Objetives:

To determine the prevalence of primary hyperparathyroidism (HPTP) using PTH and Ionic calcium screening in a population sample of Guayaquil (Ecuador).

Material and methods:

Prospective, cross-sectional study carried out between January 1, 2009 and November 30, 2014 of 13,860 people who attended routine control tests. All were tested in serum parathyroid hormone (PTH), ionic calcium, serum creatinine and the 25 (OH) total vitamin D (total VD). The diagnosis of HPTP was confirmed if PTH or Ionic calcium levels remained high at least in two different occasions. We excluded patients with raised serum creatinine, vitamin D insufficiency, malabsorption, chronic liver disease, or those receiving treatments that alter phosphocalcic metabolism.

Results:

61 cases were found with raised PTH on at least two different occasions. Among these, 34 presented vitamin D insufficiency and were excluded from the analysis. In 27 cases (4 men and 23 women) the diagnosis of HPTP was confirmed. The average age for women was 64.5±15.4 years and men of 71.3±12.8 years; average PTH values were 115±24.2 pg/ml; Ionic calcium, 5.15±0.4 mg/dl; total VD, 47.1±20.2 ng/ml; and serum creatinine 0.84±0.2 mg/ml; prevalence of HPTP corresponds to 2 cases per thousand adults (95% CI: 1.71-2.18). The greatest increase in prevalence occurred in women aged 60 years.

Conclusions:

PTH prevalence in this sample is low compared to that reported in international series, being higher in advanced ages and in women. With the proposed screening for PTH and ionic calcium, we detected the normocalcemic form of HPTP in most cases.

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