Relationship of parathyroid adenoma volume with preoperative biochemical parameters

Amac: Primer hiperparatiroidizm (PHPT), paratiroid bezlerinden otonom olarak asiri parathormon salgilanmasi sonucu olusan, hiperkalsemi veya normokalseminin goruldugu klinik bir tablodur. Serum paratiroid hormonu (iPTH), kalsiyum (Ca), fosfor (P) seviyeleri ve vitamin D duzeyleri (25-OH D3) ile adenom hacmi arasinda anlamli bir iliski bulunmasi, paratiroid adenomunun rezeksiyonunun boyutunu belirlemek icin prediktif degere sahip olabilir.Biz de bu calismamizda preoperatif biyokimyasal parametreler ile paratiroid adenom volumu arasindaki iliskiyi inceledik. Yontemler: Istanbul Haydarpasa Numune Egitim ve Arastirma Hastanesi Endokrinoloji polikliniginde 2011-2014 yillari arasinda primer hiperparatiroidi tanisiyla takip edilen, operasyon sonrasinda histopatolojik olarak soliter paratiroid adenomu tanisi konmus 52 hasta calismaya alindi. Adenom hacmi ile preoperatif serum parathormon (iPTH), duzeltilmis Ca, P, 25-OH D3, 24 saatlik idrarda kalsiyum duzeyi arasinda korelasyon analizi yapildi. Calisma cross-sectional olarak dizayn edildi. Bulgular: Calismaya alinan elli iki hastanin 45’i kadin (%86,5), 7’si erkekti (%13,5). Hastalarin yas ortalamasi 53,538 ± 14,996 yildi. Hastalarin ortalama preoperatif iPTH duzeyi 371,423 ± 341,857 pg/dl, ortalama duzeltilmis Ca duzeyi 11,652 ± 0,947 mg/dl, ortalama fosfor duzeyi 2,285 ± 0,434 mg/dl, ortalama 25-OH D3 duzeyi 11,442 ± 6,120 ng/ml, 24 saatlik idrarda kalsiyum duzeyi 337,486 ± 213,658 mg/24 saat olarak bulundu. Hastalarin hesaplanan paratiroid adenom volum ortalamasi 1.612 ± 2 cm3 (0,0060-11,510) idi. Paratiroid adenom volumu ile parathormon duzeyleri ve 24 saatlik idrar kalsiyum duzeyleri arasinda pozitif yonde, 25-hidroksi vitamin D duzeyleri arasinda negatif yonde korelasyon saptandi.  Sonuc: PHPT hastalarda adenom boyutu parathormon ve vitamin D duzeyi ile korelasyon gostermektedir. Bu nedenle, preoperatif iPTH ve vitamin D duzeylerinin adenom boyutu hakkinda prediktif degere sahip olabilecegini dusunmekteyiz.

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