HEALTH-RELATED QUALITY OF LIFE IS IMPAIRED IN HYPERPARATHYROIDISM AND SIGNIFICANTLY IMPROVES AFTER SURGERY

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 234-256-Bone & Calcium Metabolism: Clinical Trials & Case Series
Clinical
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-244
Eeva Ryhanen*1, Risto Roine2, Ilkka Heiskanen3, Harri Sintonen4, Matti Valimaki5 and Camilla Schalin-Jantti6
1Helsinki University Hospital, Espoo, Finland, 2Helsinki University Hospital, Helsinki and Uusimaa District, HUS, 3Helsinki University Hospital, HUS, 4Hjelt Institute, University of Helsinki, 5Helsinki University Hospital, 6Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Introduction: Patients with biochemically confirmed primary hyperparathyroidism (PHPT) and specific disease symptoms should undergo surgery. The impact of parathyroidectomy on neuropsychological and other nonspecific symptoms is still unclear.

Aim:To study whether health-related quality of life (HRQoL) is impaired in PHPT and whether it improves after surgery. 

Design and Method:HRQoL was assessed by the 15D instrument in 93 patients  referred for surgery because of PHPT. Patients biochemically cured by surgery  (n= 84, mean age 64.4 yrs (range 39-85), 67/17 F/M) were restudied at 6 mo (n= 63) and 12 mo (n= 46) and their results were compared to that of a large Finnish background population of similar age (n= 4801).

Results:Serum ionized calcium (reference range 1.15-1.30 mmol/l) and PTH (reference range 12-47 ng/l) concentrations decreased significantly after surgery (1.48 mmol/l ± 0.13 vs  1.24 ± 0.075 mmol/l  and 192 ± 186 ng/l vs 27 ± 23 ng/l, respectively, both P< 0.001). At baseline, PHPT patients had significantly lower mean total 15D scores compared to the control group (0.81 ± 0.11  vs 0.87 ± 0.12, P<0.001). The patients were worse off especially in the dimensions excretion, usual activities, mental function, discomfort and symptoms, vitality and sexual activity. Six mo after surgery, mean total 15D scores had improved significantly from baseline (from 0.81 ± 0.11 to 0.86 ± 0.12 , P< 0.001). This improvement was sustained at 12 mo (0.87 ± 0.12; P< 0.001 vs baseline) and did not differ significantly from that of the control group anymore (0.87 ± 0.12 vs 0.87 ± 0.11, P=0.64).  In single dimensions, significant improvement at 6 mo compared to baseline was seen in vitality, depression and sexual activity (all P< 0.001) as well as in speech, excretion, discomfort and symptoms and mental function (all P< 0.01). At 12 mo, significant improvements compared to baseline were observed in vitality, discomfort and symptoms and sexual activity (all P<0.001), in mental function and depression  (both P< 0.01) and in sleeping, speech, excretion and usual activities (all P<0.05).

Conclusion: HRQoL is significantly impaired in PHPT and this impairment affects several dimensions of HRQoL. However, HRQoL significantly improves after successful surgery and the beneficial effects are sustained at 1 yr after surgery.

Nothing to Disclose: ER, RR, IH, HS, MV, CS

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: This study was supported by grants from Research Funding of Helsinki University Hospital and the Jalmari and Rauha Ahokas Foundation (E.R).