Околощитовидные железы (в литературе также используются термины «паращитовидные», «паратиреоидные» железы) являются важнейшими регуляторами минерального обмена. История открытия околощитовидных желез началась лишь в 1880 г. и включала в себя длительный период определения их роли в организме человека. Даже сам термин «околощитовидные железы» отражает первоначальное ошибочное представление о них как о недоразвитых частях щитовидной железы. В настоящее время накоплено большое количество знаний о роли данной эндокринной железы в жизнедеятельности человеческого организма, описаны основные патологические состояния, развивающиеся при ее неправильной работе: первичный, вторичный, третичный гиперпаратиреоз, гипопаратиреоз. В статье суммированы данные об основных патологиях фосфорно-кальциевого обмена, представлены результаты ведения профильных баз данных пациентов с первичным гиперпаратиреозом и гипопаратиреозом, а также отражены основные тенденции в изменении структуры заболеваемости в мире и Российской Федерации.
The parathyroid glands are the most important regulators of mineral metabolism. The parathyroid glands were first discovered only in 1880 and their function went the long way unrecognized. Even the term "parathyroid gland" itself speaks of the initial misconception of it as an underdeveloped part of the thyroid. To date, there is a large amount of data regarding the role of this endocrine gland in the human body and the significant changes associated with their dysfunction, including such widespread diseases such primary, secondary and tertiary hyperparathyroidism, hypoparathyroidism. This review covers the problem of the main disturbances in calcium-phosphorus metabolism, presents the results of databases of patients with primary hyperparathyroidism and hypoparathyroidism, as well as current epidemiological trends in Russia and in the world.
1. Воронкова И.А., Еремкина А.К., Крупинова Ю.А., Гуревич Л.Е. Нейроэндокринные маркеры в опухолях околощитовидных желез. Архив патологии. 2020;82(6):70-8 [Voronkova IA, Eremkina AK, Krupinova IuA, Gurevich LE. Neuroendocrine markers in parathyroid tumors. Arkhiv patologii. 2020;82(6):70-8 (in Russian)]. DOI:10.17116/patol20208206170
2. Мокрышева Н.Г., Крупинова Ю.А., Воронкова И.А. Околощитовидные железы: нормальное развитие, анатомическое и гистологическое строение. Эндокринная хирургия. 2018;12(4):178-87 [Mokrysheva NG, Krupinova JA, Voronkova IA. Parathyroid glands: the normal development, anatomy and histological structure. Endocr Surg. 2019;12(4):178-87 (in Russian)]. DOI:10.14341/serg10039
3. Мокрышева Н.Г., Крупинова Ю.А. История открытия околощитовидных желез и их роль в организме. Вестник Российской академии медицинских наук. 2019;74(1):35-43. [Mokrysheva NG, Krupinova JA. The history of the discovery of parathyroid glands, and their role in the body. Vestn Ross Akad Meditsinskikh Nauk. 2019;74(1):35-43 (in Russian)]. DOI:10.15690/vramn1072
4. Мокрышева Н.Г., Крупинова Ю.А., Ковалева Е.В. Паратиреоидный гормон и подобные ему пептиды. Обзор литературы. Вестник РАМН. 2019;74(2):136–44. [Mokrysheva NG, Krypinova JA, Kovaleva EV. The parathyroid hormone and peptides like it. Literature review. Vestn Ross Akad Meditsinskikh Nauk. 2019;74(2):136-44 (in Russian)]. DOI:10.15690/vramn1104
5. Бибик Е.Е., Еремкина А.К., Крупинова Ю.А., и др. Нарушения углеводного обмена и другие метаболические изменения при первичном гиперпаратиреозе. Сахарный диабет. 2020;23(5):459-66. [Bibik EE, Eremkina AK, Krupinova JA, et al. Impaired glucose metabolism and other metabolic disorders in patients with primary hyperparathyroidism. Diabetes Mellitus. 2021;23(5):459-66 (in Russian)]. DOI:10.14341/DM12436
