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Objective <p>Surgery indications for primary hyperparathyroidism (PHPT) mostly concern kidney and bone outcome, but not cardiovascular disease (CVD). Age less than 50 and eGFR less than 60&#xa0;ml/min/1.73m<sup>2</sup> are two surgery indications. This study aims to evaluate factors influencing the 10-year CVD risk in PHPT patients.</p> Method <p>159 PHPT patients diagnosed between January 2024 - March 2025 were enrolled. The relationships between biochemical and echocardiographic parameters with 10-year CVD risk score calculated by PREVENT<sup>™</sup> were analyzed. Univariate, multivariate, logistic regression and receive operation curve (ROC) analysis were employed.</p> Results <p>10-year CVD risk score was positively corelated with age (R<sup>2</sup><sub>adjusted</sub> = 0.604, β = 0.541), systolic blood pressure (R<sup>2</sup> <sub>adjusted</sub> =0.149, β = 0.185), eGFR (R<sup>2</sup> <sub>adjusted</sub> =0.452, β=-0.252), triglyceride (R<sup>2</sup> <sub>adjusted</sub> =0.134, β = 3.629) with <i>P</i> &lt; 0.001.These parameters together with smoking, diabetes and left ventricular end-diastolic diameter were responsible for 10-year CVD risk (R<sup>2</sup> <sub>adjusted</sub> =0.849, <i>P</i> &lt; 0.001). Age and eGFR were the two strongest factors to discriminate moderate-to-high risk and low risk, with area under the curve 0.935 (95%CI 0.896–0.974) and 0.827 (95%CI 0.763–0.891), respectively. The optimal cutoffs to identify moderate-to-high CVD risk were age at 56.5 and eGFR at 98.5&#xa0;ml/min/1.73m<sup>2</sup>, PHPT patients older or lower than these two thresholds had significantly higher CVD risk than their counterparts (<i>P</i> &lt; 0.001).</p> Conclusion <p>Age and eGFR were significant contributors to CVD risk in PHPT. Patients should be closely monitored and managed for dysregulated gluco-lipid metabolism. Less restrictive surgery indication for PHPT, such as age &lt; 56, irrespective of renal function might be considered.</p>

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10-year cardiovascular disease risk and its contributing factors in primary hyperparathyroidism

  • 期刊论文

  • 发表日期：

    2026年1月5日

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  • Song-feng Zhao,
  • Yi-zhu Wang,
  • Jia-xi Song,
  • Min-ting Zhu,
  • Bei Tao,
  • Jian-min Liu,
  • Li-hao Sun,
  • Yu-ying Yang

摘要

Objective

Surgery indications for primary hyperparathyroidism (PHPT) mostly concern kidney and bone outcome, but not cardiovascular disease (CVD). Age less than 50 and eGFR less than 60 ml/min/1.73m2 are two surgery indications. This study aims to evaluate factors influencing the 10-year CVD risk in PHPT patients.

Method

159 PHPT patients diagnosed between January 2024 - March 2025 were enrolled. The relationships between biochemical and echocardiographic parameters with 10-year CVD risk score calculated by PREVENT™ were analyzed. Univariate, multivariate, logistic regression and receive operation curve (ROC) analysis were employed.

Results

10-year CVD risk score was positively corelated with age (R2adjusted = 0.604, β = 0.541), systolic blood pressure (R2 adjusted =0.149, β = 0.185), eGFR (R2 adjusted =0.452, β=-0.252), triglyceride (R2 adjusted =0.134, β = 3.629) with P < 0.001.These parameters together with smoking, diabetes and left ventricular end-diastolic diameter were responsible for 10-year CVD risk (R2 adjusted =0.849, P < 0.001). Age and eGFR were the two strongest factors to discriminate moderate-to-high risk and low risk, with area under the curve 0.935 (95%CI 0.896–0.974) and 0.827 (95%CI 0.763–0.891), respectively. The optimal cutoffs to identify moderate-to-high CVD risk were age at 56.5 and eGFR at 98.5 ml/min/1.73m2, PHPT patients older or lower than these two thresholds had significantly higher CVD risk than their counterparts (P < 0.001).

Conclusion

Age and eGFR were significant contributors to CVD risk in PHPT. Patients should be closely monitored and managed for dysregulated gluco-lipid metabolism. Less restrictive surgery indication for PHPT, such as age < 56, irrespective of renal function might be considered.