Primer hiperparatiroidide adenom hacmi ile laboratuvar parametreleri ve kardiyo-metabolik risk faktörlerinin ilişkisi
Abstract
Amaç: Primer hiperparatiroidili hastalarda, paratiroid adenom ağırlığı
veya hacminin hiperparatiroidinin biyokimyasal parametreleri ile
ilişkisini araştıran çalışmaların sonuçları çelişkilidir. Bu çalışmada, primer hiperparatiroidili
hastalarda preoperatif adenom hacmi ile labaratuvar parametreleri ve kardiyo-metabolik
risk faktörleri arasındaki ilişkinin değerlendirilmesini amaçladık.
Gereç ve Yöntemler: Çalışmaya primer hiperparatiroidisi olan 75 hasta ve 96 kontrol olgusu alındı.
Demografik, antropometrik ve biyokimyasal veriler kaydedildi. Adenom hacmi ile
labaratuvar ve kardiyo-metabolik risk faktörleri arasındaki ilişki korrelasyon
analizi ile değerlendirildi. Preoperatif adenoma hacmi ellipsoid model formülü
ile hesaplandı.
Sonuçlar: Ortalama yaş her iki grupta
benzerdi (52.69 ± 10.91 to 53.33 ± 7.70, p:0.667). Ortalama adenom hacmi 1.42 ± 2.62 cm3 idi. Paratiroid adenom
hacmi, parathormon ve kalsiyum düzeyleri ile pozitif korrele iken, vitamin D
düzeyleri ile negatif korrele idi (p<0.05). Paratiroid adenom hacmi, kardiyo-metabolik
risk faktörleri olan sistolik ve diyastolik kan basıncı, yaş, açlık plazma
glukozu, lipid profili, vücut kitle indeksi, karotis intima media kalınlığı,
CRP ve HOMA-IR ile ilişkili değildi (p>0.05).
Parathormon, kalsiyum,
fosfor veya vitamin D düzeyleri ile kardiyo-metabolik risk faktörleri arasında
ilişki saptanmadı (p>0.05).
Sonuç: Paratiroid adenoma hacmi ile parathormon, kalsiyum ve
vitamin D düzeyleri arasında korrelasyon olmasına rağmen paratiroid adenoma hacmi
ile kardiyo-metabolik
risk faktörleri arasında ilişki saptanmadı.
References
- Minisola S, Pepe J, Piemonte S C, Cipriani C. The diagnosis and management of hypercalcaemia. BMJ 2015; 350: h2723.
- Bilezikian JP, Cusano NE, Khan AA, Liu J-M, Marcocci C, Bandeira F. Primary hyperparathyroidism. Nat Rev Dis Prim 2016; 2: 16033.
- Schluter KD, Piper HM. Cardiovascular actions of parathyroid hormone and parathyroid hormone-related peptide. Cardiovasc Res 1998; 37: 34–41.
- Fitzpatrick LA, Bilezikian JP, Silverberg SJ. Parathyroid hormone and the cardiovascular system. Curr Osteoporos Rep 2008; 6: 77–83.
- Taylor EN, Curhan GC, Forman JP. Parathyroid hormone and the risk of incident hypertension. J Hypertens 2008; 26: 1390–4.
- Saleh FN, Schirmer H, Sundsfjord J, Jorde R. Parathyroid hormone and left ventricular hypertrophy. Eur Heart J 2003; 24: 2054–60.
- Rienstra M, Lubitz SA, Zhang ML, Cooper RR, Ellinor PT. Elevation of parathyroid hormone levels in atrial fibrillation. J Am Coll Cardiol 2011; 57: 2542–3.
- Hagström E, Hellman P, Larsson TE et al. Plasma parathyroid hormone and the risk of cardiovascular mortality in the community. Circulation 2009; 119: 2765–71.
- Welsh P, Doolin O, McConnachie A et al. Circulating 25OHD, dietary vitamin D, PTH, and calcium associations with incident cardiovascular disease and mortality: The MIDSPAN family study. J Clin Endocrinol Metab 2012; 97: 4578–87.
- Folsom AR, Alonso A, Misialek JR et al. Parathyroid hormone concentration and risk of cardiovascular diseases: The Atherosclerosis Risk in Communities (ARIC) study. Am Heart J 2014; 168: 296–302
- Smith JC, Page MD, John R et al. Augmentation of central arterial pressure in mild primary hyperparathyroidism. J Clin Endocrinol Metab 2000; 85: 3515–9.
