African Americans present with more severe primary hyperparathyroidism than non-African Americans

Emad Kandil, Hua Ling Tsai, Helina Somervell, Alan P. Dackiw, Ralph P. Tufano, Anthony P. Tufaro, Jeanne Kowalski, Martha A. Zeiger

Research output: Contribution to journalArticle

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Abstract

Background: Similar to other disease states, we postulated that African American patients present with more severe signs of primary hyperparathyroidism than non-African Americans. To test this hypothesis, we compared relevant preoperative laboratory values, sestamibi scan results, and intraoperative findings between African American and non-African American patients with primary hyperparathyroidism who underwent parathyroidectomy between January 2002 and May 2007. Methods: In all, 588 patients were included and 113 (19%) were African American. A linear model was used to examine the effect of race with respect to mean differences in serum calcium, 25-hydroxyvitamin D (25(OH)D), intact parathyroid hormone (iPTH), alkaline phosphatase (ALKP) levels, gland weight, presence of double adenomas and, sestamibi scan sensitivity. Results: Adjusted for age and gender, African Americans exhibited significantly higher median calcium (11.36 [SD = 0.91] vs 11.06 [SD = 0.72] mg/dL, P < .001), iPTH (138.5 [SD = 166.03] vs 117 [73.22] pg/mL, P < .01), and ALKP (101 [SD = 57.86] vs 90.5 [SD = 29.78] U/L, P < .01) levels compared with non- African Americans. They exhibited significantly lower median serum 25(OH)D (14 [SD = 9.36] vs 23 [SD = 12.160] ng/mL, P < .001), greater gland weight (P < .001), a higher probability of double adenomas (odds ratio = 2.83, 95% confidence interval [CI], 1.36-5.88), and a higher probability of presenting with a positive sestamibi scan (odds ratio = 4.99, 95% CI = 2.44-10.19) compared with non-African Americans. Conclusion: African Americans present with more advanced signs of primary hyperparathyroidism than non-African Americans. These results may reflect less access to health care, surgical consultations, or other unidentified factors. These highly significant findings, however, warrant additional investigation.

Original languageEnglish (US)
Pages (from-to)1023-1027
Number of pages5
JournalSurgery
Volume144
Issue number6
DOIs
StatePublished - Dec 2008

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Primary Hyperparathyroidism
African Americans
Parathyroid Hormone
Adenoma
Alkaline Phosphatase
Odds Ratio
Confidence Intervals
Calcium
Weights and Measures
Parathyroidectomy
Health Services Accessibility
Serum
Linear Models
Referral and Consultation

ASJC Scopus subject areas

  • Surgery

Cite this

Kandil, E., Tsai, H. L., Somervell, H., Dackiw, A. P., Tufano, R. P., Tufaro, A. P., ... Zeiger, M. A. (2008). African Americans present with more severe primary hyperparathyroidism than non-African Americans. Surgery, 144(6), 1023-1027. https://doi.org/10.1016/j.surg.2008.08.021

African Americans present with more severe primary hyperparathyroidism than non-African Americans. / Kandil, Emad; Tsai, Hua Ling; Somervell, Helina; Dackiw, Alan P.; Tufano, Ralph P.; Tufaro, Anthony P.; Kowalski, Jeanne; Zeiger, Martha A.

In: Surgery, Vol. 144, No. 6, 12.2008, p. 1023-1027.

Research output: Contribution to journalArticle

Kandil, E, Tsai, HL, Somervell, H, Dackiw, AP, Tufano, RP, Tufaro, AP, Kowalski, J & Zeiger, MA 2008, 'African Americans present with more severe primary hyperparathyroidism than non-African Americans', Surgery, vol. 144, no. 6, pp. 1023-1027. https://doi.org/10.1016/j.surg.2008.08.021
Kandil, Emad ; Tsai, Hua Ling ; Somervell, Helina ; Dackiw, Alan P. ; Tufano, Ralph P. ; Tufaro, Anthony P. ; Kowalski, Jeanne ; Zeiger, Martha A. / African Americans present with more severe primary hyperparathyroidism than non-African Americans. In: Surgery. 2008 ; Vol. 144, No. 6. pp. 1023-1027.
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title = "African Americans present with more severe primary hyperparathyroidism than non-African Americans",
abstract = "Background: Similar to other disease states, we postulated that African American patients present with more severe signs of primary hyperparathyroidism than non-African Americans. To test this hypothesis, we compared relevant preoperative laboratory values, sestamibi scan results, and intraoperative findings between African American and non-African American patients with primary hyperparathyroidism who underwent parathyroidectomy between January 2002 and May 2007. Methods: In all, 588 patients were included and 113 (19{\%}) were African American. A linear model was used to examine the effect of race with respect to mean differences in serum calcium, 25-hydroxyvitamin D (25(OH)D), intact parathyroid hormone (iPTH), alkaline phosphatase (ALKP) levels, gland weight, presence of double adenomas and, sestamibi scan sensitivity. Results: Adjusted for age and gender, African Americans exhibited significantly higher median calcium (11.36 [SD = 0.91] vs 11.06 [SD = 0.72] mg/dL, P < .001), iPTH (138.5 [SD = 166.03] vs 117 [73.22] pg/mL, P < .01), and ALKP (101 [SD = 57.86] vs 90.5 [SD = 29.78] U/L, P < .01) levels compared with non- African Americans. They exhibited significantly lower median serum 25(OH)D (14 [SD = 9.36] vs 23 [SD = 12.160] ng/mL, P < .001), greater gland weight (P < .001), a higher probability of double adenomas (odds ratio = 2.83, 95{\%} confidence interval [CI], 1.36-5.88), and a higher probability of presenting with a positive sestamibi scan (odds ratio = 4.99, 95{\%} CI = 2.44-10.19) compared with non-African Americans. Conclusion: African Americans present with more advanced signs of primary hyperparathyroidism than non-African Americans. These results may reflect less access to health care, surgical consultations, or other unidentified factors. These highly significant findings, however, warrant additional investigation.",
author = "Emad Kandil and Tsai, {Hua Ling} and Helina Somervell and Dackiw, {Alan P.} and Tufano, {Ralph P.} and Tufaro, {Anthony P.} and Jeanne Kowalski and Zeiger, {Martha A.}",
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T1 - African Americans present with more severe primary hyperparathyroidism than non-African Americans

