№ 1/2010 ОстеОпОрОз и ОстеОпатии ОбзОРы лИтЕРАтуРы , , , . , . . ., . . . . . ., . . . . . , . . ., ( ( , . , , : , . , . , , , ( ( ) [9]. , 0,5 34 — 0,4–18,8 . ) — ( ) ( , 1000 10 000 ) , 55 — 2%, 2–3 [23,24]. , , ( . , 2008 . ), — 0,03 0,698 1000 , 2009 (. , 5%. , , . 3%, 5% , , [8]. (75%) (80–85%), — (10%) II -1, (20%), (5%). , , 9% - 1-5%) - , :I — ( ( , - ) — . . , , , d - , , S- 2- d1, , ) , 44,0±4,0%, , - . . , (42±2,8 - — ) , Prad1- , - , , 11q13, — 11p15. Prad1 . — Prad1, [3]. , (5%) . ( 2 , . (4%), 1 . - 600 100 . . ( .1,2) , - , , . - , ( , - . 6,6%. - , ), 1 , - . 1%, : - . , . , , , ), , - . , , . . , , , . . . . . . — - , , , , )— ., *, , . - , . , . carling ) [11, 12]. d, - ., d , - 13 ОбзОРы лИтЕРАтуРы № 1/2010 ОстеОпОрОз и ОстеОпатии 1,25( )2d3, 2008 0,698 100 - . . . - . 120 100 . 80 60 - 1970- 40 , 20 0 , . , , .1. ( 2009 400 , 0,03 ( ). ( ) ( - 5-10 350 , 300 , . 250 . , , 80%[9]. ( 1.) 5 200 460 150 100 64 33%, 6%. 50 , 50 , 0 .2. ( - - . . , 2009 .) : , ; , , ( ( , ); ( , ); ( — , , , Qt, ). [4, 5] , , - , , , , , , . , ); , - . . 1. , 14 , ( , ). 0,5 363 .) , . -2,5Sd , 1000 , , , / ) , ( ) — - № 1/2010 ОстеОпОрОз и ОстеОпатии ОбзОРы лИтЕРАтуРы , . , , , , , , . , , , / , , . - - ( [20]. , ), . 90 % , 15-20% [8]. 70%, -2,5 Sd — 20% [6]. , , , ( . , " ( , , . 7,9%, , , - , , ( - - , , , 4,5 , . , , ( , — - , - , . , . [1]. / 3,49–3,99 . , , ), , - , [5]. - , 10 41 , — , . - . - . 60% . , , 6-21% [4]. — , . . - (57,1%)[2]. - [4]. ", 65% , . Stefenelli , , , . , [17]. , . - , ). . - , , ). . , - , . ), - . - ( [6]. 4,5% - , , . 30% , - . , 10–15% , — - [3]. , . , 7–12% . , - , , , , . , - ). , , - , 60% [1]. / . . - , 15 ОбзОРы лИтЕРАтуРы № 1/2010 ОстеОпОрОз и ОстеОпатии [16]. , . . . , , . [2] , - d d— - . , , . - -6 0,2–0,3 87% . ( . 50 , , , . 0,5 . 16 . , . [10]. - , . . , , . ( ; , , , - ( , - , ); ; , ); [7] . - ; ; ; ; , ; ; , , , . - - , - , . . , , , - . , , . - . , - , . , ) , - . 2 , , - [14]. 25 - 75%, ( ( 80%), , . - 34% . - ) - - , /raNkl, [22]. , 36 . . , , . 500 — . , , -6 30%). . I . [14]. ( - 99m 90% [13] . . , 99%. , - ) , , d, , ( - d, . - . . . , , , - . , , . - - № 1/2010 ОстеОпОрОз и ОстеОпатии . , ОбзОРы лИтЕРАтуРы 12 , [2]. - 10,9% ( <0,001), 16,5% ( =0,025), , 0,25 . 2. 3. / 50 -2,5Sd 4. / 5. , . 50 . , 95-98% , 1-2% . , . . , . , - . , , . , 3,5-3,7 / , , . . . , - - . , , , « ). , ) « (1500-3000 » d( . - . ( , 3-8% [15, 18]. ) , . , . , . , , , (120-180 , . ( 50%) ). ( [19]. / , , - , - ) . - [13]. [19, 21]. - - , - , . », . [15, - , , , . - , , - II , 18, 20]. . - . , , . , . [8]. . - - . 60 . [6], . . ( 2 , - : 2% ) . 2008 ., [16], , . . - 12- , . 1. , - 8,7% ( <0,001), 9,3% ( <0,001), , - . - ( , ) , . , , , 17 ОбзОРы лИтЕРАтуРы № 1/2010 ОстеОпОрОз и ОстеОпатии , - . . » — ( 23 ) , 62% 10 , , « . - , . - - [8]. - . , . , - , , - . . SUMMARY Primary hyperparathyroidism (PHPT) is a common endocrine disorder that affects bones, urinary tract, cardiovascular system, gastrointestinal tract, and another organs and tissues. The most cases of PHPT are mild forms and those patients have nonspeciic symptoms, which require careful diagnostic considerations and choice of treatment. There is not enough data about prevalence of PHPT, especially it’s mild forms, in Russian Federation, and future epidemiological research needs to be done. Present literature review includes information about etiology, pathogenesis, clinical indings, diagnostic and differential diagnostic, indication for surgery and medical treatment of PHPT. The review is based on data of studies from the different countries and few studies from Endocrine science center. Key words. Primary hyperparathyroidism, epidemiology, clinical indings, indications for surgery, medical treatment. 1. 2. . . medicum, 2006, 8( . . 5. 6. 18 . . 9), .105—110. . . . . . , 2005. . . . » // consilium .« . 