Abstract
To evaluate the association between metabolic abnormalities and cardiovascular risk factors in patients with chronic hypoparathyroidism (HPP). Patients 18years and older, glomerular filtration > 30mL/min/1.73 m2and no documented coronary artery disease were selected. Serum calcium, phosphorus, glucose, lipids, PTH, 25(OH)D and FGF23 were measured. Cardiovascular risk was estimated by the European Society of Cardiology (ESC) calculator. Transthoracic echocardiogram and carotid ultrasound were performed to detect carotid plaques (CP), carotid intima-media thickness (IMT), cardiac valve calcification (CVC), and left ventricular hypertrophy (LVH). Thirty-seven patients (94.6% female), aged 56.0 ± 13.5years and HPP duration 7.0 (4.0; 11.3) years, were included. Fifteen were classified as low cardiovascular risk, 9 as intermediate risk, 9 as high risk and none as very high risk. The prevalence of CP, CVC and LVH was 24.3%, 24.3% and 13.5%, respectively. IMT values were within normal ranges in all cohort.FGF23 were not associatedwithCP, IMT, CVC or LVH.After logistic regression, phosphorus was the only significant metabolic variable impacting CVC in univariate analysis (OR 2.795; 95% CI 1.132-6.905; p = 0.026), as well as in the multivariate analysis (OR 3.572; 95% CI 1.094-11.665; p = 0.035).Analysis by ROC curve showed serum phosphorus > 5.05mg/dL(AUC 0.748; CI 0.584-0.877; p = 0.05) as the best cutoff point associatedwith valve heart calcification (sensitivity 78%;negative predictive value91.3%). Hyperphosphatemia was associatedwith CVC in HPP patients.Further studies are needed to investigate whether the control of hyperphosphatemia may reduce cardiovascular risk in this population.
Published Version
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