6. Khan AA, Hanley DA, Rizzoli R, et al. Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus. Osteoporos Int. 2017;28(1):1-19. DOI:10.1007/s00198-016-3716-2
7. Yeh MW, Ituarte PHG, Zhou HC, et al. Incidence and prevalence of primary hyperparathyroidism in a racially mixed population. J Clin Endocrinol Metab. 2013;98(3):1122-9. DOI:10.1210/jc.2012-4022
8. Bandeira F, Griz L, Caldas G, et al. From mild to severe primary hyperparathyroidism: The Brazilian experience. Arq Bras Endocrinol Metabol. 2006;50(4):657-63. DOI:10.1590/s0004-27302006000400011
9. Zhao L, Liu JM, He XY, et al. The changing clinical patterns of primary hyperparathyroidism in Chinese patients: Data from 2000 to 2010 in a single clinical center. J Clin Endocrinol Metab. 2013;98(2):721-8. DOI:10.1210/jc.2012-2914
10. Мокрышева Н.Г., Мирная С.С., Добрева Е.А., и др. Первичный гиперпаратиреоз в России по данным регистра. Проблемы эндокринологии. 2019;65(5):300-10 [Mokrysheva NG, Mirnaia SS, Dobreva EA, et al. Primary hyperparathyroidism in Russia according to the registry. Problemy endokrinologii. 2019;65(5):300-10 (in Russian)]. DOI:10.14341/probl10126
11. Добровольская О.В., Торопцова Н.В., Лесняк О.М. Экономические аспекты осложненного остеопороза: стоимость лечения в течение первого года после перелома. Современная ревматология. 2016;10(3):29-34
[Dobrovolskaia OV, Toroptsova NV, Lesniak OM. Economic aspects of complicated osteoporosis: The cost of treatment in the first year after fracture. Sovremennaia revmatologiia. 2016;10(3):29-34 (in Russian)]. DOI:10.14412/1996-7012-2016-3-29-34
12. Добрева Е.А., Еремкина А.К., Мирная С.С., и др. Кардиоваскулярные нарушения у пациентов с первичным гиперпаратиреозом по данным регистра. Профилактическая медицина. 2020;23(6):26-35 [Dobreva EA, Eremkina AK, Mirnaia SS, et al. Cardiovascular disorders in patients with primary hyperparathyroidism according to registry data. Russ J Prev Med. 2020;23(6):26-35 (in Russian)].
13. Мокрышева Н.Г. Генетические детерминированные формы первичного гиперпаратиреоза: сложности диагностики. Монография. М., 2019 [Mokrysheva NG. Genetic deterministic forms of primary hyperparathyroidism: diagnostic difficulties. Monograph. Moscow, 2019 (in Russian)].
14. Крупинова Ю.А., Воронкова И.А., Айнетдинова А.Р., и др. Многоцентровое ретроспективное исследование клинико-лабораторных предикторов и морфологических характеристик рака околощитовидной железы. Вестник РАМН. 2021;76(1):111-24 [Krupinova IuA, Voronkova IA, Ainetdinova AR, et al. A retrospective study of the clinical and laboratory predictors and morphological characteristics of the parathyroid carcinoma. Vestnik RAMN. 2021;76(1):111-24 (in Russian)]. DOI:10.15690/vramn1458
15. Underbjerg L, Sikjaer T, Mosekilde L. Cardiovascular and renal complications to postsurgical hypoparathyroidism: A Danish nationwide controlled historic follow-up study. J Bone Miner Res. 2013;28(11):2277-85. DOI:10.1002/jbmr.1979
16. Underbjerg L, Sikjaer T, Mosekilde L. Postsurgical hypoparathyroidism-Risk of fractures, Psychiatric Diseases, Cancer, Cataract, and Infections. J Bone Miner Res. 2014;29(S1):2504-10. DOI:10.1002/jbmr.2273
17. Bollerslev J, Rejnmark L, Marcocci C, et al. European Society of Endocrinology Clinical Guideline: Treatment of chronic hypoparathyroidism in adults. Eur J Endocrinol. 2015;173(2):G1-20. DOI:10.1530/EJE-15-0628
18. Мокрышева Н.Г., Eремкина А.К., Ковалева Е.В. Хронический гипопаратиреоз у взрослых: клиническая картина, диагностика, лечение, динамический контроль. Ожирение и метаболизм. 2018;15(4):74-82. [Mokrysheva NG, Eremkina AK, Kovaleva EV. Chronic hypoparathyroidism in adults: Clinical features, diagnosis, management and treatment. Obe Metab. 2018;15(4):74-82 (in Russian)].
