Primer Hiperparatiroidili Hastalarda Proadrenomedülin Seviyelerinin İncelemesi
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Tarih
2025
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Primer Hiperparatiroidizm(PHPT) en yaygın rutin biyokimyasal taramada asemptomatik hiperkalsemi ile saptanır. Bununla birlikte, klinik semptomatik şiddetli hiperkalsemiden (paratiroid krizi) normokalsemik PHPT’ye kadar değişen bir kalsiyum homeostazı bozuklukları spekturumunu içerebelir. PHPT, gözlemsel çalışmalarda hipertansiyon, aritmi, ventriküler hipertrofi ve vasküler kapak kalsifikasyonu, karotis intima media kalınlığı (CIMT)’nda artış dahil olmak üzere kardiyovasküler hastalıklarla ilişkili olduğu gösterilmiştir1. Yapılan çalışmalarda pro-Adrenomedülin (pro-ADM) seviyelerinin kardiyovasüler hastalılarda artmış olduğu gösterilmiş olup, yapılan bu çalışmamızda primer hiparatiroidili hastalar ile sağlıklı kontrol grubu arasında serum proaderenomedülin seviyelerinin karşılaştırılması ve kardiovasküler risk faktörleri ile ilişkisinin incelenmesi amaçlanmıştır.
Materyal ve Metod: Bu çalışmaya primer hiperparatiroidi tanısı almış 43 hasta ve 34 adet sağlık kontrol grubu dahil edilmiştir. Primer hiperparatiroidi tanısı alan ve takipte olan hastalardan ve kontrol grubundaki kişilerden rutin kontroller sırasında bakılan biyokimyasal tetkikler, antropometrik ölçümler ve pro-Adrenomedülin (pro-ADM) seviyeleri değerlendirilecektir. Aynı zamanda çalışmaya ultrasonografi ile bakılan karotis intima media (CIMT) kalınlığı dahil edilmiştir.
Bulgular: Primer hiperparatiroidili hastalar ile kontrol grubu arasında kalsiyum (Ca), fosfor (P), paratiroid hormonu (PTH), alkalen fosfataz (ALP), karotis intima media kalınlığı (CIMT) ve proadrenomedülin değerlerinde anlamlı düzeyde fark saptandı (p=0.000). Yaş, bel, kalça, bel/kalça, VKİ, albümin, TSH, üre, glukoz, HBA1C, kolesterol, LDL, trigliserit, HDL, insülin, D vitamini, CRP değerleri bakımından hiperparatiroidili hastalar ve kontrol grupları arasındaki farklılık istatistiki olarak anlamlı değildir (p>0.05).Hasta ve kontrol gurubu arasındaki yapılan değerlendirmede Pro-adrenomedülin seviyeleri ile kalsiyum ,PTH, ALP ve CIMT değerleri ile pozitif yönlü ilişki tespit edilirken, fosfor ile ters yönlü bir istatistiki ilişki tespit edilmiştir.
Sonuç: Çalışmamızda primer hiperparatiroidili hastalarda Pro-ADM düzeylerinin daha yüksek oluğu ve bunun kardiyovasküler risk faktörleri ile korele olduğu saptanmıştır.
Objective: Primary Hyperparathyroidism (PHPT) is most commonly detected by asymptomatic hypercalcemia on routine biochemical screening. However, it may include a spectrum of calcium homeostasis disorders ranging from clinically symptomatic severe hypercalcemia (parathyroid crisis) to normocalcemic PHPT. Observational studies have shown that PHPT is associated with cardiovascular diseases including hypertension, arrhythmia, ventricular hypertrophy and vascular valve calcification, and increased carotid intima-media thickness (CIMT). In this study, we aimed to compare serum proaderenomedullin levels between patients with Primary Hyparathyroidism and healthy controls and to examine the relationship with cardiovascular risk factors. Matherials and Method: This study included 43 patients diagnosed with Primary Hyperparathyroidism and 34 health controls. Biochemical tests, anthropometric measurements and pro-Adrenomedullin (pro-ADM) levels will be evaluated during routine check-ups from patients diagnosed with Primary Hyperparathyroidism and those in the control group. Carotid intima media (CIMT) thickness measured by ultrasonography was also included in the study. Results: There was a significant difference between primary hyperparathyroidism patients and the control group in terms of calcium (Ca), phosphorus (P), parathyroid hormone (PTH), alkaline phosphatase (ALP), carotid intima media thickness (CIMT) and proadrenomedullin values (p=0.000). The difference between hyperparathyroidism patients and the control groups in terms of age, waist, hip, waist/hip, BMI, albumin, TSH, urea, glucose, HBA1C, cholesterol, LDL, triglyceride, HDL, insulin, vitamin D, CRP values was not statistically significant (p>0.05). In the evaluation made between the patient and control groups, a positive correlation was found between pro-adrenomedullin levels and calcium, PTH, ALP and CIMT values, while an inverse statistical correlation was found with phosphorus. Conclusion: In our study, it was found that Pro-ADM levels were higher in patients with primary hyperparathyroidism and this was correlated with cardiovascular risk factors.
Objective: Primary Hyperparathyroidism (PHPT) is most commonly detected by asymptomatic hypercalcemia on routine biochemical screening. However, it may include a spectrum of calcium homeostasis disorders ranging from clinically symptomatic severe hypercalcemia (parathyroid crisis) to normocalcemic PHPT. Observational studies have shown that PHPT is associated with cardiovascular diseases including hypertension, arrhythmia, ventricular hypertrophy and vascular valve calcification, and increased carotid intima-media thickness (CIMT). In this study, we aimed to compare serum proaderenomedullin levels between patients with Primary Hyparathyroidism and healthy controls and to examine the relationship with cardiovascular risk factors. Matherials and Method: This study included 43 patients diagnosed with Primary Hyperparathyroidism and 34 health controls. Biochemical tests, anthropometric measurements and pro-Adrenomedullin (pro-ADM) levels will be evaluated during routine check-ups from patients diagnosed with Primary Hyperparathyroidism and those in the control group. Carotid intima media (CIMT) thickness measured by ultrasonography was also included in the study. Results: There was a significant difference between primary hyperparathyroidism patients and the control group in terms of calcium (Ca), phosphorus (P), parathyroid hormone (PTH), alkaline phosphatase (ALP), carotid intima media thickness (CIMT) and proadrenomedullin values (p=0.000). The difference between hyperparathyroidism patients and the control groups in terms of age, waist, hip, waist/hip, BMI, albumin, TSH, urea, glucose, HBA1C, cholesterol, LDL, triglyceride, HDL, insulin, vitamin D, CRP values was not statistically significant (p>0.05). In the evaluation made between the patient and control groups, a positive correlation was found between pro-adrenomedullin levels and calcium, PTH, ALP and CIMT values, while an inverse statistical correlation was found with phosphorus. Conclusion: In our study, it was found that Pro-ADM levels were higher in patients with primary hyperparathyroidism and this was correlated with cardiovascular risk factors.
Açıklama
Anahtar Kelimeler
Primer hiperparatiroidi, primary hyperparathyroidism, kardiovasküler risk, cardiocaskuler risk, Pro-ADM, Karotis İntima Media Kalınlığı, carotis intime media thickness
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Yorgancı, Z. F. (2025). Primer Hiperparatiroidili Hastalarda Proadrenomedülin Seviyelerinin İncelemesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Tıp Fakültesi Dahili Tıp Bilimleri Bölümü İç Hastalıkları Anabilim Dalı, Konya.
