovaleva E.V., Eremkina A.K., Mokrysheva N.G. Chronic hypoparathyroidism: clinical manifestations, complications and impact on the quality of life. FOCUS. Endocrinology. 2023;4(1):78-83. (In Russ.) https://doi.org/10.15829/2713-0177-2023-27. EDN: TQSOUN
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