19. Ковалева Е.В., Айнетдинова А.Р., Еремкина А.К. Результаты анализа базы данных пациентов с гипопаратиреозом ФГБУ «НМИЦ эндокринологии» Минздрава России. Проблемы эндокринологии. 2020;66(5):7-14
[Kovaleva EV, Ainetdinova AR, Eremkina AK. Evaluation of chronic hypoparathyroidism course according to the Database of Endocrinology Research Centre. Problemy endokrinologii. 2020;66(5):7-14 (in Russian)]. DOI:10.14341/probl12675
20. Пигарова Е.А., Рожинская Л.Я., Белая Ж.Е., и др. Клинические рекомендации Российской ассоциации эндокринологов по диагностике, лечению и профилактике дефицита витамина D у взрослых. Проблемы эндокринологии. 2016;62(4):60-86 [Pigarova EA, Rozhinskaia LIa, Belaia ZhE, et al. Russian Association of Endocrinologists recommendations for diagnosis, treatment and prevention of vitamin D deficiency in adults. Problemy endokrinologii. 2016;62(4):60-86 (in Russian)]. DOI:10.14341/probl201662460-84
21. Cipriani C, Pepe J, Colangelo L, Minisola S. Vitamin D and Secondary Hyperparathyroid. States. Front Horm Res. 2018;50:138-48. DOI:10.1159/000486077
22. Kuchuk NO, Pluijm SMF, Van Schoor NM, et al. Relationships of serum 25-hydroxyvitamin D to bone mineral density and serum parathyroid hormone and markers of bone turnover in older persons. J Clin Endocrinol Metab. 2009;94(4):1244-50. DOI:10.1210/jc.2008-1832
23. Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev. 2001;22(4):477-501. DOI:10.1210/edrv.22.4.0437
24. Bikbov B, Brian B, Andrusev A, et al. Hemodialysis practice patterns in the Russia Dialysis Outcomes and Practice Patterns Study (DOPPS), with international comparisons. Hemodialysis International. 2017;21:393-408. DOI:10.1111/hdi.12503
25. Hedgeman E, Lipworth L, Lowe K, et al. International burden of chronic kidney disease and secondary hyperparathyroidism: a systematic review of the literature and available data. Int J Nephrol. 2015;2015:184321. DOI:10.1155/2015/184321
26. Cozzolino M, Shilov E, Li Z, et al. Pattern of laboratory parameters and management of secondary hyperparathyroidism in countries of Europe, Asia, the Middle East, and North America. Adv Ther. 2020;37(6):2748-62. DOI:10.1007/s12325-020-01359-1
27. Portillo MR, Rodriguez-Ortiz ME. Secondary hyperparthyroidism: pathogenesis, diagnosis, preventive and therapeutic strategies. Rev Endocr Metab Disord. 2017;18(1):79-95. DOI:10.1007/s11154-017-9421-4
28. KDIGO 2017 Clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Kidney Int Suppl. 2017;7(1):1-59. DOI:10.1016/j.kisu.2017.04.001
29. Мокрышева Н.Г., Егшатян Л.В. Минерально-костный обмен при хронической болезни почек. М.: МИА, 2020 [Mokrysheva NG, Egshatian LV. Mineral and bone metabolism in chronic kidney disease. Moscow: MIA, 2020 (in Russian)].
