Abstract
Objective
Nonsurgical hypoparathyroidism (ns-HP) is a rare disease. There are few studies on Quality of Life (QoL) among patients with ns-HP. This study aimed to investigate the QoL among ns-HP patients with regular conventional treatment, and explore the influence factors affecting QoL among these Chinese ns-HP patients.
Methods
This is a cross-sectional study comparing 101 patients identified as ns-HP and 101 healthy controls. The questionnaires of Short Form 36 Health Survey questionnaire version 2(SF-36v2) were used to evaluate QoL.
Results
Scores of all eight subdomains of SF-36v2 and physical component scores (PCS), mental component scores (MCS) were significantly lower in the ns-HP group compared with the healthy controls. The indices of all subdomains of SF-36v2 between Q1 (the lowest quartile) and Q4 (the highest quartile) groups were compared, suggesting higher percentages of detectable parathyroid hormone (PTH) before treatment in Q4 group among all QoL indices except two subdomains (physical function and body pain).
Conclusion
Both mental and physical QoL were impaired in the ns-HP patients even with regular conventional treatment for hypocalcemia, which were more severe in cases with lower baseline PTH levels.
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Data availability
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
References
Underbjerg L, Sikjaer T, Mosekilde L et al (2015) The epidemiology of nonsurgical hypoparathyroidism in Denmark: a nationwide case finding study. J Bone Miner Res 30:1738–1744
Nakamura Y, Matsumoto T, Tamakoshi A et al (2000) Prevalence of idiopathic hypoparathyroidism and pseudohypoparathyroidism in Japan. J Epidemiol 10:29–33
Halabe A, Arie R, Mimran D et al (1994) Hypoparathyroidism–a long-term follow-up experience with 1 alpha-vitamin D3 therapy. Clin Endocrinol (Oxf) 40:303–307
Cooper MS, Gittoes NJ (2008) Diagnosis and management of hypocalcaemia. BMJ 336:1298–1302
Denko JD, Kaelbling R (1962) The psychiatric aspects of hypoparathyroidism. Acta Psychiatr Scand Suppl 38:1–70
Arlt W, Fremerey C, Callies F et al (2002) Well-being, mood and calcium homeostasis in patients with hypoparathyroidism receiving standard treatment with calcium and vitamin D. Eur J Endocrinol 146:215–222
Buttner M, Musholt TJ, Singer S (2017) Quality of life in patients with hypoparathyroidism receiving standard treatment: a systematic review. Endocrine 58:14–20
Palermo A, Santonati A, Tabacco G et al (2018) PTH (1–34) for surgical hypoparathyroidism: a 2-year prospective, open-label investigation of efficacy and quality of life. J Clin Endocrinol Metab 103:271–280
Cusano NE, Rubin MR, McMahon DJ et al (2013) The effect of PTH (1–84) on quality of life in hypoparathyroidism. J Clin Endocrinol Metab 98:2356–2361
Cusano NE, Rubin MR, McMahon DJ et al (2014) PTH (1–84) is associated with improved quality of life in hypoparathyroidism through 5 years of therapy. J Clin Endocrinol Metab 99:3694–3699
Santonati A, Palermo A, Maddaloni E et al (2015) PTH (1–34) for surgical hypoparathyroidism: a prospective, open-label investigation of efficacy and quality of life. J Clin Endocrinol Metab 100:3590–3597
Tabacco G, Tay YD, Cusano NE et al (2019) Quality of Life in hypoparathyroidism improves with rhPTH (1–84) throughout 8 Years of therapy. J Clin Endocrinol Metab 104:2748–2756
Sikjaer T, Rolighed L, Hess A et al (2014) Effects of PTH(1–84) therapy on muscle function and quality of life in hypoparathyroidism: results from a randomized controlled trial. Osteoporos Int 25:1717–1726
Roszko KL, Hu TY, Guthrie LC et al (2022) PTH 1–34 replacement therapy has minimal effect on quality of life in patients with hypoparathyroidism. J Bone Miner Res 37:68–77
