Physical Activity and the Risk of Primary Hyperparathyroidism.

Document Type


Publication Date



Nephrology and Transplant

Journal Title

The Journal of clinical endocrinology and metabolism

MeSH Headings

Adult, Exercise, Female, Humans, Hyperparathyroidism, Primary, Incidence, Maine, Middle Aged, Prospective Studies, Risk Factors


CONTEXT: Primary hyperparathyroidism (P-HPTH) is relatively common and predominantly affects women. Prior studies have shown that physical activity (PA) can lower PTH levels.

OBJECTIVE: Our objective was to evaluate the hypothesis that lower PA is a risk factor for developing P-HPTH.

DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study included 69 621 female participants in the Nurses' Health Study I followed for 22 years.

EXPOSURES: PA and other dietary and demographic exposures were quantified via detailed, and validated, biennial questionnaires.

OUTCOMES: Incident P-HPTH was confirmed by medical record review after initial assessment by questionnaire. Adjusted Cox proportional hazards models were used to evaluate whether PA was an independent risk factor for developing P-HPTH. We also evaluated the risk of developing P-HPTH when combining low PA (/week) with a previously identified independent risk factor for developing P-HPTH: low calcium intake (/day). The relation between PA and PTH levels was evaluated in 625 participants.

RESULTS: We confirmed 302 incident cases of P-HPTH during 1 474 993 person-years of follow-up. Participants in the highest quintile (Q) of PA had a 50% lower risk of developing P-HPTH: age-adjusted relative risks and 95% confidence intervals for incident P-HPTH by lowest to highest of PA were Q1 = 1.0 (reference); Q2 = 0.83 (0.60–1.15); Q3 = 0.84 (0.61–1.15); Q4 = 0.50 (0.34–0.74); Q5 = 0.50 (0.35–0.73); P for trend

CONCLUSION: Low physical activity may be a modifiable risk factor for developing P-HPTH in women.



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