30. Alfieri C, Regalia A, Zanoni F, et al. The importance of adherence in the treatment of secondary hyperparathyroidism. Blood Purif. 2019;47(1-3):37-44. DOI:10.1159/000492918
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1. Voronkova IA, Eremkina AK, Krupinova IuA, Gurevich LE. Neuroendocrine markers in parathyroid tumors. Arkhiv patologii. 2020;82(6):70-8 (in Russian). DOI:10.17116/patol20208206170
2. Mokrysheva NG, Krupinova JA, Voronkova IA. Parathyroid glands: the normal development, anatomy and histological structure. Endocr Surg. 2019;12(4):178-87 (in Russian). DOI:10.14341/serg10039
3. Mokrysheva NG, Krupinova JA. The history of the discovery of parathyroid glands, and their role in the body. Vestn Ross Akad Meditsinskikh Nauk. 2019;74(1):35-43 (in Russian). DOI:10.15690/vramn1072
4. Mokrysheva NG, Krypinova JA, Kovaleva EV. The parathyroid hormone and peptides like it. Literature review. Vestn Ross Akad Meditsinskikh Nauk. 2019;74(2):136-44 (in Russian). DOI:10.15690/vramn1104
5. Bibik EE, Eremkina AK, Krupinova JA, et al. Impaired glucose metabolism and other metabolic disorders in patients with primary hyperparathyroidism. Diabetes Mellitus. 2021;23(5):459-66 (in Russian). DOI:10.14341/DM12436
6. Khan AA, Hanley DA, Rizzoli R, et al. Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and international consensus. Osteoporos Int. 2017;28(1):1-19. DOI:10.1007/s00198-016-3716-2
7. Yeh MW, Ituarte PHG, Zhou HC, et al. Incidence and prevalence of primary hyperparathyroidism in a racially mixed population. J Clin Endocrinol Metab. 2013;98(3):1122-9. DOI:10.1210/jc.2012-4022
8. Bandeira F, Griz L, Caldas G, et al. From mild to severe primary hyperparathyroidism: The Brazilian experience. Arq Bras Endocrinol Metabol. 2006;50(4):657-63. DOI:10.1590/s0004-27302006000400011
9. Zhao L, Liu JM, He XY, et al. The changing clinical patterns of primary hyperparathyroidism in Chinese patients: Data from 2000 to 2010 in a single clinical center. J Clin Endocrinol Metab. 2013;98(2):721-8. DOI:10.1210/jc.2012-2914
10. Mokrysheva NG, Mirnaia SS, Dobreva EA, et al. Primary hyperparathyroidism in Russia according to the registry. Problemy endokrinologii. 2019;65(5):300-10 (in Russian). DOI:10.14341/probl10126
11. Dobrovolskaia OV, Toroptsova NV, Lesniak OM. Economic aspects of complicated osteoporosis: The cost of treatment in the first year after fracture. Sovremennaia revmatologiia. 2016;10(3):29-34 (in Russian). DOI:10.14412/1996-7012-2016-3-29-34
12. Dobreva EA, Eremkina AK, Mirnaia SS, et al. Cardiovascular disorders in patients with primary hyperparathyroidism according to registry data. Russ J Prev Med. 2020;23(6):26-35 (in Russian).
13. Mokrysheva NG. Genetic deterministic forms of primary hyperparathyroidism: diagnostic difficulties. Monograph. Moscow, 2019 (in Russian).