- Yu N, Donnan PT, Flynn RW V et al. Increased mortality and morbidity in mild primary hyperparathyroid patients. the Parathyroid Epidemiology and Audit Research Study (PEARS). Clin Endocrinol (Oxf) 2010;73:30–4.
- Nilsson IL, Åberg J, Rastad J et al. Circadian cardiac autonomic nerve dysfunction in primary hyperparathyroidism improves after parathyroidectomy. Surgery 2003; 134: 1013-9
- Piovesan A, Molineri N, Casasso F et al. Left ventricular hypertrophy in primary hyperparathyroidism. Effects of successful parathyroidectomy. Clin Endocrinol (Oxf) 1999; 50: 321–8.
- Stefenelli T, Abela C, Frank H et al. Cardiac abnormalities in patients with primary hyperparathyroidism: implications for follow-up. J Clin Endocrinol Metab 1997; 82: 106–12.
- Randhawa PS, Mace AD, Nouraei SAR, Stearns MP. Primary hyperparathyroidism: Do perioperative biochemical variables correlate with parathyroid adenoma weight or volume? Clin Otolaryngol 2007; 32: 179–84.
- Bindlish V, Freeman JL, Witterick IJ, Asa SL. Correlation of biochemical parameters with single parathyroid adenoma weight and volume. Head Neck 2002; 24: 1000–3.
- Rutledge R, Stiegel M, Thomas Jr. CG, Wild RE. The relation of serum calcium and immunoparathormone levels to parathyroid size and weight in primary hyperparathyroidism. Surgery 1985; 98: 1107–12.
- Dubost C, Bordier PJ, Ferry J GJ. The estimation of parathormone in primary hyperparathyroidism. Nouv Press Med 1978; 7: 21–5.
- Wagner PK, Rothmund M. Correlation of tumor weight and typical pathologic laboratory parameters in primary and secondary hyperparathyroidism. Langenbecks Arch Chir 1983; 360: 133-9
- Hedbäck G, Odén A, Tisell LE, Hedback G, Oden A. Parathyroid adenoma weight and the risk of death after treatment for primary hyperparathyroidism. Surgery 1995; 117: 134–9.
- Bilezikian JP, Potts JT, El-Hajj Fuleihan G et al. Summary statement from a workshop on asymptomatic primary hyperparathyroidism: A perspective for the 21st century. J Clin Endocrinol Metab. 2002; 87: 5353-61
- Mather KJ, Hunt AE, Steinberg HO et al. Repeatability characteristics of simple indices of insulin resistance: Implications for research applications. J Clin Endocrinol Metab 2001; 86: 5457–64.
- Vitti P, Rago T, Mazzeo S et al. Thyroid blood flow evaluation by color-flow doppler sonography distinguishes Graves’ disease from Hashimoto’s thyroiditis. J Endocrinol Invest 1995; 18: 857–61
- Williams JG, Wheeler MH, Aston JP, Brown RC, Woodhead JS. The relationship between adenoma weight and intact (1-84) parathyroid hormone level in primary hyperparathyroidism. Am J Surg 1992; 163: 301–4.
- Mózes G, Curlee KJ, Rowland CM et al. The predictive value of laboratory findings in patients with primary hyperparathyroidism. J Am Coll Surg 2002; 194: 126–30.
- Kamani F, Najafi A, Mohammadi SS, Tavassoli S, Shojaei SP. Correlation of Biochemical Markers of Primary Hyperparathyroidism with Single Adenoma Weight and Volume. Indian J Surg 2013; 75: 102–5
- Wetzel J, Pilz S, Grübler MR et al. Plasma parathyroid hormone and cardiovascular disease in treatment-naive patients with primary hyperparathyroidism: The EPATH trial. J Clin Hypertens 2017;Aug 20. [Epub ahead of print]
- Akhabue E, Thiboutot J, Cheng J-W et al. New and emerging risk factors for coronary heart disease. Am J Med Sci 2014; 347: 151–8.
- Cannon CP. Cardiovascular disease and modifiable cardiometabolic risk factors. Clin Cornerstone 2007; 8: 11–28.
- Andersson P, Rydberg E, Willenheimer R. Primary hyperparathyroidism and heart disease--a review. Eur Hear J 2004; 25: 1776–87.
