## Protocol Section
### Identification Module
**NCT ID:** NCT06419270

**Acronym:** CAREHYPO

**Brief Title:** Cardiovascular, Renal, and Skeletal Complications in Patients With Post-Surgical Hypoparathyroidism

**Official Title:** Cardiovascular, Renal, and Skeletal Complications in Patients With Post-Surgical Hypoparathyroidism

#### Organization Study ID Info
**ID:** VK-1-10-72-169-23
#### Organization
**Class:** OTHER
**Full Name:** University of Aarhus
### Status Module
#### Completion Date
**Date:** 2028-12

**Type:** ESTIMATED

#### Expanded Access Info
#### Last Update Post Date
**Date:** 2024-05-23

**Type:** ACTUAL

**Last Update Submit Date:** 2024-05-21

**Overall Status:** NOT_YET_RECRUITING

#### Primary Completion Date
**Date:** 2026-05

**Type:** ESTIMATED

#### Start Date
**Date:** 2024-05

**Type:** ESTIMATED

**Status Verified Date:** 2024-04

#### Study First Post Date
**Date:** 2024-05-17
**Type:** ACTUAL
**Study First Submit Date:** 2024-05-07
**Study First Submit QC Date:** 2024-05-13
### Sponsor Collaborators Module

#### Collaborators

**Class:** OTHER

**Name:** Gødstrup Hospital

#### Lead Sponsor

**Class:** OTHER

**Name:** University of Aarhus

#### Responsible Party

**Type:** SPONSOR

### Oversight Module

**Is FDA Regulated Device:** False

**Is FDA Regulated Drug:** False

### Description Module

**Brief Summary:** The aim of this observational study is to learn about long term effects to post surgical hypoparathyroidism. The main questions are:

1. Patients with hypoparathyroidism do not have an increased arterial stiffness compared to healthy controls.
2. Patients with hypoparathyroidism do not have an increased coronary artery plaque burden assessed by cardiac CT compared to healthy controls.
3. Patients with hypoparathyroidism do not have an increased prevalence of vertebral fractures compared to healthy controls.

Results will be compared with gender and age matched controls from the general population.

Participants will have a CT scan, DXA scan, tonometry, blood samples and questionaries performed and collect a 24-hour urine sample.

**Detailed Description:** Hypoparathyroidism is a rare endocrine disorder characterized by hypocalcemia with low or undetectable levels of parathyroid hormone. The most common cause of hypoparathyroidism is following neck surgery, whereas approximately 25% of hypoparathyroidism patients are suffering from non-surgical hypoparathyroidism due to e.g., genetic or autoimmune causes. According to updated international guidelines, the condition is considered chronic if treatment with calcium and activated vitamin D is still needed a year after surgery.

A large retrospective cohort study of patients with chronic hypoparathyroidism shows that patients with chronic hypoparathyroidism have a significantly higher risk of cardiovascular disease, compared to patients without hypoparathyroidism. Additionally, it is well known that patients with hypoparathyroidism are at increased risk of renal and extra-skeleton calcifications, although cardiovascular calcifications are only sparsely investigated. Furthermore, both higher arterial stiffness assessed by pulse wave velocity and an increased heart rate have previously been shown in patients with non-surgical hypoparathyroidism. It is largely unknown whether this also applies to patients with post-surgical hypoparathyroidism.

The overall aim of the project is to investigate cardiovascular, renal, and skeletal indices in patients diagnosed with Post Surgical hypoparathyroidism and test the following (null-)hypotheses:

1. H0: Patients with post-surgical hypoparathyroidism do not have an increased arterial stiffness compared to healthy controls.
2. H0: Patients with post-surgical hypoparathyroidism do not have an increased coronary artery plaque burden assessed by cardiac CT compared to healthy controls.
3. H0: Patients with post-surgical hypoparathyroidism do not have an increased prevalence of vertebral fractures compared to healthy controls.

Patients and controls who accept participation will undergo a detailed examination in terms of: Medical history, physical examination, questionnaires, blood and 24-hour urine samples, DXA scan, HRpQCT, tonometry, 12-lead electrocardiogram, 24-hour blood pressure and a CT scan

Data are analyzed according to their distribution using parametric or non-parametric statistics. To address the hypotheses, statistical power calculations have been performed.

50 patients with post-surgical hypoparathyroidism will be matched on sex and age (± 2 years) with 50 randomly selected otherwise healthy controls from the general population.

