{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T05:42:19Z","timestamp":1770961339877,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T00:00:00Z","timestamp":1664150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The incidence of hyperparathyroidism has increased in the USA. The previous work from our institution detected environmental chemicals (EC) within hyperplastic parathyroid tumors. The National Health and Nutrition Examination Survey (NHANES) is a program designed to assess the health status of people in the USA and includes measurements of EC in serum. Our aim was to determine which EC are associated with elevated parathyroid hormone (PTH) and calcium levels within NHANES.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>NHANES was queried from 2003\u20132016 for our analysis with calcium. A separate subgroup was queried from 2003\u20132006 that included PTH levels. Subjects with elevated calcium, and elevated PTH and normal Vitamin D levels were identified. Wilcoxon rank sum tests were used to analyze levels of EC in those with elevated calcium, and those with elevated PTH in the subgroup. All EC with <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05 were then included in separate multivariate models adjusting for serum vitamin D and creatinine for PTH and albumin for calcium.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 51,395 subjects analyzed, and calcium was elevated in 2.1% (1080) of subjects. Our subgroup analysis analyzed 14,681 subjects, and PTH was elevated without deficient Vitamin D in 9.4% (1,377). Twenty\u2010nine different polychlorinated biphenyls and the organochlorine pesticides hexachlorobenzene, transnonachlor, oxychlordane, and p,p\u2019\u2010dichlorodiphenyldichloroethylene (DDE) were found to be associated with elevated calcium and separately with elevated PTH (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In NHANES, 33 ECs were found to be associated with elevated calcium as well as elevated PTH levels on our subgroup analysis. These chemicals may lead us toward a causal link between environmental factors and the development of hyperparathyroidism and should be the focus of future studies looking at chemical levels within specimens.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-022-06759-8","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T14:02:45Z","timestamp":1664200965000},"page":"296-303","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Environmental Chemicals and their Association with Hyperparathyroidism"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6492-4953","authenticated-orcid":false,"given":"Jessica Liu","family":"McMullin","sequence":"first","affiliation":[{"name":"Department of Surgery Emory University 1365 Clifton Road, Clinic A 4th Floor 30322 Atlanta Gabon"},{"name":"1808 7th Ave South, BDB D509R 35233 Birmingham Albania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse","family":"Codner","sequence":"additional","affiliation":[{"name":"Department of Surgery Emory University 1365 Clifton Road, Clinic A 4th Floor 30322 Atlanta Gabon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Snehal G.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Surgery Emory University 1365 Clifton Road, Clinic A 4th Floor 30322 Atlanta Gabon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jyotirmay","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Surgery Emory University 1365 Clifton Road, Clinic A 4th Floor 30322 Atlanta Gabon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Hu","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine Emory University Atlanta Gabon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dean P.","family":"Jones","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine Emory University Atlanta Gabon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Collin J.","family":"Weber","sequence":"additional","affiliation":[{"name":"Department of Surgery Emory University 1365 Clifton Road, Clinic A 4th Floor 30322 Atlanta Gabon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil D.","family":"Saunders","sequence":"additional","affiliation":[{"name":"Department of Surgery Emory University 1365 Clifton Road, Clinic A 4th Floor 30322 Atlanta 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