- Walker MD, Fleischer J, Rundek T et al. Carotid vascular abnormalities in primary hyperparathyroidism. J Clin Endocrinol Metab 2009; 94: 3849–56.
- Ljunghall S, Palmer M, Akerstrom G, Wide L. Diabetes mellitus, glucose tolerance and insulin response to glucose in patients with primary hyperparathyroidism before and after parathyroidectomy. Eur J Clin Invest 1983; 13: 373–7.
- Almqvist EG, Bondeson AG, Bondeson L, Svensson J. Increased markers of inflammation and endothelial dysfunction in patients with mild primary hyperparathyroidism. Scand J Clin Lab Invest 2011; 71: 139–44.
- Luigi P, Chiara FM, Laura Z et al. Arterial hypertension, metabolic syndrome and subclinical cardiovascular organ damage in patients with asymptomatic primary hyperparathyroidism before and after parathyroidectomy: Preliminary results. Int J Endocrinol 2012; 2012: 408295
- Rao DS, Honasoge M, Divine GW et al. Effect of vitamin D nutrition on parathyroid adenoma weight: Pathogenetic and clinical implications. J Clin Endocrinol Metab 2000; 85: 1054–8.
- Moosgaard B, Vestergaard P, Heickendorff L, Melsen F, Christiansen P, Mosekilde L. Vitamin D status, seasonal variations, parathyroid adenoma weight and bone mineral density in primary hyperparathyroidism. Clin Endocrinol (Oxf) 2005; 63: 506–13.
The association of adenoma size with the biochemical parameters and cardio-metabolic risk factors in primary hyperparathyroidism
Abstract
Aim: The
studies conducted to investigate the association between biochemical
manifestations of hyperparathyroidism such as serum parathyroid hormone, serum
calcium, and serum phosphate levels, and parathyroid adenoma weight and volume
have conflicting results. We aimed to investigate whether there is an association
of preoperative size of adenoma with laboratory parameters and cardio-metabolic
risk factors in patients with primary hyperparathyroidism.
Material and Method: Seventy-five patients with PHPT and 96 control
subjects were enrolled in the study. Demographic, anthropometric and
biochemistry data were recorded. Correlation analysis was used for determining
the relation between adenoma volume and cardio-metabolic parameters.
Preoperative adenoma volume was calculated by
the ellipsoid model formula.
Results: Mean age
was similar between groups (52.69 ± 10.91 to 53.33 ± 7.70, p:0.667). Mean size
of adenoma was 1.42 ± 2.62
cm3. Size of adenoma was positively correlated with calcium and
parathormone levels and negatively correlated with vitamin D level (p<0.05).
Size of adenoma was not correlated with cardio-metabolic risk factors including
systolic
blood pressure, diastolic blood pressure, age, fasting plasma glucose, lipid
profile, body mass index, carotis intima media thickness, CRP and HOMA-IR
(p>0.05). PTH, calcium, phosphorus or vitamin D levels were also not
correlated cardio-metabolic risk factors.
Conclusions: Adenoma
volume has a correlation with parathormone, calcium, phosphorus and vitamin D
levels, however, it is not associated with cardio-metabolic risk factors.
References
- Minisola S, Pepe J, Piemonte S C, Cipriani C. The diagnosis and management of hypercalcaemia. BMJ 2015; 350: h2723.
- Bilezikian JP, Cusano NE, Khan AA, Liu J-M, Marcocci C, Bandeira F. Primary hyperparathyroidism. Nat Rev Dis Prim 2016; 2: 16033.
- Schluter KD, Piper HM. Cardiovascular actions of parathyroid hormone and parathyroid hormone-related peptide. Cardiovasc Res 1998; 37: 34–41.
- Fitzpatrick LA, Bilezikian JP, Silverberg SJ. Parathyroid hormone and the cardiovascular system. Curr Osteoporos Rep 2008; 6: 77–83.
- Taylor EN, Curhan GC, Forman JP. Parathyroid hormone and the risk of incident hypertension. J Hypertens 2008; 26: 1390–4.
- Saleh FN, Schirmer H, Sundsfjord J, Jorde R. Parathyroid hormone and left ventricular hypertrophy. Eur Heart J 2003; 24: 2054–60.
- Rienstra M, Lubitz SA, Zhang ML, Cooper RR, Ellinor PT. Elevation of parathyroid hormone levels in atrial fibrillation. J Am Coll Cardiol 2011; 57: 2542–3.
