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Endocr Connect. 2018 Jul 16. pii: EC-18-0259. doi: 10.1530/EC-18-0259. [Epub ahead of print]

The effect of surgery on fat mass, lipid and glucose metabolism in mild primary hyperparathyroidism.

Author information

1
K Godang, Section of Specialized Endocrinology, Oslo University Hospital Rikshospitalet, Oslo, N-0027 , Norway.
2
K Lundstam, Department of Radiology, Institute of Clinical Sciences, Sahlgrenska universitetssjukhuset, Goteborg, Sweden.
3
C Mollerup, Clinic of Breast and Endocrine Surgery, Rigshospitalet, Copenhagen, Denmark.
4
S Fougner, Department of Endocrinology, St. Olavs Hospital, Trondheim, Norway.
5
Y Pernow, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
6
J Nordenström, Department of Molecular Medicine and Surgery, Karolinska Universitetssjukhuset, Stockholm, Sweden.
7
T Rosen, Department of Medicine, Sahlgrenska universitetssjukhuset, Goteborg, Sweden.
8
S Jansson, Department of Endocrine Surgery, Sahlgrenska universitetssjukhuset, Gothenburg, Sweden.
9
M Hellström, Department of Radiology, Institute of Clinical Sciences, Sahlgrenska universitetssjukhuset, Gothenburg, Sweden.
10
J Bollerslev, Section of Specialized Endocrinology and Faculty of Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.
11
A Heck, Section of Specialized Endocrinology and Faculty of Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway ansgar.heck@medisin.uio.no.

Abstract

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 five 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<0.001), but did not change in the OBS group. No difference in parameters of glucose metabolism was detected.

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.

PMID:
30012647
DOI:
10.1530/EC-18-0259
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