Normocalcemic primary hyperparathyroidism is not associated with cardiometabolic alterations.
Blood pressure
Calcium
Cardiometabolic
Glucose
Normocalcemic primary hyperparathyroidism
Parathormone
Journal
Endocrine
ISSN: 1559-0100
Titre abrégé: Endocrine
Pays: United States
ID NLM: 9434444
Informations de publication
Date de publication:
15 Oct 2024
15 Oct 2024
Historique:
received:
14
08
2024
accepted:
27
09
2024
medline:
15
10
2024
pubmed:
15
10
2024
entrez:
15
10
2024
Statut:
aheadofprint
Résumé
Cardiometabolic disorders are non-classical complications of hypercalcemic primary hyperparathyroidism (HC-PHPT), but whether this risk connotes normocalcemic PHPT (NC-PHPT) remains to be elucidated. We investigated cardiometabolic alterations in both forms of PHPT, looking for their association with indices of disease activity. Patients with HC-PHPT (n = 17), NC-PHPT (n = 17), and controls (n = 34) matched for age, sex, and BMI were assessed for glucose, lipid, blood pressure alterations, and history of cardiovascular events to perform a case-control study at an ambulatory referral center for Bone Metabolism Diseases. NC-PHPT, in comparison to controls, showed similar glucose (mean ± SD, 88 ± 11 vs 95 ± 22 mg/dl), total cholesterol (199 ± 25 vs 207 ± 36 mg/dl), and systolic blood pressure levels (SBP, 132 ± 23 vs 132 ± 19 mmHg), together with a comparable frequency of glucose alterations (6% vs 9%), lipid disorders (41% vs 50%) and hypertension (53% vs 59%, p = NS for all comparisons). Conversely, all these abnormalities were more prevalent in HC-PHPT vs controls (p < 0.05). When compared to NC-PHPT, HC-PHPT showed higher glucose (113 ± 31 mg/dl), total cholesterol (238 ± 43 mg/dl), and SBP levels (147 ± 15 mmHg) as well as an increased frequency of glucose (41%) and lipid alterations (77%) and a higher number of cardiovascular events (18% vs 0%, p < 0.05 for all comparisons). Among indices of PHPT activity, calcium levels displayed a significant correlation with glucose (R = 0.46) and SBP values (R = 0.60, p < 0.05). NC-PHPT is not associated with cardiovascular alterations. The predominant pathogenetic role of hypercalcemia in the development of cardiometabolic disorders could account for the absence of such alterations in NC-PHPT.
Identifiants
pubmed: 39404961
doi: 10.1007/s12020-024-04063-0
pii: 10.1007/s12020-024-04063-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
M.D. Walker, S.J. Silverberg, Primary hyperparathyroidism. Nat. Rev. Endocrinol. 14, 115–125 (2018). https://doi.org/10.1038/nrendo.2017.104
doi: 10.1038/nrendo.2017.104
pubmed: 28885621
S. Minisola, A. Arnold, Z. Belaya, M.L. Brandi, B.L. Clarke, F.M. Hannan et al. Epidemiology, pathophysiology, and genetics of primary hyperparathyroidism. J. Bone Miner. Res. 37, 2315–2329 (2022). https://doi.org/10.1002/jbmr.4665
doi: 10.1002/jbmr.4665
pubmed: 36245271
J.P. Bilezikian, A.A. Khan, S.J. Silverberg, G.E.H. Fuleihan, C. Marcocci, S. Minisola et al. Evaluation and management of primary hyperparathyroidism: summary statement and guidelines from the fifth international workshop. J. Bone Miner. Res. 37, 2293–2314 (2022). https://doi.org/10.1002/jbmr.4677
doi: 10.1002/jbmr.4677
pubmed: 36245251
N.E. Cusano, F. Cetani, Normocalcemic primary hyperparathyroidism. Arch. Endocrinol. Metab. 66, 666–677 (2022). https://doi.org/10.20945/2359-3997000000556
doi: 10.20945/2359-3997000000556
pubmed: 36382756
pmcid: 10118830
J. Bollerslev, L. Rejnmark, A. Zahn, A. Heck, N.M. Appelman-Dijkstra, L. Cardoso et al. European expert consensus on practical management of specific aspects of parathyroid disorders in adults and in pregnancy: recommendations of the ESE educational program of parathyroid disorders. Eur. J. Endocrinol. 186, 33 (2022). https://doi.org/10.1530/EJE-21-1044
doi: 10.1530/EJE-21-1044
M. Procopio, G. Borretta, Derangement of glucose metabolism in hyperparathyroidism. J. Endocrinol. Invest. 26, 1136–1142 (2003). https://doi.org/10.1007/BF03345264
