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The Epidemiology of Hypoparathyroidism in Italy: An 8-Year Register-Based Study

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Abstract

Hypoparathyroidism is a rare endocrine disorder, but few studies have focused on the epidemiology and hospital management of the disease and none has been performed in Italy. We investigated the prevalence of different forms of hypoparathyroidism among hospitalized patients in Italy during an 8-year period. This study is designed as a retrospective register-based study. We retrieved data from the “Record of Hospital Discharge” (SDO) of the Italian Health Ministry, from the year 2006 to 2013 and analyzed the codes corresponding to hypoparathyroidism-related diagnoses. The inpatient prevalence of the disease was also calculated after excluding repeated hospitalizations. Overall, 27,692 hospitalization episodes for hypoparathyroidism were identified during the entire period (72.2% in women and 27.8% in men; mean age 49.5 ± 22.9 years). The mean length of stay was 7.4 ± 9.8 days (25.9% of the episodes requiring less than 3 days of stay). The mean hospitalization rate for hypoparathyroidism was 5.9/100,000 inhabitants per year and there was a significant decrease during the period of 2006–2013 (p < 0.0001). The mean hospitalization rate for postsurgical hypoparathyroidism was 1.4/100,000 inhabitants per year and the trend showed a significant reduction during the years (p < 0.0001). The mean prevalence of hypoparathyroidism among inpatients was 5.3/100,000 inhabitants per year, and there was a significant decrease over the years (p < 0.0001). Hypoparathyroidism, particularly the postsurgical form of the disease, is not an uncommon condition among hospitalized patients in Italy. We observed a tendency to a decrease in the frequency of hospitalization during the period 2006–2013.

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References

  1. Bilezikian JP, Khan A, Potts JT Jr., Brandi ML, Clarke BL, Shoback D, Jüppner H, D’Amour P, Fox J, Rejnmark L, Mosekilde L, Rubin MR, Dempster D, Gafni R, Collins MT, Sliney J, Sanders J (2011) Hypoparathyroidism in the adult: epidemiology, diagnosis, pathophysiology, target-organ involvement, treatment, and challenges for future research. J Bone Miner Res 26:2317–2337. doi:10.1002/jbmr.483

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Clarke BL, Brown EM, Collins MT, Jüppner H, Lakatos P, Levine MA, Mannstadt MM, Bilezikian JP, Romanischen AF, Thakker RV (2016) Epidemiology and diagnosis of hypoparathyroidism. J Clin Endocrinol Metab 101:2284–2299. doi:10.1210/jc.2015-3908

    Article  CAS  PubMed  Google Scholar 

  3. Powers J, Joy K, Ruscio A, Lagast H (2013) Prevalence and incidence of hypoparathyroidism in the United States using a large claims database. J Bone Miner Res 28:2570–2576. doi:10.1002/jbmr.2004

    Article  PubMed  Google Scholar 

  4. Underbjerg L, Sikjaer T, Mosekilde L, Rejnmark L (2013) Cardiovascular and renal complications to postsurgical hypoparathyroidism: a Danish nationwide controlled historic follow-up study. J Bone Miner Res 28:2277–2285. doi:10.1002/jbmr.1979

    Article  PubMed  Google Scholar 

  5. Underbjerg L, Sikjaer T, Mosekilde L, Rejnmark L (2015) The epidemiology of nonsurgical hypoparathyroidism in Denmark: a nationwide case finding study. J Bone Miner Res 30:1738–1744. doi:10.1002/jbmr.2501

    Article  CAS  PubMed  Google Scholar 

  6. Clarke BL et al (2011) Co-morbid- medical conditions associated with prevalent hypoparathyroidism: a population-based study. J Bone Miner Res 26:S182 (Abstract SA1070)]

  7. Cipriani C, Carnevale V, Biamonte F, Piemonte S, Pepe J, Nieddu L, Bilezikian JP, Minisola S (2012) Hospital care for primary hyperparathyroidism in Italy: a 6-year register-based study. Eur J Endocrinol 171:481–487. doi:10.1530/EJE-14-0493

    Article  Google Scholar 

  8. Clarke BL (2013) Epidemiology of primary hyperparathyroidism. J Clin Densitom. 16:8–13. doi:10.1016/j.jocd.2012.11.009

    Article  PubMed  Google Scholar 

  9. Brandi ML, Bilezikian JP, Shoback D, Bouillon R, Clarke B, Thakker RV, Khan A, Potts JT Jr (2016) Management of hypoparathyroidism: summary statement and guidelines. J Clin Endocrinol Metab 101:2273–2283. doi:10.1210/jc.2015-3907

    Article  CAS  PubMed  Google Scholar 

  10. Page C, Strunski V (2007) Parathyroid risk in total thyroidectomy for bilateral, benign, multinodular goiter: report of 351 surgical cases. J Laryngol Otol 121:237–241

    CAS  PubMed  Google Scholar 

  11. Ito Y, Kihara M, Kobayashi K, Miya A, Miyauchi A (2014) Permanent hypoparathyroidism after completion total thyroidectomy as a second surgery: how do we avoid it? Endocr J 61:403–408

    Article  PubMed  Google Scholar 

  12. Zarnegar R, Brunaud L, Clark OH (2003) Prevention, evaluation, and management of complications following thyroidectomy for thyroid carcinoma. Endocrinol Metab Clin North Am 32:483–502

    Article  PubMed  Google Scholar 

  13. Paek SH, Lee YM, Min SY, Kim SW, Chun KW, Youn YK (2013) Risk factors of hypoparathyroidism following total thyroidectomy for thyroid cancer. World J Surg 37:94–101. doi:10.1007/s00268-012-1809-4