2009 . 3. 4. , . . . , . . . , . // 3- . 59. — .24—29. . .« . ., , - // . . — , . . , 2006- 2, .33—41. . ., . ., - . / .. 2006 . 7. alok Sachdeva, Bruce e goeckeritz and alyce m oliver // Symptomatic hypercalciemia in a patient with chronic tophaceous gout: a case report // cases J. -2008 — 1 P.72. 8. the merican association of clinical endocrinologists and the merican association of endocrine surgeons. Position statement on the diagnosis and management of primary hyperparathyroidism. endocrine practice vol 11 no. 1 January/february 2005. 9. Bilezician JP, Potts Jt Jr, fuleihan, gel-h et al. Summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21-st century. J Bone mineral res 2002 ; 17 Suppl 2:N2. 10. Brian h. eisner, m.d., Jennifer ahn, B.a., and marshall l. Stoller, m.d. differentiating Primary from Secondary hyperparathyroidism in Stone Patients: the «thiazide challenge» journal of endourology vol. 23, number 2, february 2009. 11. carling ., rastad J., Szabo e. et al. reduced parathyroid vitamin d receptor messenger ribonucleic acid levels in primary and secondary hyperparathyroidism // J. clin. endocrinol. metab. — 2000.—vol. 85, — P. 2000—2003. 12. carling ., Szabo e., Bai m. et al. familial hypercalcemia and hypercalciuria caused by a novel mutation in the cytoplasmic tail of the calcium receptor // J. clin. endocrinol. metab. — 2000. —vol. 85, P. 2042—2047. 13. P Iglesias, J J dıez. current treatments in the management of patients with primary hyperparathyroidism. Postgrad. Med. J. 2009;85;15—23. 14. kaji1 h., r. Nomura1, m. yamauchi, k. chihara1, t. Sugimoto the usefulness of Bone metabolic Indices for the Prediction of changes in Bone mineral density after Parathyroidectomy in Patients with Primary hyperparathyroidism // horm metab res.—2006; 38(6): 411—6. 15. khan a, Bilezikian J, kung a et al. alendronate in Primary hyperparathyroidism: a double-Blind, randomized, Placebocontrolled trial. J Clin.Endocrinol.Metab — 2004 — 89(7) — pp.3319—25. 16. khan a.a., Bilezikian J.P., Potts J.t., Jr. the third International Workshop on asymptomatic Primary hyperparathyroidism. // J clin endokcrin metab, february 2009, 94(2):333—334. 17. kushner d. calcium and the kidney // the american Journal of clinical Nutrition — 2006 vol. 4 N.5 — pp. 561—579. 18. Parker c., Blackwell P., fairbairn k., d. J. hosking. alendronate in the treatment of Primary hyperparathyroid-related osteoporosis: a 2-year Study. J Clin.Endocrinol.Metab — 2002 — 87(10) — pp.4482—9. 19. Peacock m, Bolognese ma, Borofsky m, Scumpia S, Sterling Lr, cheng S, Shoback d. cinacalcet treatment of primary hyperparathyroidism: biochemical and bone densitometric outcomes in a ive-year study. J clin endocrinol metab. 2009 dec;94(12):4860-7. epub 2009 oct 16. 20. rossini m, gatti d, Isaia g, Sartori l, Braga v, adami S 2001 effects of oral alendronate in elderly patients with osteoporosis and mild primary hyperparathyroidism. J Bone miner res 16:113—119. 21. Steddon S.J, cunningham J calcimimetics and calciuritic — fooling the calcium receptor. // lancet 365:2237—2239, 2005. 22. Stilgren l.S., rettmer e., eriksen e.f., hegedus l., Beck-Nielsen h., abrahamsen B. Skeletal changes in osteoprotegerin and receptor activator of nuclear factor-kappab ligand mrNa levels in primary hyperparathyroidism: effect of parathyroidectomy and association with bone metabolism // Bone.-2004; 35(1): 256—65. 23. Ning yu*, Peter t. donnan*, michael J. murphy† and graham P. leese. epidemiology of primary hyperparathyroidism in tayside, Scotland, uk . clinical endocrinology (2009) 71, 485—493. 24. Wermers ra, khosla S, atkinson eJ et al. Incidence of primary hyperparathyroidism in rochester, minnesota, 1993-2001: an update on the changing epidemiology of the disease. // J Bone miner res. 2006 Jan;21(1):171—7. , 2009 — . . » - * – e-mail: mokryshevaN@yandex.ru