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Identifying Clinical Characteristics of Hypoparathyroidism in Turkey: HIPOPARATURK-NET Study

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Abstract

Hypoparathyroidism is an orphan disease with ill-defined epidemiology that is subject to geographic variability. We conducted this study to assess the demographics, etiologic distribution, treatment patterns and complication frequency of patients with chronic hypoparathyroidism in Turkey. This is a retrospective, cross-sectional database study, with collaboration of 30 endocrinology centers located in 20 cities across seven geographical regions of Turkey. A total of 830 adults (mean age 49.6 ± 13.5 years; female 81.2%) with hypoparathyroidism (mean duration 9.7 ± 9.0 years) were included in the final analysis. Hypoparathyroidism was predominantly surgery-induced (n = 686, 82.6%). The insulting surgeries was carried out mostly due to benign causes in postsurgical group (SG) (n = 504, 73.5%) while patients in nonsurgical group (NSG) was most frequently classified as idiopathic (n = 103, 71.5%). The treatment was highly dependent on calcium salts (n = 771, 92.9%), calcitriol (n = 786, 94.7%) and to a lower extent cholecalciferol use (n = 635, 76.5%) while the rate of parathyroid hormone (n = 2, 0.2%) use was low. Serum calcium levels were most frequently kept in the normal range (sCa 8.5–10.5 mg/dL, n = 383, 46.1%) which might be higher than desired for this patient group. NSG had a lower mean plasma PTH concentration (6.42 ± 5.53 vs. 9.09 ± 7.08 ng/l, p < 0.0001), higher daily intake of elementary calcium (2038 ± 1214 vs. 1846 ± 1355 mg/day, p = 0.0193) and calcitriol (0.78 ± 0.39 vs. 0.69 ± 0.38 mcg/day, p = 0.0057), a higher rate of chronic renal disease (9.7% vs. 3.6%, p = 0.0017), epilepsy (6.3% vs. 1.6%, p = 0.0009), intracranial calcifications (11.8% vs. 7.3%, p < 0.0001) and cataracts (22.2% vs. 13.7%, p = 0.0096) compared to SG. In conclusion, postsurgical hypoparathyroidism is the dominant etiology of hypoparathyroidism in Turkey while the nonsurgical patients have a higher disease burden with greater need for medications and increased risk of complications than the postsurgical patients.

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Data Availability

The lead author affirms that this manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained. The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

Code Availability

All statistical analyses were performed using GraphPad Prism version 9.0.0 for Mac OS.

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Funding

This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

Author information

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Faculty of Medicine, Ufuk University, Ankara, Turkey

