High prevalence of hyperuricemia and its risk factors in a Chinese cohort of primary hyperparathyroidism patients.

Objective: Primary hyperparathyroidism (PHPT) is characterized by autonomous and excessive parathyroid hormone (PTH) secretion due to parathyroid gland lesions. Patients can be complicated with hyperuricemia (HUA), however, data about HUA in Chinese PHPT patients are lacking. This study aimed to explore the prevalence of HUA, factors influencing serum uric acid (SUA) level and the impacts of parathyroidectomy (PTX).

Methods: 328 inpatients diagnosed with PHPT were included in total. Clinical data were collected and compared between HUA and non-HUA group. Multivariate linear regression was used to explore the factors affecting preoperative SUA and its variation after PTX. The impacts of SUA on bone mineral density (BMD) under different models were also analyzed.

Results: The prevalence of HUA in PHPT patients was nearly 32%. Compared with non-HUA group, HUA group had significantly higher serum calcium (Ca) (2.92 [2.75, 3.26] vs. 2.78 [2.62, 3.03] mmol/L, P < 0.001), while PTH increased without significance. Gender, body mass index, serum Ca, triglycerides and renal function were independently associated with SUA. SUA decreased after PTX (340.00 [291.50, 421.00] vs. 315.00 [270.50, 375.00] μmol/L, P = 0.018), with change of SUA significantly associating with changes in serum Ca and phosphate. Presurgical SUA was positively related with femoral neck, total hip and lumbar spine BMDs after adjusting for confounders.

Conclusions: A relatively high proportion of HUA was found in our study. Besides the common risk factors, hypercalcemia may contribute to the increased SUA in PHPT patients, which could be significantly improved by curative PTX. SUA might have a protective effect on bone loss in PHPT patients.