doi: 10.1007/BF03345264
pubmed: 15008255
M. Procopio, G. Magro, F. Cesario, A. Piovesan, A. Pia, N. Molineri et al. The oral glucose tolerance test reveals a high frequency of both impaired glucose tolerance and undiagnosed Type 2 diabetes mellitus in primary hyperparathyroidism. Diabet. Med. 19, 958–961 (2002). https://doi.org/10.1046/j.1464-5491.2002.00809.x
doi: 10.1046/j.1464-5491.2002.00809.x
pubmed: 12421435
R. Luboshitzky, Y. Chertok-Schaham, I. Lavi, A. Ishay, Cardiovascular risk factors in primary hyperparathyroidism. J. Endocrinol. Investig. 32, 317–321 (2009). https://doi.org/10.1007/BF03345719
doi: 10.1007/BF03345719
E. Hagström, E. Lundgren, H. Lithell, L. Berglund, S. Ljunghall, P. Hellman et al. Normalized dyslipidaemia after parathyroidectomy in mild primary hyperparathyroidism: population-based study over five years. Clin. Endocrinol. 56, 253–260 (2002). https://doi.org/10.1046/j.0300-0664.2001.01468.x
doi: 10.1046/j.0300-0664.2001.01468.x
J. Pepe, C. Cipriani, C. Sonato, O. Raimo, F. Biamonte, S. Minisola, Cardiovascular manifestations of primary hyperparathyroidism: a narrative review. Eur. J. Endocrinol. 177, 297 (2017). https://doi.org/10.1530/EJE-17-0485
doi: 10.1530/EJE-17-0485
D. Han, S. Trooskin, X. Wang, Prevalence of cardiovascular risk factors in male and female patients with primary hyperparathyroidism. J. Endocrinol. Investig. (2012). https://doi.org/10.1530/EJE-17-0485
F. Tassone, M. Procopio, L. Gianotti, G. Visconti, A. Pia, M. Terzolo et al. Insulin resistance is not coupled with defective insulin secretion in primary hyperparathyroidism. Diabet. Med. 26, 968–973 (2009). https://doi.org/10.1111/j.1464-5491.2009.02804.x
doi: 10.1111/j.1464-5491.2009.02804.x
pubmed: 19900227
A.S. Hanson, S.L. Linas, Parathyroid hormone/adenylate cyclase coupling in vascular smooth muscle cells. Hypertension 23, 468–475 (1994). https://doi.org/10.1161/01.hyp.23.4.468
doi: 10.1161/01.hyp.23.4.468
pubmed: 7511568
K.C. Chiu, L.M. Chuang, N.P. Lee, J.M. Ryu, J.L. McGullam, G.P. Tsai et al. Insulin sensitivity is inversely correlated with plasma intact parathyroid hormone level. Metabolism 49, 1501–1505 (2000). https://doi.org/10.1053/meta.2000.17708
doi: 10.1053/meta.2000.17708
pubmed: 11092519
P. Farahnak, M. Ring, K. Caidahl, L.O. Farnebo, M.J. Eriksson, I.L. Nilsson, Cardiac function in mild primary hyperparathyroidism and the outcome after parathyroidectomy. Eur. J. Endocrinol. 163, 461–467 (2010). https://doi.org/10.1530/EJE-10-0201
doi: 10.1530/EJE-10-0201
pubmed: 20562163
pmcid: 2921810
M. Procopio, M. Barale, S. Bertaina, S. Sigrist, R. Mazzetti, M. Loiacono et al. Cardiovascular risk and metabolic syndrome in primary hyperparathyroidism and their correlation to different clinical forms. Endocrine 47, 581–589 (2014). https://doi.org/10.1007/s12020-013-0091-z
doi: 10.1007/s12020-013-0091-z
pubmed: 24287796
F. Tassone, M. Maccario, L. Gianotti, C. Baffoni, M. Pellegrino, S. Cassibba et al. Insulin sensitivity in normocalcaemic primary hyperparathyroidism. Endocrine 44, 812–814 (2013). https://doi.org/10.1007/s12020-013-0059-z
doi: 10.1007/s12020-013-0059-z
pubmed: 24065311
I. Cakir, K. Unluhizarci, F. Tanriverdi, G. Elbuken, Z. Karaca, F. Kelestimur, Investigation of insulin resistance in patients with normocalcemic primary hyperparathyroidism. Endocrine 42, 419–422 (2012). https://doi.org/10.1007/s12020-012-9627-x
doi: 10.1007/s12020-012-9627-x
pubmed: 22327928
S. Beysel, M. Caliskan, M. Kizilgul, M. Apaydin, S. Kan, M. Ozbek et al. Parathyroidectomy improves cardiovascular risk factors in normocalcemic and hypercalcemic primary hyperparathyroidism. BMC Cardiovasc. Disord. 19, 106 (2019). https://doi.org/10.1186/s12872-019-1093-4
doi: 10.1186/s12872-019-1093-4
pubmed: 31068134
pmcid: 6505186