    Ceyla Konca Degertekin & Banu Aktas Yilmaz

  2. Endokrinoloji BD, Ufuk Üniversitesi Hastanesi, Mevlana Bulvarı (Konya Yolu) No:86-88 Balgat, Ankara, Turkey

    Ceyla Konca Degertekin

  3. Department of Endocrinology and Metabolism, Faculty of Medicine, Marmara University, Istanbul, Turkey

    Dilek Gogas Yavuz

  4. Department of Endocrinology and Metabolism, Faculty of Medicine, Dicle University, Diyarbakir, Turkey

    Zafer Pekkolay

  5. Endocrinology and Metabolism Clinic, Canakkale Mehmet Akif Ersoy State Hospital, Canakkale, Turkey

    Emre Saygili

  6. Department of Endocrinology and Metabolism, Faculty of Medicine, Fırat University, Elazig, Turkey

    Kader Ugur & Faruk Kilinc

  7. Endocrinology and Metabolism Clinic, Kecioren Training and Research Hospital, Ankara, Turkey

    Arzu Or Koca

  8. Department of Endocrinology and Metabolism, Faculty of Medicine, Aydın Adnan Menderes University, Aydin, Turkey

    Mustafa Unubol

  9. Endocrinology and Metabolism Clinic, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey

    Omercan Topaloglu

  10. Endocrinology and Metabolism Clinic, Batman Training and Research Hospital, Batman, Turkey

    Berna Imge Aydogan

  11. Department of Endocrinology and Metabolism, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey

    Nilufer Ozdemir Kutbay & Zeliha Hekimsoy

  12. Department of Endocrinology and Metabolism, Faculty of Medicine, Akdeniz University, Antalya, Turkey

    Nusret Yilmaz & Mustafa Kemal Balci

  13. Endocrinology and Metabolism Clinic, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey

    Seher Tanrikulu

  14. Department of Endocrinology and Metabolism, Faculty of Medicine, Bursa Uludağ University, Bursa, Turkey

    Yasemin Aydogan Unsal & Canan Ersoy

  15. Endocrinology and Metabolism Clinic, Ankara Training and Research Hospital, Ankara, Turkey

    Tulay Omma

  16. Endocrinology and Metabolism Clinic, Ankara Numune Training and Research Hospital, Ankara, Turkey

    Muge Keskin

  17. Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey

    Mehmet Muhittin Yalcin & Ilhan Yetkin

  18. Department of Endocrinology and Metabolism, Faculty of Medicine, Kırsehir Ahi Evran University, Kirsehir, Turkey

    Hikmet Soylu

  19. Department of Endocrinology and Metabolism, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey

    Melia Karakose

  20. Endocrinology and Metabolism Clinic, Samsun Gazi Training and Research Hospital, Samsun, Turkey

    Merve Yilmaz

  21. Department of Endocrinology and Metabolism, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey

    Ersen Karakilic

  22. Endocrinology and Metabolism Clinic, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey

    Hamide Piskinpasa

  23. Endocrinology and Metabolism Clinic, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey

    Adnan Batman

  24. Department of Endocrinology and Metabolism, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey

    Gulhan Akbaba

  25. Department of Endocrinology and Metabolism, Faculty of Medicine, Tekirdag Namık Kemal University, Tekirdag, Turkey

    Gulsah Elbuken

  26. Department of Endocrinology and Metabolism, Faculty of Medicine, Amasya University, Amasya, Turkey

    Cigdem Tura Bahadir

  27. Endocrinology and Metabolism Clinic, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey

    Muhammet Cuneyt Bilginer

  28. Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, Ankara, Turkey

    Ozlem Turhan Iyidir

  29. Department of Endocrinology and Metabolism, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey

    Zeynep Canturk

  30. Department of Endocrinology and Metabolism, Faculty of Medicine, Nigde University, Nigde, Turkey

    Zeynel Abidin Sayiner

  31. Department of Endocrinology and Metabolism, Faculty of Medicine, Balıkesir University, Balikesir, Turkey

    Mustafa Eroglu

Authors
  1. Ceyla Konca Degertekin
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  2. Dilek Gogas Yavuz
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  3. Zafer Pekkolay
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  4. Emre Saygili
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  5. Kader Ugur
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  6. Arzu Or Koca
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  7. Mustafa Unubol
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  8. Omercan Topaloglu
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  9. Berna Imge Aydogan
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  10. Nilufer Ozdemir Kutbay
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  12. Nusret Yilmaz
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  13. Mustafa Kemal Balci
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  14. Seher Tanrikulu
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  15. Yasemin Aydogan Unsal
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  16. Canan Ersoy
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  17. Tulay Omma
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  18. Muge Keskin
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  19. Mehmet Muhittin Yalcin
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  20. Ilhan Yetkin
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  21. Hikmet Soylu
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  22. Melia Karakose
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  23. Merve Yilmaz
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  24. Ersen Karakilic
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  25. Hamide Piskinpasa
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  26. Adnan Batman
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  27. Gulhan Akbaba
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  28. Gulsah Elbuken
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  29. Cigdem Tura Bahadir
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  30. Faruk Kilinc
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  31. Muhammet Cuneyt Bilginer
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  32. Ozlem Turhan Iyidir
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  33. Zeynep Canturk
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  34. Banu Aktas Yilmaz
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  35. Zeynel Abidin Sayiner
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  36. Mustafa Eroglu
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Corresponding author

Correspondence to Ceyla Konca Degertekin.

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Conflict of interest

Ceyla Konca Degertekin, Dilek Gogas Yavuz, Zafer Pekkolay, Emre Saygili, Kader Ugur, Arzu Or Koca, Mustafa Unubol, Omercan Topaloglu, Berna Imge Aydogan, Nilufer Ozdemir Kutbay, Zeliha Hekimsoy, Nusret Yilmaz, Mustafa Kemal Balci, Seher Tanrikulu, Yasemin Aydogan Unsal, Canan Ersoy, Tulay Omma, Muge Keskin, Muhittin Yalcin, Ilhan Yetkin, Hikmet Soylu, Melia Karakose, Merve Yilmaz, Ersen Karakilic, Hamide Piskinpasa, Adnan Batman, Gulhan Akbaba, Gulsah Elbuken, Cigdem Tura Bahadir, Faruk Kilinc, Muhammet Cuneyt Bilginer, Ozlem Turhan Iyidir, Zeynep Canturk, Banu Aktas Yilmaz, Zeynel Abidin Sayiner, Mustafa Eroglu declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

Ethical Approval

The study protocol was approved by the local ethics committee of Marmara University School of Medicine (09.2018.756). All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Human and Animal Rights and Informed Consent

This retrospective chart review study involving human participants was in accordance with the ethical standarts of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standarts. The local ethics committee of Marmara University School of Medicine approved this study (09.2018.756).

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Konca Degertekin, C., Gogas Yavuz, D., Pekkolay, Z. et al. Identifying Clinical Characteristics of Hypoparathyroidism in Turkey: HIPOPARATURK-NET Study. Calcif Tissue Int 110, 204–214 (2022). https://doi.org/10.1007/s00223-021-00908-2

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