14. Krupinova IuA, Voronkova IA, Ainetdinova AR, et al. A retrospective study of the clinical and laboratory predictors and morphological characteristics of the parathyroid carcinoma. Vestnik RAMN. 2021;76(1):111-24 (in Russian). DOI:10.15690/vramn1458
15. Underbjerg L, Sikjaer T, Mosekilde L. Cardiovascular and renal complications to postsurgical hypoparathyroidism: A Danish nationwide controlled historic follow-up study. J Bone Miner Res. 2013;28(11):2277-85. DOI:10.1002/jbmr.1979
16. Underbjerg L, Sikjaer T, Mosekilde L. Postsurgical hypoparathyroidism-Risk of fractures, Psychiatric Diseases, Cancer, Cataract, and Infections. J Bone Miner Res. 2014;29(S1):2504-10. DOI:10.1002/jbmr.2273
17. Bollerslev J, Rejnmark L, Marcocci C, et al. European Society of Endocrinology Clinical Guideline: Treatment of chronic hypoparathyroidism in adults. Eur J Endocrinol. 2015;173(2):G1-20. DOI:10.1530/EJE-15-0628
18. Mokrysheva NG, Eremkina AK, Kovaleva EV. Chronic hypoparathyroidism in adults: Clinical features, diagnosis, management and treatment. Obe Metab. 2018;15(4):74-82 (in Russian).
19. Kovaleva EV, Ainetdinova AR, Eremkina AK. Evaluation of chronic hypoparathyroidism course according to the Database of Endocrinology Research Centre. Problemy endokrinologii. 2020;66(5):7-14 (in Russian). DOI:10.14341/probl12675
20. Pigarova EA, Rozhinskaia LIa, Belaia ZhE, et al. Russian Association of Endocrinologists recommendations for diagnosis, treatment and prevention of vitamin D deficiency in adults. Problemy endokrinologii. 2016;62(4):60-86 (in Russian). DOI:10.14341/probl201662460-84
21. Cipriani C, Pepe J, Colangelo L, Minisola S. Vitamin D and Secondary Hyperparathyroid. States. Front Horm Res. 2018;50:138-48. DOI:10.1159/000486077
22. Kuchuk NO, Pluijm SMF, Van Schoor NM, et al. Relationships of serum 25-hydroxyvitamin D to bone mineral density and serum parathyroid hormone and markers of bone turnover in older persons. J Clin Endocrinol Metab. 2009;94(4):1244-50. DOI:10.1210/jc.2008-1832
23. Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev. 2001;22(4):477-501. DOI:10.1210/edrv.22.4.0437
24. Bikbov B, Brian B, Andrusev A, et al. Hemodialysis practice patterns in the Russia Dialysis Outcomes and Practice Patterns Study (DOPPS), with international comparisons. Hemodialysis International. 2017;21:393-408. DOI:10.1111/hdi.12503
25. Hedgeman E, Lipworth L, Lowe K, et al. International burden of chronic kidney disease and secondary hyperparathyroidism: a systematic review of the literature and available data. Int J Nephrol. 2015;2015:184321. DOI:10.1155/2015/184321
26. Cozzolino M, Shilov E, Li Z, et al. Pattern of laboratory parameters and management of secondary hyperparathyroidism in countries of Europe, Asia, the Middle East, and North America. Adv Ther. 2020;37(6):2748-62. DOI:10.1007/s12325-020-01359-1
27. Portillo MR, Rodriguez-Ortiz ME. Secondary hyperparthyroidism: pathogenesis, diagnosis, preventive and therapeutic strategies. Rev Endocr Metab Disord. 2017;18(1):79-95. DOI:10.1007/s11154-017-9421-4
28. KDIGO 2017 Clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD). Kidney Int Suppl. 2017;7(1):1-59. DOI:10.1016/j.kisu.2017.04.001
29. Mokrysheva NG, Egshatian LV. Mineral and bone metabolism in chronic kidney disease. Moscow: MIA, 2020 (in Russian).
30. Alfieri C, Regalia A, Zanoni F, et al. The importance of adherence in the treatment of secondary hyperparathyroidism. Blood Purif. 2019;47(1-3):37-44. DOI:10.1159/000492918