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

Journal article
Authors Kristin Godang
Karolina Lundstam
Charlotte Mollerup
Fougner Fougner
Ylva Pernow
Jörgen Nordenström
Thord Rosén
Svante Jansson
Mikael Hellström
Jens Bollerslev
Ansgar Heck
Published in Endocrine connections
Volume 7
Issue 8
Pages 941-948
ISSN 2049-3614
Publication year 2018
Published at Institute of Clinical Sciences, Department of Radiology
Pages 941-948
Language en
Links dx.doi.org/10.1530/EC-18-0259
www.ncbi.nlm.nih.gov/entrez/query.f...
Subject categories Endocrinology

Abstract

Mild primary hyperparathyroidism has been associated with increased body fat mass and unfavorable cardiovascular risk factors.To assess the effect of parathyroidectomy on fat mass, glucose and lipid metabolism.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.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.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.

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