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The clinical significance of calcium/magnesium ratio in primary hyperparathyroidism: unveiling a clinical association

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Abstract

Purpose

In previous studies, magnesium (Mg) was found to be lower in cases with more severe primary hyperparathyroidism (PHPT) and higher calcium (Ca) levels. This study evaluated the relationship between serum Mg and serum Ca and phosphorus (P) levels in PHPT and their utility in determining the presence of osteoporosis and nephrolithiasis.

Methods

Patients who were followed up with PHPT between March 2019 and March 2023 were analyzed retrospectively. Biochemical data, renal ultrasonography results, dual-energy x-ray absorptiometry (DEXA) reports, and technetium 99 m sestamibi parathyroid scintigraphy reports were obtained. MgxP, Mg/P, Ca/P, and corrected Ca (cCa)/P values were calculated. The relationships between biochemical parameters and clinical outcomes were evaluated statistically.

Results

A total of 543 patients were included in the study. Patients with nephrolithiasis had higher cCa/Mg or Ca/Mg than those without nephrolithiasis. Additionally, ROC analysis revealed that cCa/Mg greater than 5.24 could identify the presence of nephrolithiasis with a sensitivity of 73.3% and a specificity of 73%. No statistically significant correlation existed between the results of the Mg/P, MgxP, cCa/Mg, Ca/Mg values, and DEXA-bone mineral densitometry(BMD).

Conclusion

Ca/Mg and cCa/Mg ratios in particular seem more valuable in determining the presence of nephrolithiasis than the currently used 24-h urine Ca measurement. Compared to urinary Ca measurements, they are cheaper, more practical, and more accessible.

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Data availability

The datasets generated and analysed during the current study are available from the corresponding author on reasonable request.

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Funding

This research received no specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Ankara Bilkent City Hospital, Üniversiteler Mahallesi 1604. Cadde No: 9 Çankaya, Ankara, Turkey

    Ekin Yiğit Köroğlu, Sevgül Fakı & Belma Tural Balsak

  2. Department of Endocrinology and Metabolism, Ankara Yıldırım Beyazıt University Faculty of Medicine, Üniversiteler Mahallesi 1604. Cadde No: 9 Çankaya, Ankara, Turkey

    Abbas Ali Tam, Didem Özdemir, Oya Topaloğlu, Reyhan Ersoy & Bekir Çakır

  3. Department of Radiology, Ankara Bilkent City Hospital, Üniversiteler Mahallesi 1604. Cadde No: 9 Çankaya, Ankara, Turkey

    Fatma Ayça Edis Özdemir

Authors
  1. Ekin Yiğit Köroğlu
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  2. Abbas Ali Tam
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Contributions

Conceptualization: Ekin Yiğit Köroğlu, Abbas Ali Tam, and Didem Özdemir; data curation: Ekin Yiğit Köroğlu and Sevgül Fakı; formal analysis: Ekin Yiğit Köroğlu and Belma Tural Balsak; funding acquisition: Ekin Yiğit Köroğlu; investigation: Ekin Yiğit Köroğlu and Abbas Ali Tam; methodology: Ekin Yiğit Köroğlu, Abbas Ali Tam, and Didem Özdemir; project administration: Ekin Yiğit Köroğlu, Fatma Ayça Edis Özdemir, and Sevgül Fakı; resources: Oya Topaloğlu, Reyhan Ersoy, and Bekir Çakır; software: Ekin Yiğit Köroğlu; supervision: Oya Topaloğlu, Reyhan Ersoy, and Bekir Çakır; validation: Didem Özdemir and Bekir Çakır; visualization: Ekin Yiğit Köroğlu; writing—original draft: Ekin Yiğit Köroğlu; writing—review and editing: Abbas Ali Tam and Didem Özdemir.

Corresponding author

Correspondence to Ekin Yiğit Köroğlu.

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Ethical approval

Ankara City Hospital’s ethical committee approval was obtained on March 22nd, 2023 (E1-23-3406), in accordance with the ethical standards of the Declaration of Helsinki.

Informed consent

Informed consent was obtained from all participants included in the study.

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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. The authors have no relevant financial or non-financial interests to disclose.

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Köroğlu, E.Y., Tam, A.A., Fakı, S. et al. The clinical significance of calcium/magnesium ratio in primary hyperparathyroidism: unveiling a clinical association. Hormones (2024). https://doi.org/10.1007/s42000-024-00530-5

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