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

Almqvist, Erik G.; Bondeson, Anne-Greth LU ; Bondeson, Lennart LU ; Mellstrom, Dan and Svensson, Johan (2012) In Scandinavian Journal of Clinical & Laboratory Investigation 72(2). p.92-99
Abstract
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... (More)
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. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
PTH, SHBG, osteocalcin, insulin, hyperparathyroidism, erythropoietin, Adiponectin
in
Scandinavian Journal of Clinical & Laboratory Investigation
volume
72
issue
2
pages
92 - 99
publisher
Informa Healthcare
external identifiers
  • wos:000301456100002
  • scopus:84858403182
ISSN
1502-7686
DOI
10.3109/00365513.2011.634432
language
English
LU publication?
yes
id
b94a0193-3f67-469f-b2fd-e12331bf2f8f (old id 2515390)
date added to LUP
2012-05-07 08:50:38
date last changed
2017-11-05 04:03:56
@article{b94a0193-3f67-469f-b2fd-e12331bf2f8f,
  abstract     = {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 &lt; 0.05), and SHBG and osteocalcin had decreased (p &lt; 0.05 and p &lt; 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.},
  author       = {Almqvist, Erik G. and Bondeson, Anne-Greth and Bondeson, Lennart and Mellstrom, Dan and Svensson, Johan},
  issn         = {1502-7686},
  keyword      = {PTH,SHBG,osteocalcin,insulin,hyperparathyroidism,erythropoietin,Adiponectin},
  language     = {eng},
  number       = {2},
  pages        = {92--99},
  publisher    = {Informa Healthcare},
  series       = {Scandinavian Journal of Clinical & Laboratory Investigation},
  title        = {Factors influencing insulin sensitivity in patients with mild primary hyperparathyroidism before and after parathyroidectomy},
  url          = {http://dx.doi.org/10.3109/00365513.2011.634432},
  volume       = {72},
  year         = {2012},
}