Prevalence and natural history of NPHPT
| Study | Patient cohort | Vitamin D cut-off (nmol/L) | eGFR cut-off (mL/min) | NPHPT prevalence (%) | Natural history |
| Population - based studies on asymptomatic patients | |||||
| Kontogeorgos et al 14 (WHO MONICA, Sweden) | General population aged 25–64 years (n=608) | >50 | Not provided | 11.0 | One person progressed to hypercalcaemia None developed end-organ involvement (13-year follow-up) |
| Lundgren et al
15 16 (Sweden) | Postmenopausal women (n=5202) | Not excluded | Not provided (serum Cr >150 μmol/L) | 0.5 | When reassessed at 8.9 years there was a similar prevalence of NPHPT Serum calcium increased by 0.04±0.10 mmol/L |
| Cusano et al
17 (MrOS, USA) | Unselected community-dwelling men aged ≥65 years (n=2364) | >50 | >60 | 0.4 | Not followed-up |
| Cusano et al
17 (DHS, USA) | General population aged 18–65 years (n=3450) | >50 | >60 | 3.1 | one person progressed to hypercalcaemia None developed end-organ involvement 29 patients no longer met the criteria for NPHPT at follow-up (8 years) |
| García-Martín et al 18 (Spain) | Postmenopausal women (n=100) | >75 | >60 | 6.0 | No progression (1-year follow-up) |
| Berger et al
19 (CaMos, Canada) | General population aged 31–97(n=1871) | >50 | Not excluded | 16.7 | Not followed-up |
| Rejnmark et al 38 (DOPS, Denmark) | Postmenopausal women (n=2016) | Not excluded | >60 | 17.0 | One person progressed to hypercalcaemia (16-year follow-up) |
| Referral population of high-risk patients* | |||||
| Lowe et al
6 (USA) | Referred patients to metabolic bone unit aged 32–78 years (NPHPT, n=37) | >50 | >40 | 19% progressed to hypercalcaemia 40% developed further end-organ involvement (mean follow-up of 3.1±0.3 years) | |
| Maruani et al 10 (France) | Referred patients aged 55±11 years to metabolic unit (n=178) | >15 | >50 | 19.1 | Data on progression not available |
| Šiprová et al
11 (Czech Republic) | Referred patients aged 26–85 years with suspected PHPT (NPHPT, n=187) | >50 | Not provided | 19% progressed to hypercalcaemia (6-year follow-up—most progressed within 2 years) | |
| Tordjman et al
13 (Israel) | Referred patients aged 60.5±10.5 years with suspected PHPT (NPHPT, n=32) | >50 | Not provided | 12 required surgery No progression in the rest (mean follow-up of 4.1±3 years) | |
| Marques et al
21 (Brazil) | Referred women aged 62.4±10.5 years to exclude osteoporosis(n=156) | >75 | >40 | 8.9 | Data on progression not available |
*Patients who are at a higher risk of metabolic bone disease or already have adverse bone and renal outcomes like osteoporosis, fragility fractures or renal calculi.
eGFR, estimated glomerular filtration rate; NPHPT, normocalcaemic hyperparathyroidism; PHPT, primary hyperparathyroidism.