{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T09:15:57Z","timestamp":1772010957506,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,4,19]],"date-time":"2013-04-19T00:00:00Z","timestamp":1366329600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aims to identify the best biochemical risk factors alongside other factors for predicting adverse outcomes seen in untreated primary hyperparathyroidism (<jats:styled-content style=\"fixed-case\">PHPT<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Population\u2010based cohort study, 1997\u20132006.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tayside, Scotland,<jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Patients with untreated diagnosed<jats:styled-content style=\"fixed-case\">PHPT<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcome measures and methods<\/jats:title><jats:p>Outcomes considered were all\u2010cause mortality, fatal and nonfatal cardiovascular disease (<jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>). Models were derived using survival analysis. Potential biochemical predictors tested were baseline serum calcium, parathyroid hormone (<jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content>), creatinine and alkaline phosphatase (<jats:styled-content style=\"fixed-case\">ALP<\/jats:styled-content>), and other covariates considered were gender, age at diagnosis, deprivation, previous comorbidities and bisphosphonates usage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 1997 to 2006, 2097 patients (mean age, 68\u00b74\u00a0years; 69\u00b79% women) with untreated<jats:styled-content style=\"fixed-case\">PHPT<\/jats:styled-content>were identified with a total follow\u2010up of 7338 person years, in the population of Tayside, Scotland. The median baseline calcium was 2\u00b761\u00a0m<jats:sc>m<\/jats:sc>, and<jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content>was 7\u00b72\u00a0p<jats:sc>m<\/jats:sc>.<jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content>was the only statistically significant risk factor in all outcomes observed adjusting for other covariates. Serum creatinine and<jats:styled-content style=\"fixed-case\">ALP<\/jats:styled-content>predicted mortality outcomes in the short term (\u22643\u00a0years), but not long term. Calcium was associated with increased risk of all\u2010cause mortality in the short term but had no significant impact on other outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Baseline<jats:styled-content style=\"fixed-case\">PTH<\/jats:styled-content>, rather than calcium, best predicts long\u2010term outcomes in untreated<jats:styled-content style=\"fixed-case\">PHPT<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12206","type":"journal-article","created":{"date-parts":[[2013,3,18]],"date-time":"2013-03-18T14:25:30Z","timestamp":1363616730000},"page":"27-34","source":"Crossref","is-referenced-by-count":47,"title":["What predicts adverse outcomes in untreated primary hyperparathyroidism? 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