Identifying clinical characteristics of hypoparathyroidism in Turkey: HIPOPARATURK‑NET study

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

Is oxidative stress a factor in the pathogenesis of subacute thyroiditis?

Introduction: In a performed study, selenium levels were detected to be lower in subacute thyroiditis (SAT). This outcome suggests that the oxidant-antioxidant system may play a role in the aetiopathogenesis of SAT, as is the case for many other diseases. The aim of the present study was to detect whether any association exists between SAT and oxidative stress, and to determine the factors of a possible association. Material and methods: Twenty-five patients who were newly diagnosed with SAT and 30 healthy volunteers were enrolled in the study. Total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), paraoxonase 1 (PON1), and dynamic thiol/disulphide [native thiol (NT), total thiol (TT), disulphide (DS), DS/TT, DS/NT, and NT/TT] levels of the participants were evaluated. Results: Total thiol and NT levels were found to be lower in the SAT group (p &lt; 0.001). DS/NT and DS/TT levels were significantly higher in the patients with SAT, whereas NT/TT levels were lower (p &lt; 0.05). A negative correlation was detected between C-reactive protein (CRP) and TAS, whereas a positive correlation was detected between CRP and OSI. There was a negative association between TSH and TAS only in the partial correlation analysis by adjusting for age, white blood cell count, neutrophil (Neu) level, CRP, and erythrocyte sedimentation rate (ESR) (r = –0.481, p = 0.043). Conclusions: Thiol levels are significantly decreased and thiol/disulphide homoeostasis is disrupted in patients with SAT. The present study has presented for the first time that there may be an association between SAT and oxidative stress