Carotid Intima-Media Thickness in Surgically or Conservatively Managed Patients With Primary Hyperparathyroidism.

Autor:	Carnevale V; Unit of Internal Medicine, 'Casa Sollievo della Sofferenza' Hospital, IRCCS, 71013 San Giovanni Rotondo, FG, Italy., Pugliese F; Unit of Endocrinology, 'Casa Sollievo della Sofferenza' Hospital, IRCCS, 71013 San Giovanni Rotondo, FG, Italy., Eller-Vainicher C; Endocrinology Unit, Fondazione IRCCS 'Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy., Salcuni AS; Unit of Endocrinology and Metabolism, University-Hospital S. Maria Della Misericordia, 33100 Udine, Italy., Nieddu L; Department of Humanistic and International Social Sciences, UNINT University, 00147 Rome, Italy., Chiodini I; Unit of Endocrinology, Ospedale Niguarda Cà Granda, 20112 Milan, Italy., Scillitani A; Unit of Endocrinology, 'Casa Sollievo della Sofferenza' Hospital, IRCCS, 71013 San Giovanni Rotondo, FG, Italy.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2024 Nov 18; Vol. 109 (12), pp. e2342-e2347.
DOI:	10.1210/clinem/dgae053
Abstrakt:	Context: Current evidence of cardiovascular (CV) risk in primary hyperparathyroidism (PHPT) is still inconsistent. Objective: To prospectively investigate changes of early atherosclerosis in patients with PHPT undergoing parathyroidectomy (PTx) or conservative management, according to consensus criteria. Methods: Biochemical parameters of PHPT, CV risk factors (systolic and diastolic blood pressure, cholesterol [total, high-density, and low-density], triglyceride, HbA1c, HOMA-IR), and carotid intima-media thickness (IMT) and plaque were assessed in 52 consecutive postmenopausal PHPT patients both at baseline and ≥ 24 months after surgery (PTx, n = 22) or conservative management (non-PTx, n = 30). Results: At baseline, PTx and non-PTx showed comparable age, BMI, renal function, and 25(OH)D levels, and did not differ for CV risk factors, IMT and plaques, or for prevalence of smoking, diabetes mellitus, or antihypertensive or statin therapy, while all parameters characterizing PHPT differed. Follow-up duration in PTx was longer than in non-PTx (P = .004). Parameters characterizing PHPT significantly improved ≥ 24 months after surgery, whereas in non-PTx serum phosphate slightly decreased and parathyroid hormone increased. Systolic and diastolic blood pressure increased at follow-up in both groups, while other CV risk factors did not significantly vary. In PTx, IMT did not significantly vary after surgery (0.85 ± 0.14 to 0.89 ± 0.22 mm, P = .366), whereas it significantly increased in non-PTx (0.80 ± 0.18 to 0.93 ± 0.23 mm, P = .008), even adjusting for blood pressure. Plaque prevalence and incidence did not significantly differ in the 2 groups. Conclusion: Our results suggest that in postmenopausal patients with PHPT, subclinical atherosclerosis could be halted by PTx, whereas it worsens over time in nonoperated patients with milder disease. (© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)
Databáze:	MEDLINE
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