{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T23:10:21Z","timestamp":1778281821702,"version":"3.51.4"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Horm Metab Res"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Ambulatory hypercalcemia is a proxy for primary hyperparathyroidism. Reports of\n                    an increased incidence of hypercalcemia and undiagnosed primary\n                    hyperparathyroidism in several electronic medical record studies have prompted a\n                    population-based trend analysis of serum calcium. Data from the 2000\u20132020 U.S.\n                    National Health and Nutritional Examination Survey were used to study the trend\n                    of serum calcium and related factors. The NHANES has contemporary insight into\n                    the ambulatory state of health in the large and diverse U.S. population.\n                    Joinpoint regression estimated yearly changes of serum calcium and related\n                    factors using annual percentage changes. Serum calcium levels increased by an\n                    average of 0.65 mg\/dL\/y from 2000 to 2004 and then decreased on average by 0.12\n                    mg\/dL annually from 2004 to 2020. Among women, serum calcium levels increased by\n                    an average of 0.69 mg\/dL\/y from 2000 to 2004 but then decreased on average by\n                    0.13 mg\/dL annually from 2004 to 2020. Among men, serum calcium levels increased\n                    by an average of 0.61 mg\/dL\/y from 2000 to 2004 and then remained stable. Trends\n                    of body mass index increased by an average of 0.49\/y from 2014 to 2020.\n                    Ambulatory hypercalcemia is a proxy for primary hyperparathyroidism. Over 20\n                    years in the U.S. National Health and Nutritional Examination Survey\n                    (2000\u20132020), calcium levels have been decreasing slightly since 2004 after an\n                    increase while body mass index has been increasing since 2014. These data\n                    conflict with reported observations of the undiagnosed and increased incidence\n                    of primary hyperparathyroidism. These data may ultimately serve to refine\n                    primary hyperparathyroidism data phenotype for machine learning deployed within\n                    an electronic medical record.<\/jats:p>","DOI":"10.1055\/a-2854-1289","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T22:45:11Z","timestamp":1777329911000},"page":"186-192","source":"Crossref","is-referenced-by-count":0,"title":["Contemporary Trends in Calcium Levels and Related Clinical\n                    Conditions: A Two Decade Analysis of U.S. National Health and Nutritional\n                    Examination Survey Data"],"prefix":"10.1055","volume":"58","author":[{"given":"Ethan","family":"Frank","sequence":"additional","affiliation":[{"name":"Molecular Biology, Brigham Young University, Provo,\n                    United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Adjei Boakye","sequence":"additional","affiliation":[{"name":"Data Science, Henry Ford Health System, Detroit, United\n                    States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan C.","family":"Stack Jr","sequence":"additional","affiliation":[{"name":"Otolaryngology HNS, Southern Illinois University School\n                    of Medicine, Springfield, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"issue":"07","key":"ref1","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1055\/a-2638-1810","article-title":"Associations of obesity, Vitamin D, adjusted total calcium, and\n                    parathyroid hormone in US from NHANES","volume":"57","author":"E Frank","year":"2025","journal-title":"Horm Metab Res"},{"issue":"16","key":"ref3","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1001\/jama.2022.18331","article-title":"Hypercalcemia: A review","volume":"328","author":"M D Walker","year":"2022","journal-title":"JAMA"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1002\/lio2.415","article-title":"Investigating the potential underdiagnosis of primary hyperparathyroidism at the\n                    university of arkansas for medical sciences","volume":"5","author":"R J Quilao","year":"2020","journal-title":"Laryngoscope Invest Otolaryngol"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1097\/SLA.0000000000002370","article-title":"Failure to diagnose hyperparathyroidism in 10,432 patients with hypercalcemia:\n                    Opportunities for system-level intervention to increase surgical referrals and\n                    cure","volume":"266","author":"H Chen","year":"2017","journal-title":"Ann Surg"},{"issue":"06","key":"ref6","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1016\/j.surg.2013.06.051","article-title":"The prevalence of underdiagnosed and unrecognized 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and clinical picture","volume":"15","author":"S Ljunghall","year":"1991","journal-title":"World J Surg"},{"issue":"03","key":"ref13","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1007\/s00198-022-06629-y","article-title":"Primary hyperparathyroidism and fracture probability","volume":"34","author":"J A Kanis","year":"2023","journal-title":"Osteoporos Int"},{"issue":"10","key":"ref14","doi-asserted-by":"crossref","first-page":"e1117","DOI":"10.1210\/clinem\/dgad201","article-title":"Stable incidence and increasing prevalence of primary hyperparathyroidism in a\n                    population-based study in Scotland","volume":"108","author":"E Soto-Pedre","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.bone.2014.12.003","article-title":"Secular trends in the incidence of primary hyperparathyroidism over five decades\n                    (1965\u20132010)","volume":"73","author":"M L Griebeler","year":"2015","journal-title":"Bone"},{"issue":"09","key":"ref16","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1001\/jamainternmed.2019.1747","article-title":"Diagnosis and management of primary hyperparathyroidism across the veterans\n                    affairs health care system","volume":"179","author":"E A Alore","year":"2019","journal-title":"JAMA Int Med"},{"issue":"09","key":"ref17","doi-asserted-by":"crossref","first-page":"e828","DOI":"10.1634\/theoncologist.2018-0424","article-title":"Failure to diagnose and treat hyperparathyroidism among patients with\n                    hypercalcemia: Opportunities for intervention at the patient and physician level\n                    to increase surgical referral","volume":"24","author":"A Asban","year":"2019","journal-title":"Oncologist"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1097\/SLA.0000000000002370","article-title":"Failure to diagnose hyperparathyroidism in 10,432 patients with hypercalcemia:\n                    Opportunities for system-level intervention to increase surgical referrals and\n                    cure","volume":"266","author":"C J Balentine","year":"2017","journal-title":"Ann Surg"},{"issue":"06","key":"ref19","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1016\/j.surg.2013.06.051","article-title":"The prevalence of undiagnosed and unrecognized primary hyperparathyroidism: A\n                    population-based analysis from the electronic medical record","volume":"154","author":"D M Press","year":"2013","journal-title":"Surgery"},{"issue":"03","key":"ref20","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.ijporl.2012.12.008","article-title":"Characterization of hyperparathyroidism in youth and adolescents: A literature\n                    review","volume":"77","author":"R Belcher","year":"2013","journal-title":"Int J Pediatr 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