F. Yener Ozturk, S. Erol, M.M. Canat, S. Karatas, I. Kuzu, S. Dogan Cakir et al. Patients with normocalcemic primary hyperparathyroidism may have similar metabolic profile as hypercalcemic patients. Endocr. J. 63, 111–118 (2016). https://doi.org/10.1507/endocrj.EJ15-0392
doi: 10.1507/endocrj.EJ15-0392
pubmed: 26581584
E. Hagström, E. Lundgren, J. Rastad, P. Hellman, Metabolic abnormalities in patients with normocalcemic hyperparathyroidism detected at a population-based screening. Eur. J. Endocrinol. (2006). https://doi.org/10.1530/eje.1.02173
K.M. Tordjman, M. Yaron, E. Izkhakov, E. Osher, G. Shenkerman, Y. Marcus-Perlman et al. Cardiovascular risk factors and arterial rigidity are similar in asymptomatic normocalcemic and hypercalcemic primary hyperparathyroidism. Eur. J. Endocrinol. 162, 925–933 (2010). https://doi.org/10.1530/EJE-09-1067
doi: 10.1530/EJE-09-1067
pubmed: 20421337
World Health Organization & International Diabetes Federation: Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of a WHO/IDF consultation. World Health Organization (2006). https://iris.who.int/handle/10665/43588
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report, Third report of the National Cholesterol Education Program (NCEP). Circulation 106(25), 3143–3421 (2002)
B. Williams, G. Mancia, W. Spiering, E. Agabiti Rosei, M. Azizi, M. Burnier et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J. Hypertens. 36, 1953–2041 (2018). https://doi.org/10.1097/HJH.0000000000001940
doi: 10.1097/HJH.0000000000001940
pubmed: 30234752
F.L.J. Visseren, F. Mach, Y.M. Smulders, D. Carballo, K.C. Koskinas, M. Bäck et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur. Heart J. 42, 3227–3337 (2021). https://doi.org/10.1093/eurheartj/ehab484
doi: 10.1093/eurheartj/ehab484
pubmed: 34458905
T.L. Kelly, K.E. Wilson, S.B. Heymsfield, Dual energy X-Ray absorptiometry body composition reference values from NHANES. PLoS One 4, 7038 (2009). https://doi.org/10.1371/journal.pone.0007038
doi: 10.1371/journal.pone.0007038
M.A. Stults-Kolehmainen, F. Mach, P.R. Stanforth, J.B. Bartholomew, T. Lu, C.J. Abolt, R. Sinha, DXA estimates of fat in abdominal, trunk and hip regions varies by ethnicity in men. Nutr. Diabetes (2013). https://doi.org/10.1038/nutd.2013 .
M.D. Walker, S.J. Silverberg, Cardiovascular aspects of primary hyperparathyroidism. J. Endocrinol. Invest. 31, 925–931 (2008). https://doi.org/10.1007/BF03346443
doi: 10.1007/BF03346443
pubmed: 19092300
pmcid: 6056175
C. Letizia, P. Ferrari, D. Cotesta, C. Caliumi, R. Cianci, S. Cerci et al. Ambulatory monitoring of blood pressure (AMBP) in patients with primary hyperparathyroidism. J. Hum. Hypertens. 19, 901–906 (2005). https://doi.org/10.1038/sj.jhh.1001907
doi: 10.1038/sj.jhh.1001907
pubmed: 16034450
R.A. Wermers, S. Khosla, E.J. Atkinson, C.S. Grant, S.F. Hodgson, W.M. O'fallon et al. Survival after the diagnosis of hyperparathyroidism: a population-based study. Am. J. Med. 104, 115–122 (1998). https://doi.org/10.1016/s0002-9343(97)00270-2
doi: 10.1016/s0002-9343(97)00270-2
pubmed: 9528728
A.F. Perna, G.Z. Fadda, X.J. Zhou, S.G. Massry, Mechanisms of impaired insulin secretion after chronic excess of parathyroid hormone. Am. J. Physiol. 259, 210–216 (1990). https://doi.org/10.1152/ajprenal.1990.259.2.F210
doi: 10.1152/ajprenal.1990.259.2.F210
D. Fliser, E. Franek, P. Fode, A. Stefanski, C. Schmitt, M. Lyons et al. Subacute infusion of physiological doses of parathyroid hormone raises blood pressure in humans. Nephrol. Dial. Transplant. 12, 933–938 (1997). https://doi.org/10.1093/ndt/12.5.933
doi: 10.1093/ndt/12.5.933
pubmed: 9175045
L. Brunaud, A. Germain, R. Zarnegar, M. Rancier, S. Alrasheedi, C. Caillard et al. Serum aldosterone is correlated positively to parathyroid hormone (PTH) levels in patients with primary hyperparathyroidism. Surgery 146, 1035–1041 (2009). https://doi.org/10.1016/j.surg.2009.09.041
doi: 10.1016/j.surg.2009.09.041
pubmed: 19958930