Gittoes N, Rejnmark L, Ing SW et al (2021) The PARADIGHM (physicians advancing disease knowledge in hypoparathyroidism) registry for patients with chronic hypoparathyroidism: study protocol and interim baseline patient characteristics. BMC Endocr Disord 21:232
Kumanishi T, Washiyama K, Saito T et al (1986) Primary malignant lymphoma of the brain: an immunohistochemical study of eight cases using a panel of monoclonal and heterologous antibodies. Acta Neuropathol 71:190–196
Jorgensen CU, Homoe P, Dahl M et al (2021) Postoperative chronic hypoparathyroidism and quality of life after total thyroidectomy. JBMR Plus 5:e10479
Sikjaer T, Moser E, Rolighed L et al (2016) Concurrent hypoparathyroidism is associated with impaired physical function and quality of life in hypothyroidism. J Bone Miner Res 31:1440–1448
Astor MC, Lovas K, Debowska A et al (2016) Epidemiology and health-related quality of life in hypoparathyroidism in norway. J Clin Endocrinol Metab 101:3045–3053
Underbjerg L, Sikjaer T, Rejnmark L (2018) Health-related quality of life in patients with nonsurgical hypoparathyroidism and pseudohypoparathyroidism. Clin Endocrinol (Oxf) 88:838–847
Aggarwal S, Kailash S, Sagar R et al (2013) Neuropsychological dysfunction in idiopathic hypoparathyroidism and its relationship with intracranial calcification and serum total calcium. Eur J Endocrinol 168:895–903
Sardella A, Bellone F, Morabito N et al (2021) The association between hypoparathyroidism and cognitive impairment: a systematic review. J Endocrinol Invest 44:905–919
Saponaro F, Alfi G, Cetani F et al (2022) Serum calcium levels are associated with cognitive function in hypoparathyroidism: a neuropsychological and biochemical study in an Italian cohort of patients with chronic post-surgical hypoparathyroidism. J Endocrinol Invest 45:1909–1918
Bonavolontà V, Cianferotti L, Iolascon G et al (2022) Which physical activity in patients affected by hypoparathyroidism? A review of the literature and practical recommendations. J Endocrinol Invest 45:1289–1295
Balabanov S, Tollner U, Richter HP et al (1984) Immunoreactive parathyroid hormone, calcium, and magnesium in human cerebrospinal fluid. Acta Endocrinol (Copenh) 106:227–233
Usdin TB, Gruber C, Bonner TI (1995) Identification and functional expression of a receptor selectively recognizing parathyroid hormone, the PTH2 receptor. J Biol Chem 270:15455–15458
Bago AG, Dimitrov E, Saunders R et al (2009) Parathyroid hormone 2 receptor and its endogenous ligand tuberoinfundibular peptide of 39 residues are concentrated in endocrine, viscerosensory and auditory brain regions in macaque and human. Neuroscience 162:128–147
Vokes TJ, Mannstadt M, Levine MA et al (2018) Recombinant human parathyroid hormone effect on health-related quality of life in adults with chronic hypoparathyroidism. J Clin Endocrinol Metab 103:722–731
Chomsky-Higgins KH, Rochefort HM, Seib CD et al (2018) Recombinant parathyroid hormone versus usual care: do the outcomes justify the cost? World J Surg 42:431–436
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This work was supported by the National Natural Science Foundation of China (No. 82070817).
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This study was conducted in accordance with the principles of the Declaration of Helsinki and approved by the Ethics Committee of PUMCH (ZS-1689).
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Song, A., Chen, S., Yang, Y. et al. PTH level might be associated with impaired quality of life in patients with nonsurgical hypoparathyroidism. J Endocrinol Invest 46, 2471–2479 (2023). https://doi.org/10.1007/s40618-023-02100-9
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DOI: https://doi.org/10.1007/s40618-023-02100-9