High Ionized Calcium in the General Population and Risk of Primary Hyperparathyroidism
Authors' conclusion
High ionized calcium found in 1:40 in the general population conferred absolute 10-year risks of primary hyperparathyroidism of up to 44%. These findings support further diagnostic workup following an incidentally observed high plasma ionized calcium in otherwise healthy individuals.
Study context
- Population
- General population, Danish Copenhagen General Population Study, inclusion 2003–2015
- Participants
- 106,588 participants
- Exposure
- Moderately high and high vs low normal plasma ionized calcium
- Outcome
- Incident PHPT
- Follow-up
- 10-year absolute risk
Methodological detailspopulation-based, Cox regression and competing-risk regression, multivariable adjusted
- Population-based
- Cox regression and competing-risk regression
- Multivariable adjusted
Main finding
As reported in the abstract
PHPT
Each group vs low normalAdjusted hazard ratio (95% CI)
Moderately high
65(46–92)
High
350(251–489)
- Moderately high or high ionized calcium at baseline
- 2497 (2.5%)
- Diagnosed with PHPT during follow-up
- 441 (0.4%)
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| PHPT, womenModerately highvs Low normal | 63 (42–95) | |
| PHPT, womenHighvs Low normal | 326 (221–482) | |
| PHPT, menModerately highvs Low normal | 73 (37–145) | |
| PHPT, menHighvs Low normal | 490 (256–935) | |
| 0.050.21520Hazard ratio (log scale) |
Absolute risk of PHPT, women and men >65 years
- Moderately high, women / men
- 7.9% / 3.3%
- High, women / men
- 44% / 21%
Original publication
High Ionized Calcium in the General Population and Risk of Primary Hyperparathyroidism. J Clin Endocrinol Metab. Published 20 February 2025. doi:10.
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