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Factors influencing insulin sensitivity in patients with mild primary hyperparathyroidism before and after parathyroidectomy

På svenska

Author

  • Erik G. Almqvist
  • Anne-Greth Bondeson
  • Lennart Bondeson
  • Dan Mellstrom
  • Johan Svensson

Summary, in English

Objectives. Primary hyperparathyroidism (PHPT) is associated with cardiovascular disease. The aims of this study were to investigate lipid and glucose metabolism in mild PHPT, and to identify whether insulin sensitivity correlates with circulating levels of adiponectin, SHBG, and osteocalcin before and after parathyroidectomy (PTX). Materials and methods. Forty-five patients with PHPT were examined before and 1 year after PTX. Circulating levels of triglycerides, total cholesterol, HDL-cholesterol, insulin, glucose, adiponectin, SHBG, osteocalcin, and erythropoietin were measured. Results. At baseline, the mean serum levels of total cholesterol, LDL-cholesterol and triglycerides were above the upper reference limit or in the upper normal range, and insulin sensitivity was reduced as assessed using the HOMA index. One year after parathyroidectomy, serum lipids as well as HOMA index and erythropoietin were unchanged while adiponectin had increased (p < 0.05), and SHBG and osteocalcin had decreased (p < 0.05 and p < 0.0001, respectively). HOMA index correlated negatively with circulating levels of adiponectin, SHBG and osteocalcin. In multiple regression analysis SHBG was the most important predictor of insulin sensitivity, both pre- and postoperatively. Conclusion. Untreated mild PHPT is associated with a moderate derangement of lipid and glucose metabolism. As previously shown in population-based cohorts, insulin sensitivity is positively associated with circulating concentrations of adiponectin, SHBG and osteocalcin. One year after PTX, the mean level of adiponectin was increased, but the levels of SHBG and osteocalcin had decreased and the levels of serum lipids and the insulin sensitivity remained unchanged as compared with baseline.

Publishing year

2012

Language

English

Pages

92-99

Publication/Series

Scandinavian Journal of Clinical & Laboratory Investigation

Volume

72

Issue

2

Document type

Journal article

Publisher

Informa Healthcare

Topic

  • Surgery
  • Cell and Molecular Biology
  • Cancer and Oncology

Keywords

  • PTH
  • SHBG
  • osteocalcin
  • insulin
  • hyperparathyroidism
  • erythropoietin
  • Adiponectin

Status

Published

Research group

  • Pathology, Malmö

ISBN/ISSN/Other

  • ISSN: 1502-7686