### Conditions Module

**Conditions:**

- Hypoparathyroidism

- Cardiovascular Complication

- Fractures, Bone

- Renal Disease

### Design Module

#### Design Info

**Observational Model:** CASE_CONTROL

**Time Perspective:** CROSS_SECTIONAL

#### Enrollment Info

**Count:** 100

**Type:** ESTIMATED

**Study Type:** OBSERVATIONAL

### Arms Interventions Module

#### Arm Group 1

**Description:** Patients with post-surgical hypoparathyroidism

**Label:** Patients

#### Arm Group 2

**Description:** Gender and age matched controls from the general population

**Label:** Controls

### Outcomes Module

#### Primary Outcomes

**Description:** aortic pulse wave velocity in m/s

**Measure:** Arterial stiffness

**Time Frame:** 24 months

**Description:** VFA assessing fractures in numbers

**Measure:** Vertebral fractures

**Time Frame:** 24 months

**Description:** Heart CT scan assessing coronary artery calcium score

**Measure:** coronary artery plaque burden

**Time Frame:** 24 months

#### Secondary Outcomes

**Description:** Description of calcifications

**Measure:** Renal indices

**Time Frame:** 24 months

**Description:** Description of bone status

**Measure:** bone indices

**Time Frame:** 24 months

**Description:** Description of calcifications

**Measure:** Cardiovascular indices

**Time Frame:** 24 months

### Eligibility Module

**Eligibility Criteria:** Inclusion Criteria:

Patients only:

* Chronic post surgical hypoparathyroidism diagnosed \> 5 years ago. (In case recruitment is too challenging, we will accept duration of disease of minimum one year. Including patients with longest duration of disease first.)
* Require treatment with active vitamin D ≥ 1 µg/day

Controls only:

* No history of neck surgery
* No history of parathyroid disease

All participants:

* Age ≥ 18 years
* 25(OH)D vitamin ≥ 50 nmol/L
* Serum magnesium ≥ 0,50 mmol/L
* Able to read and understand Danish
* Willing and able to sign the informed consent form

Exclusion Criteria:

* Estimated glomerular filtration rate (eGFR) \< 30 ml/min/1.73 m3
* Active cancer or former (except thyroid and basal cell skin) cancer treatment \< 5 year ago
* Pregnancy, or breastfeeding \< 1 year ago
* Untreated thyroid or liver diseases during the last year
* Treatment with lithium within the last 4 weeks
* Known allergy or sensitivity to iodine
* Any reason that in the opinion of the investigator, that would prevent the patient from completing the study.

**Healthy Volunteers:** True

**Minimum Age:** 18 Years

**Sampling Method:** NON_PROBABILITY_SAMPLE

**Sex:** ALL

**Standard Ages:**

- ADULT

- OLDER_ADULT

**Study Population:** Patients will be recruited from endocrine clinics Controls will be recruited from the general population

### Contacts Locations Module

#### Central Contacts

**Contact 1:**

**Email:** sarthorn@rm.dk

**Name:** Sarah Thornhoj

**Phone:** 40491821

**Role:** CONTACT

#### Overall Officials

**Official 1:**

**Affiliation:** Aarhus University Hospital

**Name:** Lars Rejnmark

**Role:** PRINCIPAL_INVESTIGATOR

### IPD Sharing Statement Module

**IPD Sharing:** UNDECIDED

## Derived Section

### Condition Browse Module - Ancestors

- ID: D000010279

- Term: Parathyroid Diseases

- ID: D000004700

- Term: Endocrine System Diseases

- ID: D000014947

- Term: Wounds and Injuries

### Condition Browse Module - Browse Branches

- Abbrev: BXS

- Name: Urinary Tract, Sexual Organs, and Pregnancy Conditions

- Abbrev: All

- Name: All Conditions

- Abbrev: BC26

- Name: Wounds and Injuries

- Abbrev: BC19

- Name: Gland and Hormone Related Diseases

- Abbrev: Rare

- Name: Rare Diseases

### Condition Browse Module - Browse Leaves

- ID: M10698

- Name: Kidney Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M26370

- Name: Fractures, Bone

- Relevance: HIGH

- As Found: Fractures, Bone

- ID: M10061

- Name: Hypoparathyroidism

- Relevance: HIGH

- As Found: Hypoparathyroidism

- ID: M13192

- Name: Parathyroid Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M7862

- Name: Endocrine System Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M17685

- Name: Wounds and Injuries

- Relevance: LOW

- As Found: Unknown

- ID: T2949

- Name: Hypoparathyroidism

- Relevance: HIGH

- As Found: Hypoparathyroidism

### Condition Browse Module - Meshes

- ID: D000007011

- Term: Hypoparathyroidism

- ID: D000050723

- Term: Fractures, Bone

### Misc Info Module

- Version Holder: 2024-05-31
