Temporal Variation of Biochemical Markers and Adenoma Predictors in Normocalcemic Primary Hyperparathyroidism: A Multicenter Retrospective Analysis

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dc.authorid0000-0002-3118-4549
dc.authorid0000-0002-6493-9194
dc.authorid0000-0001-7085-5846
dc.authorid0000-0002-7001-4075
dc.authorid0000-0002-7445-2275
dc.authorid0000-0003-3590-2656
dc.authorid0000-0003-2606-1103
dc.contributor.authorAycicek, Bercem
dc.contributor.authorTuna, Mazhar Muslum
dc.contributor.authorEngin, Ismail
dc.contributor.authorSahin, Mustafa
dc.contributor.authorZuhur, Sayid
dc.contributor.authorGulcelik, Nese Ersoz
dc.contributor.authorYagci, Huseyin
dc.date.accessioned2026-02-03T12:00:44Z
dc.date.available2026-02-03T12:00:44Z
dc.date.issued2025
dc.departmentÇanakkale Onsekiz Mart Üniversitesi
dc.description.abstractObjective: This study aimed to evaluate the diagnostic performance of biochemical markers in normocalcemic primary hyperparathyroidism (nPHPT), analyse their temporal variations, and assess their correlation with adenoma localisation and size. Methods: In this multicenter retrospective study-the largest patient cohort reported in the literature to date (n = 474) we comprehensively profiled normocalcemic patients diagnosed with primary hyperparathyroidism nPHPT was diagnosed based on persistently elevated PTH levels with normal serum calcium after excluding secondary causes such as vitamin D deficiency, renal impairment, and other conditions. This retrospective multicenter study included a large cohort of patients whose biochemical markers-including serum calcium, phosphorus, magnesium, vitamin D, parathyroid hormone (PTH), and glomerular filtration rate (GFR)-were measured at three time points, using standardised laboratory protocols. Although in routine clinical practice these measurements are typically performed at regular intervals of 3-6 months, resulting in approximately three assessments during an 18-month follow-up period. Urinary calcium and creatinine levels were also determined, and imaging modalities (ultrasonography, sestamibi scintigraphy, and computed tomography) were employed for adenoma detection. Statistical analyses comprised repeated measures ANOVA, logistic regression, correlation analysis, and ROC analysis, performed using Jamovi software. Results: Serial evaluations revealed significant temporal changes in key biochemical parameters, including a significant decline in serum calcium and PTH levels alongside a significant increase in urinary calcium excretion. Logistic regression analysis identified higher PTH levels, higher corrected calcium, and larger adenoma size as independent predictors of adenoma localisation, while ROC analysis confirmed that PTH exhibited the highest diagnostic accuracy (AUC = 0.91, 95% CI: 0.84-0.95, p < 0.001). Conclusion: The large scale of our patient cohort reinforces the robustness of our statistical analyses and provides comprehensive insight into the dynamic nature of nPHPT.
dc.identifier.doi10.1111/cen.70024
dc.identifier.endpage814
dc.identifier.issn0300-0664
dc.identifier.issn1365-2265
dc.identifier.issue6
dc.identifier.pmid40891177
dc.identifier.scopus2-s2.0-105014760156
dc.identifier.scopusqualityQ2
dc.identifier.startpage805
dc.identifier.urihttps://doi.org/10.1111/cen.70024
dc.identifier.urihttps://hdl.handle.net/20.500.12428/34686
dc.identifier.volume103
dc.identifier.wosWOS:001561535300001
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherWiley
dc.relation.ispartofClinical Endocrinology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WOS_20260130
dc.subjectadenoma predictors
dc.subjectbiochemical markers
dc.subjectdiagnostic performance
dc.subjectimaging modalities
dc.subjectlongitudinal analysis
dc.subjectnormocalcemic primary hyperparathyroidism
dc.subjectnPHPT
dc.titleTemporal Variation of Biochemical Markers and Adenoma Predictors in Normocalcemic Primary Hyperparathyroidism: A Multicenter Retrospective Analysis
dc.typeArticle

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