Work

Increased mortality in chronic hypoparathyroidism: a nationwide cohort study in Sweden

Year: 2026

Type: article

Abstract: CONTEXT: Previous studies on mortality outcomes in patients with chronic hypoparathyroidism have reported inconsistent results. OBJECTIVE: To assess all-cause and cause-specific mortality and estimate the prevalence of chronic hypoparathyroidism in Sweden. METHODS: Chronic hypoparathyroidism was defined as the combination of ICD-10 diagnoses and long-term dispensations of active vitamin D. Nationwide diagnostic codes, drug dispensation, and mortality data were obtained from the National Patient Register, Prescribed Drugs Register, Cause of Death Register, and the Total Population Register. Mortality was compared between groups using Cox proportional hazards models, adjusting for age and baseline comorbidities. RESULTS: We identified 1,982 individuals with chronic hypoparathyroidism between 1997 and 2018, yielding a minimum prevalence of 19.4 per 100,000 inhabitants. We randomly selected 19,820 controls matched by age, sex, and county of residence.After excluding individuals with baseline thyroid cancer and their controls, 1,825 patients and 17,922 controls remained. Patients had higher all-cause mortality than controls (HR: 1.55; 95% CI: 1.40-1.72). Mortality was higher in patients with nonsurgical (HR: 2.16, 95% CI: 1.76-2.65) than postsurgical hypoparathyroidism (HR: 1.39, 95% CI: 1.23-1.58). The strongest associations were observed for endocrine, nutritional, and metabolic disorders (HR: 6.46, 95% CI: 2.43-17.21), followed by infectious diseases (HR: 3.53, 95% CI: 2.07-6.04), genitourinary diseases (HR: 2.40, 95% CI: 1.33-4.33), respiratory diseases (HR: 1.67, 95% CI: 1.23-2.28), and circulatory diseases (HR: 1.47, 95% CI: 1.23-1.77). CONCLUSION: Patients with chronic hypoparathyroidism have an elevated risk of all-cause mortality, particularly those with nonsurgical disease. These findings highlight the clinical burden of the disease.

Source: Endocrine Connections

DOI: 10.1530/ec-25-0450

Authors: Wafa Kamal, Ylva Trolle Lagerros, Michael Mannstadt, Tim Spelman, Olle Kämpe, Sigridur Björnsdottir

Institutions: Karolinska University Hospital, Karolinska Institutet, Harvard University, Massachusetts General Hospital

Language: English

Topic: Thyroid and Parathyroid Surgery

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,146