Unusually high calcium levels in the blood can almost always be traced to primary hyperparathyroidism, an undertreated, underreported condition that affects mainly women and the elderly, according to a new study by UCLA researchers.
The condition, which results from overactive parathyroid glands and includes symptoms of bone loss, depression and fatigue that may go undetected for years, is most often seen in African American women over the age of 50, the researchers discovered.
The study, currently online in the Journal of Clinical Endocrinology and Metabolism, is one of the first to examine a large, racially and ethnically diverse population — in this case, one that was 65 percent non-white. Previous studies had focused on smaller, primarily Caucasian populations.
The four parathyroid glands, which are located in the neck, next to the thyroid, regulate the body's calcium levels. When one is dysfunctional, it can cause major imbalances — for example, by releasing calcium from the bones and into the bloodstream. Over time, calcium loss from bones often leads to osteoporosis and fractures, and excessive calcium levels in the blood can cause kidney stones and worsening kidney function.
The UCLA researchers determined that hyperparathyroidism is the leading cause of high blood-calcium levels and is responsible for nearly 90 percent of all cases."The findings suggest that hyperparathyroidism is the predominant cause of high calcium levels, so if patients find they have high calcium, they should also have their parathyroid hormone level checked," said the study's lead author, Dr. Michael W. Yeh, an associate professor of surgery and endocrinology at the David Geffen School of Medicine at UCLA.
For the study, researchers utilized a patient database from Kaiser Permanente Southern California that included information on 3.5 million individuals, a population roughly the size of Ohio. Using data from lab results, the research team identified 15,234 cases of chronic high-calcium levels. Of those cases, 13,327 patients (87 percent) were found to have hyperparathyroidism.
The incidence of hyperparathyroidism — reported as the number of cases per 100,000 people per year — was found to be highest among African Americans (92 women and 46 men), followed by Caucasians (81 women and 29 men), Asians (52 women, 28 men) and Hispanics (49 women and 17 men).
The research team also found that with advancing age, the incidence of hyperparathyroidism (per 100,000 people per year) increased and that more women were affected:Under age 50: 12 to 24 cases for both genders
However, since black women tend to have stronger bones and fewer fractures, more study is needed to see how the disorder is manifested in this patient group. African American women's physiology may be different and more protective of calcium and bone, Yeh said.
Yeh also noted that further study of the disorder may result in new, more targeted treatment guidelines based on racial differences. African American women, for instance, may require less vitamin D than is commonly prescribed to protect bone health, he said.
In the study, the researchers also found that the prevalence of hyperparathyroidism has tripled in the last 10 years, increasing from 76 women to 233 (out of 100,000) and from 30 men to 85.The researchers noted that the growing prevalence is likely due to increased calcium testing, annual lab tests to monitor patients with symptoms and the low rate of surgery to treat the disorder. Previous research has shown that only 28 percent of patients with hyperparathyroidism undergo surgery to remove the overactive parathyroid gland — the most reliable way to correct the disorder.
The next step, Yeh said, is further study of this patient population to examine the long-term impact of the condition on bone health and the effectiveness of different management strategies on outcomes.
"We are aiming to better understand how hyperparathyroidism affects people of different racial backgrounds," he said.
The study was funded with support from the Earl Gales Family Foundation, the National Institute on Aging and the American Geriatrics Society.
Additional authors include Philip H.G. Ituarte, Ph.D., Stacie Nishimoto and Dr. Avital Harari of the section of endocrine surgery at the David Geffen School of Medicine at UCLA; Hui Cynthia Zhou, In-Lu Amy Liu and Annette L. Adams, Ph.D., of the department of research and evaluation at Kaiser Permanente Southern California; and Dr. Philip I. Haigh of the department of surgery at Kaiser Permanente Los Angeles Medical Center.
For more news, visit the UCLA Newsroom and follow us on Twitter.
Rachel Champeau | EurekAlert!
Monitoring the heart's mitochondria to predict cardiac arrest?
21.09.2017 | Boston Children's Hospital
Highly precise wiring in the Cerebral Cortex
21.09.2017 | Max-Planck-Institut für Hirnforschung
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...
MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems Holding GmbH about commercial use of a multi-well tissue plate for automated and reliable tissue engineering & drug testing.
MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems...
19.09.2017 | Event News
12.09.2017 | Event News
06.09.2017 | Event News
21.09.2017 | Physics and Astronomy
21.09.2017 | Life Sciences
21.09.2017 | Health and Medicine