Association of hypercalcemia with biochemical parameters in patients with endocrine disorders

Abstract

Background. Although today primary hyperparathyroidism and cancers are considered the main factors of hypercalcemia (HC), the latter is quite often detected in various endocrinopathies. According to modern data, ionized calcium (Ca2+) is an intracellular mediator in the functioning of enzymes and hormones. All this determines the importance of finding out the features of the associations between HC and biochemical indicators in various endocrine disorders, which was the purpose of this study. Materials and methods. Retrospectively, according to the medical histories of 537 patients with detected HC, who were treated at the endocrinology clinic of the V. Danilevsky Institute for the Endocrine Pathology Problems in 2020–2021, we have analyzed the features of correlations between HC (by the content of Ca2+) and the levels of phosphorus (P), total protein (TP), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in various endocrine pathologies. Results. A significant difference between the spectrum and degree of probability of associations was found even within the limits of one type of pathological conditions. In the group with hypothyroidism, there was an inverse correlation of HC with P (p<0.01) and a highly probable correlation with AST (p<0.001). At the same time, a direct association with P (p<0.01) and an inverse correlation with TP (p<0.001), AST (p<0.001) and ALT (p<0.01) was revealed in case of Graves’ disease. The following data were obtained for tumors of endocrine organs: nontoxic multinodular goiter— direct with P (p<0.001) and inverse with TP (p<0.001) and ALT (p<0.01); thyroid cancer— direct correlation with P (p<0.01) and inverse highly probable with TP (p<0.001) and ALT (p<0.001); nodular pathology of the adrenal glands— direct correlation with TP (p<0.01) and inverse with AST (p<0.01) and ALT (p<0.001). In diabetes mellitus, only an inverse correlation with P was found (p<0.01). There was an inverse correlation with P (p<0.01) and TP (p<0.001), and a direct one with ALT (p<0.001) in primary hyperparathyroidism. Conclusions. Metabolic disorders in the presence of hypercalcemia in patients with various endocrine pathologies have their own characteristics. The nature of revealed correlations between ionized calcium and biochemical parameters in terms of various endocrine diseases must be taken into account when developing a therapeutic strategy for patients with hypercalcemia.