Hipoparatiroidi tanısı almış postmenopozal hastaların laboratuvar ve kemik mineral dansitometri verilerinin değerlendirilmesi
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Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Hitit Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Hipoparatiroidizm tanılı postmenopozal dönem kadın hastaların kemik mineral yoğunluğu, laboratuvar verileri ve osteoporotik kırık riskinin değerlendirilmesi ve kontrol grubu ile karşılaştırılması amaçlanmıştır. Gereç ve yöntem: Bu çalışma retrospektif bir çalışma olup; çalışmamıza 40 vaka 40 kontrol grubu kadın hasta alınmıştır. Çalışmanın örneklemini Hitit Üniversitesi Erol Olçok Eğitim ve Araştırma Hastanesi Endokrinoloji polikliniğine Şubat 2017-Eylül 2023 tarihleri arasında başvurmuş hipoparatiroidizm tanılı hasta grubu ile osteoporoz tarama amaçlı kemik mineral yoğunluğu ölçülen osteoporoza yönelik laboratuvar tetkikleri yapılmış hipoparatiroidizm tanısı olmayan postmenopozal dönem kadın hastalar oluşturmaktadır. Vaka ve kontrol grubu verileri; polikliniğe başvuru sırasında alınan anemnez bilgileri, sosyo-demografik özellikleri, fizik muayene bilgileri, özgeçmiş, kullandığı ilaçları, komorbiditeleri, laboratuvar ve kemik mineral yoğunluğu ölçümleri hastane kayıtları üzerinden retrospektif olarak tarandı. Kemik mineral yoğunluğu verileri Dual X-Işını absorbsiyometri tekniği ile yapılan ölçümler ile hesaplandı. Dünya Sağlık Örgütü kırık riskini değerlendirme ölçütü (FRAX) ile 10 yıllık kırık riski, femur boynu kemik mineral yoğunluğu kullanılarak ayrı ayrı hesaplandı. Vaka ve kontrol grubu için dahil edilme kriterlerine uygun benzer demografik özelliklere sahip hastalar seçildi. Elde edilen veriler SPSS Programı kullanılarak değerlendirildi. Bulgular: Hasta grubunun kalça T-skoru, L1-L4 T-skoru, femur boynu, femur total ve L1-L4 total kemik mineral yoğunluğu ölçümleri kontrol grubundan istatistiksel olarak anlamlı yüksekti (Sırasıyla, p=0,002, p<0,001, p<0,001, p=0,001, p<0,001). Hasta grubunun parathormon, serum total kalsiyum ve düzeltilmiş kalsiyum değerleri kontrol grubundan istatistiksel olarak anlamlı düşüktü (p<0,001, p<0,001, p<0,001). Hasta grubunun 25-hidroksi vitamin D ve 24 saat idrar kalsiyum değerleri kontrol grubundan istatistiksel olarak anlamlı yüksekti (p=0,011, p=0,008). Hasta grubunda 25-hidroksi vitamin D değeri, 20 ve altı olan hastalar ile 20 üzeri olan hastalar arasında 25-hidroksi vitamin D değerlerine göre oluşturulan alt gruplar arasında kemik mineral yoğunluğu ölçümleri, kırık riski değerlendirme skorları ve laboratuvar kan değerleri istatistiksel olarak anlamlı farklı değildi. Hasta ve kontrol gruplarında v yer alan tüm hastaların (n=80) 25-hidroksi vitamin D değerleri ile sadece PHT değerleri arasında negatif yönlü zayıf düzeyde istatistiksel olarak anlamlı korelasyon belirlendi (r=- 0,371, p=0,001). 25-hidroksi vitamin D değerleri ile diğer parametreler arasında anlamlı korelasyon bulunamadı. Sonuçlar: Çalışmamız, hipoparatiroidizm tanılı postmenopozal dönem kadın hastalarda önemli bulgular ortaya koymaktadır. Özellikle, hipoparatiroidizm tanılı hastaların kontrol grubuyla karşılaştırıldığında, yüksek kemik mineral yoğunluğu ölçümleri ve düşük major osteoporotik kırık riski olduğunu tespit ettik. Hasta grubunda parathormon seviyelerinin düşük ve 24 saatlik idrarda kalsiyum seviyelerinin yüksek olması beklenen bulgular arasındaydı. Hipoparatiroidizm ile ilgili literatür incelendiğinde, çalışmamız ülkemizde hipoparatiroidizmin kemik sağlığı üzerine etkisini araştıran ilk çalışma özelliğine sahiptir. Dünya çapında hipoparatiroidizmin kırık riski üzerine etkisini araştıran çok az yayın bulunmaktadır. Bu durum, çalışmanızın uluslararası alandaki önemini vurgulamakta ve literatüre katkı sağlayacağını göstermektedir. Anahtar kelimeler: Hipoparatiroidizm, Kemik Mineral Yoğunluğu, Osteoporoz, Postmenopoz
Aim: The aim of the study was to evaluate the bone mineral density, laboratory data, and osteoporotic fracture risk in postmenopausal women diagnosed with hypoparathyroidism and compare them with a control group. Materials and methods: This study is a retrospective study; 40 female patients in the hypoparathyroidism group and 40 female patients in the control group were included in our study. The sample of the study consists of patients diagnosed with hypoparathyroidism who applied to the Endocrinology outpatient clinic of Hitit University Erol Olçok Training and Research Hospital between February 2017 and September 2023 and postmenopausal female patients who underwent bone mineral density measurements for osteoporosis screening. The data of the case and control groups were retrospectively screened through hospital records, including anamnesis information, socio-demographic characteristics, physical examination findings, medical history, medications used, comorbidities, and laboratory and BMD measurements. Bone mineral density data were calculated from measurements obtained using Dual X-Ray Absorptiometry technique. The 10 year fracture risk assessed by the FRAX tool using femoral neck bone mineral density was calculated either. Patients with similar demographic characteristics who met the inclusion criteria for the case and control groups were selected. The data obtained were analyzed using the SPSS program. Results: Hip T-score, L1-L4 T-score, femur neck, femur total and L1-L4 bone mineral density measurements of the patient group were statistically significantly higher than the control group (p=0,002, p<0,001, p<0,001, p=0,001, p<0,001 respectively). Creatinine measurements of the patient group were statistically significantly higher than the control group (p=0,013). Parathormone, serum total calcium and corrected calcium values of the patient group were statistically significantly lower than the control group (p<0,001, p<0,001, p<0,001). The 25-hydroxy vitamin D and 24-hour urine calcium values of the patient group were statistically significantly higher than the control group (p= 0,011; p= 0,008). The patient group was divided into two groups according to 25-hydroxy vitamin D levels as 20 ng/dL and below and above 20 ng/dL. Bone mineral density measurements, fracture risk assessment scores and laboratory blood values were not statistically significantly different between the subgroups formed according to hydroxyvitamin D values. A negative statistically significant correlation was determined between the 25-hydroxyvitamin D values of all patients (n=80) in the patient and control groups and only the parathyroid hormone values (r=-0,371, p=0,001). No significant correlation was found between 25-hydroxyvitamin D values and other parameters (p>0,05 for all comparisons). Conclusions: Our study reveals important findings in postmenopausal women diagnosed with hypoparathyroidism. Particularly, when compared to the control group, we identified higher bone mineral density measurements and lower risk of major osteoporotic fractures in patients diagnosed with hypoparathyroidism. It was expected to find low levels of parathyroid hormone and high levels of calcium in 24-hour urine among the patient group. Upon reviewing the literature on hypoparathyroidism, our study stands out as the first in our country to investigate the impact of hypoparathyroidism on bone health. Globally, there are very few publications examining the effect of hypoparathyroidism on fracture risk. This underscores the international significance of your study and highlights its contribution to the literature. Key words: Bone Mineral Density, Hypoparathyroidism, Osteoporosis, Postmenopause
Aim: The aim of the study was to evaluate the bone mineral density, laboratory data, and osteoporotic fracture risk in postmenopausal women diagnosed with hypoparathyroidism and compare them with a control group. Materials and methods: This study is a retrospective study; 40 female patients in the hypoparathyroidism group and 40 female patients in the control group were included in our study. The sample of the study consists of patients diagnosed with hypoparathyroidism who applied to the Endocrinology outpatient clinic of Hitit University Erol Olçok Training and Research Hospital between February 2017 and September 2023 and postmenopausal female patients who underwent bone mineral density measurements for osteoporosis screening. The data of the case and control groups were retrospectively screened through hospital records, including anamnesis information, socio-demographic characteristics, physical examination findings, medical history, medications used, comorbidities, and laboratory and BMD measurements. Bone mineral density data were calculated from measurements obtained using Dual X-Ray Absorptiometry technique. The 10 year fracture risk assessed by the FRAX tool using femoral neck bone mineral density was calculated either. Patients with similar demographic characteristics who met the inclusion criteria for the case and control groups were selected. The data obtained were analyzed using the SPSS program. Results: Hip T-score, L1-L4 T-score, femur neck, femur total and L1-L4 bone mineral density measurements of the patient group were statistically significantly higher than the control group (p=0,002, p<0,001, p<0,001, p=0,001, p<0,001 respectively). Creatinine measurements of the patient group were statistically significantly higher than the control group (p=0,013). Parathormone, serum total calcium and corrected calcium values of the patient group were statistically significantly lower than the control group (p<0,001, p<0,001, p<0,001). The 25-hydroxy vitamin D and 24-hour urine calcium values of the patient group were statistically significantly higher than the control group (p= 0,011; p= 0,008). The patient group was divided into two groups according to 25-hydroxy vitamin D levels as 20 ng/dL and below and above 20 ng/dL. Bone mineral density measurements, fracture risk assessment scores and laboratory blood values were not statistically significantly different between the subgroups formed according to hydroxyvitamin D values. A negative statistically significant correlation was determined between the 25-hydroxyvitamin D values of all patients (n=80) in the patient and control groups and only the parathyroid hormone values (r=-0,371, p=0,001). No significant correlation was found between 25-hydroxyvitamin D values and other parameters (p>0,05 for all comparisons). Conclusions: Our study reveals important findings in postmenopausal women diagnosed with hypoparathyroidism. Particularly, when compared to the control group, we identified higher bone mineral density measurements and lower risk of major osteoporotic fractures in patients diagnosed with hypoparathyroidism. It was expected to find low levels of parathyroid hormone and high levels of calcium in 24-hour urine among the patient group. Upon reviewing the literature on hypoparathyroidism, our study stands out as the first in our country to investigate the impact of hypoparathyroidism on bone health. Globally, there are very few publications examining the effect of hypoparathyroidism on fracture risk. This underscores the international significance of your study and highlights its contribution to the literature. Key words: Bone Mineral Density, Hypoparathyroidism, Osteoporosis, Postmenopause
Açıklama
Hitit Üniversitesi, Tıp Fakültesi
Anahtar Kelimeler
Hipoparatiroidizm, Kemik Mineral Yoğunluğu, Osteoporoz, Postmenopoz, Bone Mineral Density, Hypoparathyroidism, Osteoporosis, Postmenopause, Hipoparatiroidizm, Kemik Mineral Yoğunluğu, Osteoporoz, Postmenopoz, Bone Mineral Density, Hypoparathyroidism, Osteoporosis, Postmenopause
