{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:00:16Z","timestamp":1790730016918,"version":"4.1.0"},"reference-count":29,"publisher":"The Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T00:00:00Z","timestamp":1631577600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Although the inverse correlation between serum PTH and phosphate (P) levels in patients with primary hyperparathyroidism (PHPT) is well known, the relationship between P levels and the clinical picture of the disease has not been well investigated. This was thus the aim of this paper.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients<\/jats:title>\n                  <jats:p>A total of 472 consecutive patients with PHPT attending our center were retrospectively evaluated at diagnosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>P levels lower than 2.5 mg\/dL (HypoP) were found in 198\/472 patients (41.9%). HypoP was mild (2-2.5 mg\/dL), moderate (1-1.9 mg\/dL), and severe (&amp;lt;1 mg\/dL) in 168 (84.9%), 30 (15.1%), and 0 cases, respectively. P levels were lower in males than females. Patients with more severe bone density impairment at the radial (but not the vertebral or femoral) site had P levels significantly lower than other patients. PHPT severity was worse in HypoP patients, both clinically (higher prevalence of renal stones, but not of osteoporosis) and biochemically (higher serum calcium and PTH levels). All patients in the moderate HypoP group were either symptomatic or asymptomatic reaching surgical indication according to the latest guidelines.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We observed a relationship between P levels and biochemical and clinical features of PHPT severity. In asymptomatic PHPT patients, even moderate HypoP is predictive of surgical indication, regardless of age and hypercalcemia severity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgab676","type":"journal-article","created":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T10:52:07Z","timestamp":1631616727000},"page":"e612-e618","source":"Crossref","is-referenced-by-count":18,"title":["Serum Phosphate: A Neglected Test in the Clinical Management of Primary Hyperparathyroidism"],"prefix":"10.1210","volume":"107","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6622-4267","authenticated-orcid":false,"given":"Elena","family":"Castellano","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, 12100, Cuneo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Attanasio","sequence":"additional","affiliation":[{"name":"IRCCS Orthopedic Institute Galeazzi, Endocrinology Service, 20161, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Boriano","sequence":"additional","affiliation":[{"name":"Medical Physics Department, Santa Croce and Carle Hospital, 12100, Cuneo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micaela","family":"Pellegrino","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, 12100, Cuneo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Borretta","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, 12100, Cuneo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2021,9,14]]},"reference":[{"issue":"2","key":"2022011806192734900_CIT0001","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/nrendo.2017.104","article-title":"Primary hyperparathyroidism","volume":"14","author":"Walker","year":"2018","journal-title":"Nat Rev Endocrinol."},{"issue":"6","key":"2022011806192734900_CIT0002","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.beem.2018.09.001","article-title":"Classical complications of primary hyperparathyroidism","volume":"32","author":"Minisola","year":"2018","journal-title":"Best Pract Res Clin Endocrinol Metab."},{"issue":"10","key":"2022011806192734900_CIT0003","doi-asserted-by":"crossref","first-page":"3561","DOI":"10.1210\/jc.2014-1413","article-title":"Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop","volume":"99","author":"Bilezikian","year":"2014","journal-title":"J Clin Endocrinol Metab."},{"issue":"1","key":"2022011806192734900_CIT0004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00198-016-3716-2","article-title":"Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. 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