Postmenopozal kadınlarda serum parathormon yüksekliğinin nedenleri
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Date
2012
Authors
Esen, İrfan
Journal Title
Journal ISSN
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Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmada postmenopozal kadınlarda hiperparatiroidemi nedenleri ve ilişkili faktörlerin araştırılması amaçlanmıştır. Çalışmaya serum parathormon seviyesi yüksek 113 postmenopozal kadın ve serum parathormon seviyesi normal olan 43 postmenopozal kadın alındı. Çalışma ve kontrol grubundaki kadınlar; serum 25-OH vitamin D, kalsiyum ve fosfor düzeyi, 24 saatlik idrarda kalsiyum, fosfor ve kalsiyum / kreatinin düzeyi, kemik mineral yoğunluğu, menopoz yaşı, eğitim düzeyi, meslek, giyim tarzı, güneşe maruziyet dereceleri ve günlük diyetle aldıkları kalsiyum miktarları açısından karşılaştırıldı. Ayrıca bu parametrelerin birbirleri arasındaki ilişkiler araştırıldı.Çalışma grubunda serum parathormon yüksekliğinin en sık nedeninin (%92.9) serum 25-OH vitamin D eksikliği olduğu ve primer hiperparatiroidi oranının %4.4 olduğu saptandı. D vitamini eksikliğinin sadece hiperparatiroidemili kadınlarda değil kontrol grubundaki kadınlarda da çok sık olduğu görüldü. Tüm olgular beraber değerlendirildiğinde; ev hanımı olan olgularda, dış ortamlarda baş ve kolları kapalı kalacak şekilde örtülü olanlarda ve eğitim düzeyi orta öğretim düzeyinden az olanlarda serum PTH düzeylerinin istatistiksel olarak daha yüksek (p<0.05) ve serum D vitamini düzeylerinin de daha düşük (p<0.05) olduğu saptandı. Olguların serum PTH seviyelerinin logaritmik değeriyle; serum 25-OH vitamin D seviyeleri karşılaştırıldığında istatistiksel anlamlı negatif korelasyon saptandı (r= -0.188; p= 0.019).Postmenopozal kadınlarda hiperparatiroideminin en sık nedeninin D vitamini eksikliği olduğu, özellikle örtülü ve eğitim düzeyi düşük kadınlarda daha fazla olmak üzere tüm postmenopozal kadınlarda D vitamini eksikliğinin yaygın olduğu gözlendi. Bu yaş grubundaki kadınların D vitamini eksikliği açısından değerlendirilmeleri, bu kişilerin güneş ışığına maruziyetlerinin artırılması için eğitilmeleri gerekliliği gösterildi. D vitamini ile zenginleştirilmiş besinlerin topluma sunulması gerekliliği sonucuna varıldı.
In this study we aimed to investigate causes of hyperparathyroidism and related factors in postmenopausal women.The study was conducted on 43 postmenopausal women with normal serum parathyroid hormone levels and 113 postmenopausal women with elevated serum parathyroid hormone levels. Serum levels of 25-OH vitamin D, calcium and phosphorus, 24-hour urine levels of calcium, phosphorus and calcium/creatinine ratio were compared between study groups. Some features of subjects such as bone mineral density, age of menopause, educational level, profession, clothing style, daylight exposure and daily dietary calcium consumption and relationships between these parameters were investigated.In the study group it was found that cause of high level of serum parathormon was vitamin D deficiency in 92.9% and primary hyperparathyroidism in 4.4% of patients. Vitamin D deficiency was a common issue not only in hyperparathyroid postmenopausal women but also postmenopausal women in control group. Considering all cases, women whom are defined as housewife, dressed up covering their head and arms and with education level less than high school have statistically significant elevated parathyroid hormone levels (p<0.05) and low vitamin D levels (p<0.05). When serum 25-OH vitamin D levels compared to the logarithmic value of serum parathyroid hormone, statistically significant negative correlation was detected (r= -0.188; p=0.019).The most common cause of hyperparathyroidism in postmenopausal women was found to be vitamin D deficiency. Vitamin D deficiency was common in all postmenopausal women but especially in those with lower education level and dressed up that limits sunshine exposure. Women in this age group should be surveyed for vitamin D deficiency and educated to benefit more from sunshine. It is concluded that vitamin D enriched foods should be released to market.
In this study we aimed to investigate causes of hyperparathyroidism and related factors in postmenopausal women.The study was conducted on 43 postmenopausal women with normal serum parathyroid hormone levels and 113 postmenopausal women with elevated serum parathyroid hormone levels. Serum levels of 25-OH vitamin D, calcium and phosphorus, 24-hour urine levels of calcium, phosphorus and calcium/creatinine ratio were compared between study groups. Some features of subjects such as bone mineral density, age of menopause, educational level, profession, clothing style, daylight exposure and daily dietary calcium consumption and relationships between these parameters were investigated.In the study group it was found that cause of high level of serum parathormon was vitamin D deficiency in 92.9% and primary hyperparathyroidism in 4.4% of patients. Vitamin D deficiency was a common issue not only in hyperparathyroid postmenopausal women but also postmenopausal women in control group. Considering all cases, women whom are defined as housewife, dressed up covering their head and arms and with education level less than high school have statistically significant elevated parathyroid hormone levels (p<0.05) and low vitamin D levels (p<0.05). When serum 25-OH vitamin D levels compared to the logarithmic value of serum parathyroid hormone, statistically significant negative correlation was detected (r= -0.188; p=0.019).The most common cause of hyperparathyroidism in postmenopausal women was found to be vitamin D deficiency. Vitamin D deficiency was common in all postmenopausal women but especially in those with lower education level and dressed up that limits sunshine exposure. Women in this age group should be surveyed for vitamin D deficiency and educated to benefit more from sunshine. It is concluded that vitamin D enriched foods should be released to market.
Description
Keywords
Primer hiperparatiroidi, Sekonder hiperparatiroidi, D vitamini yetersizliği, Postmenopozal kadınlar, Primary hyperparathyroidism, Secondary hyperparathyroidism, Vitamin D deficiency, Postmenopausal women
Citation
Esen, İ. (2012). Postmenopozal kadınlarda serum parathormon yüksekliğinin nedenleri. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.