    Article  PubMed  Google Scholar 

  14. Thomusch O, Machens A, Sekulla C, Ukkat J, Brauckhoff M, Dralle H (2003) The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients. Surgery 133:180–185

    Article  PubMed  Google Scholar 

  15. Xiang D, Xie L, Li Z, Wang P, Ye M, Zhu M (2016) Endoscopic thyroidectomy along with bilateral central neck dissection (ETBC) increases the risk of transient hypoparathyroidism for patients with thyroid carcinoma. Endocrine 53:747–753

    Article  CAS  PubMed  Google Scholar 

  16. Richards ML, Thompson GB, Farley DR, Grant CS (2008) Reoperative parathyroidectomy in 228 patients during the era of minimal-access surgery and intraoperative parathyroid hormone monitoring. Am J Surg 196:937–943. doi:10.1016/j.amjsurg.2008.07.022

    Article  PubMed  Google Scholar 

  17. Mitchell DM, Regan S, Cooley MR, Lauter KB, Vrla MC, Becker CB, Burnett-Bowie SA, Mannstadt M (2012) Long-term follow-up of patients with hypoparathyroidism. J Clin Endocrinol Metab 97:4507–4514. doi:10.1210/jc.2012-1808

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Rubin MR, Dempster DW, Sliney J Jr, Zhou H, Nickolas TL, Stein EM, Dworakowski E, Dellabadia M, Ives R, McMahon DJ, Zhang C, Silverberg SJ, Shane E, Cremers S, Bilezikian JP (2011) PTH(1-84) administration reverses abnormal bone-remodeling dynamics and structure in hypoparathyroidism. J Bone Miner Res 26:2727–2736. doi:10.1002/jbmr.452

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Astor MC, Løvås K, Debowska A, Eriksen EF, Evang JA, Fossum C, Fougner KJ, Holte SE, Lima K, Moe RB, Myhre AG, Kemp EH, Nedrebø BG, Svartberg J, Husebye ES (2016) Epidemiology and health related quality of life in hypoparathyroidism in Norway. J Clin Endocrinol Metab 101:3045–3053

    Article  PubMed  PubMed Central  Google Scholar 

  20. Mantovani G, Spada A, Elli FM (2016) Pseudohypoparathyroidism and Gsα-cAMP-linked disorders: current view and open issues. Nat Rev Endocrinol 12:347–356. doi:10.1038/nrendo.2016.52

    CAS  PubMed  Google Scholar 

  21. Underbjerg L, Sikjaer T, Mosekilde L, Rejnmark L (2016) Pseudohypoparathyroidism—epidemiology, mortality and risk of complications. Clin Endocrinol (Oxf) 84:904–911. doi:10.1111/cen.12948

    Article  CAS  Google Scholar 

  22. Bilezikian JP, Brandi ML, Cusano NE, Mannstadt M, Rejnmark L, Rizzoli R, Rubin MR, Winer KK, Liberman UA, Potts JT Jr (2016) Management of hypoparathyroidism: present and future. J Clin Endocrinol Metab. doi:10.1210/jc.2015-3910

    Google Scholar 

  23. Underbjerg L, Sikjaer T, Mosekilde L, Rejnmark L (2014) Postsurgical hypoparathyroidism—risk of fractures, psychiatric diseases, cancer, cataract, and infections. J Bone Miner Res 29:2504–2510. doi:10.1002/jbmr.2273

    Article  PubMed  Google Scholar 

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Acknowledgements

We wish to thank Dr. Flavia Carle and Dr Marco Galadini for their contribution in retrieving data from the Italian Health Ministry database.

Author Contributions

CC contributed to design of the work, acquisition, analysis and interpretation of data, and to drafting the manuscript. JP contributed to acquisition of data and revising the manuscript. FB contributed to acquisition of data. RM contributed to design of the work. PB contributed to acquisition of data. LN contributed to data analysis. LC contributed to design of the work and interpretation of data. MLB contributed to project ideation, design of the work, interpretation of data, and revising the manuscript. SM contributed to project ideation, design of the work, analysis and interpretation of data, and revising the manuscript. All the authors have approved the final version of the manuscript.

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Authors and Affiliations

  1. Department of Internal Medicine and Medical Disciplines, “Sapienza” University of Rome, Viale del Policlinico 155, 00161, Rome, Italy

    Cristiana Cipriani, Jessica Pepe, Federica Biamonte, Rizieri Manai, Piergianni Biondi & Salvatore Minisola

  2. Faculty of Economics, UNINT University, Via Cristoforo Colombo 200, 00147, Rome, Italy

    Luciano Nieddu

  3. Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Viale Pieraccini 6, 50139, Florence, Italy

    Luisella Cianferotti & Maria Luisa Brandi

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  1. Cristiana Cipriani
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  2. Jessica Pepe
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  8. Maria Luisa Brandi
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  9. Salvatore Minisola
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Correspondence to Cristiana Cipriani.

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Conflict of interest

Cristiana Cipriani, Jessica Pepe, Federica Biamonte, Rizieri Manai, Piergianni Biondi, Luciano Nieddu, Luisella Cianferotti, Maria Luisa Brandi and Salvatore Minisola declare that they have no conflict of interest.

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The protocol was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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Cipriani, C., Pepe, J., Biamonte, F. et al. The Epidemiology of Hypoparathyroidism in Italy: An 8-Year Register-Based Study. Calcif Tissue Int 100, 278–285 (2017). https://doi.org/10.1007/s00223-016-0222-7

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  • DOI: https://doi.org/10.1007/s00223-016-0222-7

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