The effect of surgery on fat mass, lipid and glucose metabolism in mild primary hyperparathyroidism
| Autor: | Karolina Lundstam, Mikael Hellström, Charlotte L. Mollerup, Ansgar Heck, Jörgen Nordenström, Thord Rosén, Kristin Godang, Svante Jansson, Jens Bollerslev, Fougner Fougner, Ylva Pernow |
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| Rok vydání: | 2018 |
| Předmět: |
Parathyroidectomy
medicine.medical_specialty Randomization Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Context (language use) Carbohydrate metabolism lcsh:Diseases of the endocrine glands. Clinical endocrinology Gastroenterology lipids 03 medical and health sciences 0302 clinical medicine Endocrinology Internal medicine Internal Medicine medicine Vitamin D and neurology glucose homeostasis Glucose homeostasis 030212 general & internal medicine primary hyperparathyroidism lcsh:RC648-665 business.industry Lipid metabolism medicine.disease business DXA and body composition Primary hyperparathyroidism |
| Zdroj: | Endocrine Connections, Vol 7, Iss 8, Pp 941-948 (2018) |
| ISSN: | 2049-3614 |
| Popis: | Context Mild primary hyperparathyroidism has been associated with increased body fat mass and unfavorable cardiovascular risk factors. Objective To assess the effect of parathyroidectomy on fat mass, glucose and lipid metabolism. Design, patients, interventions, main outcome measures 119 patients previously randomized to observation (OBS; n = 58) or parathyroidectomy (PTX; n = 61) within the Scandinavian Investigation of Primary Hyperparathyroidism (SIPH) trial, an open randomized multicenter study, were included. Main outcome measures for this study were the differences in fat mass, markers for lipid and glucose metabolism between OBS and PTX 5 years after randomization. Results In the OBS group, total cholesterol (Total-C) decreased from mean 5.9 (±1.1) to 5.6 (±1.0) mmol/L (P = 0.037) and LDL cholesterol (LDL-C) decreased from 3.7 (±1.0) to 3.3 (±0.9) mmol/L (P = 0.010). In the PTX group, the Total-C and LDL-C remained unchanged resulting in a significant between-group difference over time (P = 0.013 and P = 0.026, respectively). This difference was driven by patients who started with lipid-lowering medication during the study period (OBS: 5; PTX: 1). There was an increase in trunk fat mass in the OBS group, but no between-group differences over time. Mean 25(OH) vitamin D increased in the PTX group (P Conclusion In mild PHPT, the measured metabolic and cardiovascular risk factors were not modified by PTX. Observation seems safe and cardiovascular risk reduction should not be regarded as a separate indication for parathyroidectomy based on the results from this study. |
| Databáze: | OpenAIRE |
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