Biomedical subjects

Jian-Min Liu

Publications and source records attributed to Jian-Min Liu.

2 recordsLinked to original sources

PubMed2026

10-year cardiovascular disease risk and its contributing factors in primary hyperparathyroidism.

OBJECTIVE: Surgery indications for primary hyperparathyroidism (PHPT) mostly concern kidney and bone outcome, but not cardiovascular disease (CVD). Age less than 50 and eGFR less than 60 ml/min/1.73m2 are two surgery indications. This study aims to evaluate factors influencing the 10-year CVD risk in PHPT patients. METHOD: 159 PHPT patients diagnosed between January 2024 - March 2025 were enrolled. The relationships between biochemical and echocardiographic parameters with 10-year CVD risk score calculated by PREVENT™ were analyzed. Univariate, multivariate, logistic regression and receive operation curve (ROC) analysis were employed. RESULTS: 10-year CVD risk score was positively corelated with age (R2adjusted = 0.604, β = 0.541), systolic blood pressure (R2adjusted =0.149, β = 0.185), eGFR (R2adjusted =0.452, β=-0.252), triglyceride (R2adjusted =0.134, β = 3.629) with P < 0.001.These parameters together with smoking, diabetes and left ventricular end-diastolic diameter were responsible for 10-year CVD risk (R2adjusted =0.849, P < 0.001). Age and eGFR were the two strongest factors to discriminate moderate-to-high risk and low risk, with area under the curve 0.935 (95%CI 0.896–0.974) and 0.827 (95%CI 0.763–0.891), respectively. The optimal cutoffs to identify moderate-to-high CVD risk were age at 56.5 and eGFR at 98.5 ml/min/1.73m2, PHPT patients older or lower than these two thresholds had significantly higher CVD risk than their counterparts (P < 0.001). CONCLUSION: Age and eGFR were significant contributors to CVD risk in PHPT. Patients should be closely monitored and managed for dysregulated gluco-lipid metabolism. Less restrictive surgery indication for PHPT, such as age < 56, irrespective of renal function might be considered.

Humans↗

PubMed2025

Approach to the Patient With Primary Hyperparathyroidism in Multiple Endocrine Neoplasia Type 1.

Multiple endocrine neoplasia type 1 (MEN1) is a rare autosomal dominant hereditary disorder in which patients develop multiple endocrine tumors simultaneously. Among these, primary hyperparathyroidism is the most common and often the earliest manifestation. All patients with MEN1 and hypercalcemia should have surgery, with most patients requiring surgical treatment before the age of 50 years. The timing of parathyroid surgery mainly depends on hypercalcemia and the presence of renal or skeletal complications. The goals of treatment are to correct hypercalcemia, prevent target organ damage, and minimize the risk of postoperative hypoparathyroidism as much as possible. Currently, the most widely recommended surgical approach is subtotal parathyroidectomy via the cervical approach (removal of 3 or 3.5 glands). With advances in imaging technology, patients with clearly localized lesions-particularly younger patients-may be candidates for individualized unilateral resection (ie, removal of both glands on the affected side). In addition, recurrent hypercalcemia after surgery is relatively common in patients with MEN1. The management of the remaining glands remains challenging, such patients usually need reoperation, calcimimetic therapy, or clinical observation. For patients requiring repeated parathyroid surgeries, in addition to searching for multifocal lesions, the possibility of ectopic parathyroid glands should also be taken into account. Ectopic parathyroid adenoma, caused by abnormal embryonic migration, complicates surgery in both sporadic and MEN1-related primary hyperparathyroidism. However, in MEN1, their higher frequency and multiglandular distribution make localization even more challenging, often leading to incomplete resection and recurrence.

Humans↗