AU - Kandil, Emad

AU - Tsai, Hua Ling

AU - Somervell, Helina

AU - Dackiw, Alan P.

AU - Tufano, Ralph P.

AU - Tufaro, Anthony P.

AU - Kowalski, Jeanne

AU - Zeiger, Martha A.

PY - 2008/12

Y1 - 2008/12

N2 - Background: Similar to other disease states, we postulated that African American patients present with more severe signs of primary hyperparathyroidism than non-African Americans. To test this hypothesis, we compared relevant preoperative laboratory values, sestamibi scan results, and intraoperative findings between African American and non-African American patients with primary hyperparathyroidism who underwent parathyroidectomy between January 2002 and May 2007. Methods: In all, 588 patients were included and 113 (19%) were African American. A linear model was used to examine the effect of race with respect to mean differences in serum calcium, 25-hydroxyvitamin D (25(OH)D), intact parathyroid hormone (iPTH), alkaline phosphatase (ALKP) levels, gland weight, presence of double adenomas and, sestamibi scan sensitivity. Results: Adjusted for age and gender, African Americans exhibited significantly higher median calcium (11.36 [SD = 0.91] vs 11.06 [SD = 0.72] mg/dL, P < .001), iPTH (138.5 [SD = 166.03] vs 117 [73.22] pg/mL, P < .01), and ALKP (101 [SD = 57.86] vs 90.5 [SD = 29.78] U/L, P < .01) levels compared with non- African Americans. They exhibited significantly lower median serum 25(OH)D (14 [SD = 9.36] vs 23 [SD = 12.160] ng/mL, P < .001), greater gland weight (P < .001), a higher probability of double adenomas (odds ratio = 2.83, 95% confidence interval [CI], 1.36-5.88), and a higher probability of presenting with a positive sestamibi scan (odds ratio = 4.99, 95% CI = 2.44-10.19) compared with non-African Americans. Conclusion: African Americans present with more advanced signs of primary hyperparathyroidism than non-African Americans. These results may reflect less access to health care, surgical consultations, or other unidentified factors. These highly significant findings, however, warrant additional investigation.

AB - Background: Similar to other disease states, we postulated that African American patients present with more severe signs of primary hyperparathyroidism than non-African Americans. To test this hypothesis, we compared relevant preoperative laboratory values, sestamibi scan results, and intraoperative findings between African American and non-African American patients with primary hyperparathyroidism who underwent parathyroidectomy between January 2002 and May 2007. Methods: In all, 588 patients were included and 113 (19%) were African American. A linear model was used to examine the effect of race with respect to mean differences in serum calcium, 25-hydroxyvitamin D (25(OH)D), intact parathyroid hormone (iPTH), alkaline phosphatase (ALKP) levels, gland weight, presence of double adenomas and, sestamibi scan sensitivity. Results: Adjusted for age and gender, African Americans exhibited significantly higher median calcium (11.36 [SD = 0.91] vs 11.06 [SD = 0.72] mg/dL, P < .001), iPTH (138.5 [SD = 166.03] vs 117 [73.22] pg/mL, P < .01), and ALKP (101 [SD = 57.86] vs 90.5 [SD = 29.78] U/L, P < .01) levels compared with non- African Americans. They exhibited significantly lower median serum 25(OH)D (14 [SD = 9.36] vs 23 [SD = 12.160] ng/mL, P < .001), greater gland weight (P < .001), a higher probability of double adenomas (odds ratio = 2.83, 95% confidence interval [CI], 1.36-5.88), and a higher probability of presenting with a positive sestamibi scan (odds ratio = 4.99, 95% CI = 2.44-10.19) compared with non-African Americans. Conclusion: African Americans present with more advanced signs of primary hyperparathyroidism than non-African Americans. These results may reflect less access to health care, surgical consultations, or other unidentified factors. These highly significant findings, however, warrant additional investigation.

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