- Hagström E, Hellman P, Larsson TE et al. Plasma parathyroid hormone and the risk of cardiovascular mortality in the community. Circulation 2009; 119: 2765–71.
- Welsh P, Doolin O, McConnachie A et al. Circulating 25OHD, dietary vitamin D, PTH, and calcium associations with incident cardiovascular disease and mortality: The MIDSPAN family study. J Clin Endocrinol Metab 2012; 97: 4578–87.
- Folsom AR, Alonso A, Misialek JR et al. Parathyroid hormone concentration and risk of cardiovascular diseases: The Atherosclerosis Risk in Communities (ARIC) study. Am Heart J 2014; 168: 296–302
- Smith JC, Page MD, John R et al. Augmentation of central arterial pressure in mild primary hyperparathyroidism. J Clin Endocrinol Metab 2000; 85: 3515–9.
- Yu N, Donnan PT, Flynn RW V et al. Increased mortality and morbidity in mild primary hyperparathyroid patients. the Parathyroid Epidemiology and Audit Research Study (PEARS). Clin Endocrinol (Oxf) 2010;73:30–4.
- Nilsson IL, Åberg J, Rastad J et al. Circadian cardiac autonomic nerve dysfunction in primary hyperparathyroidism improves after parathyroidectomy. Surgery 2003; 134: 1013-9
- Piovesan A, Molineri N, Casasso F et al. Left ventricular hypertrophy in primary hyperparathyroidism. Effects of successful parathyroidectomy. Clin Endocrinol (Oxf) 1999; 50: 321–8.
- Stefenelli T, Abela C, Frank H et al. Cardiac abnormalities in patients with primary hyperparathyroidism: implications for follow-up. J Clin Endocrinol Metab 1997; 82: 106–12.
- Randhawa PS, Mace AD, Nouraei SAR, Stearns MP. Primary hyperparathyroidism: Do perioperative biochemical variables correlate with parathyroid adenoma weight or volume? Clin Otolaryngol 2007; 32: 179–84.
- Bindlish V, Freeman JL, Witterick IJ, Asa SL. Correlation of biochemical parameters with single parathyroid adenoma weight and volume. Head Neck 2002; 24: 1000–3.
- Rutledge R, Stiegel M, Thomas Jr. CG, Wild RE. The relation of serum calcium and immunoparathormone levels to parathyroid size and weight in primary hyperparathyroidism. Surgery 1985; 98: 1107–12.
- Dubost C, Bordier PJ, Ferry J GJ. The estimation of parathormone in primary hyperparathyroidism. Nouv Press Med 1978; 7: 21–5.
- Wagner PK, Rothmund M. Correlation of tumor weight and typical pathologic laboratory parameters in primary and secondary hyperparathyroidism. Langenbecks Arch Chir 1983; 360: 133-9
- Hedbäck G, Odén A, Tisell LE, Hedback G, Oden A. Parathyroid adenoma weight and the risk of death after treatment for primary hyperparathyroidism. Surgery 1995; 117: 134–9.
- Bilezikian JP, Potts JT, El-Hajj Fuleihan G et al. Summary statement from a workshop on asymptomatic primary hyperparathyroidism: A perspective for the 21st century. J Clin Endocrinol Metab. 2002; 87: 5353-61
- Mather KJ, Hunt AE, Steinberg HO et al. Repeatability characteristics of simple indices of insulin resistance: Implications for research applications. J Clin Endocrinol Metab 2001; 86: 5457–64.
- Vitti P, Rago T, Mazzeo S et al. Thyroid blood flow evaluation by color-flow doppler sonography distinguishes Graves’ disease from Hashimoto’s thyroiditis. J Endocrinol Invest 1995; 18: 857–61
- Williams JG, Wheeler MH, Aston JP, Brown RC, Woodhead JS. The relationship between adenoma weight and intact (1-84) parathyroid hormone level in primary hyperparathyroidism. Am J Surg 1992; 163: 301–4.
- Mózes G, Curlee KJ, Rowland CM et al. The predictive value of laboratory findings in patients with primary hyperparathyroidism. J Am Coll Surg 2002; 194: 126–30.
- Kamani F, Najafi A, Mohammadi SS, Tavassoli S, Shojaei SP. Correlation of Biochemical Markers of Primary Hyperparathyroidism with Single Adenoma Weight and Volume. Indian J Surg 2013; 75: 102–5
- Wetzel J, Pilz S, Grübler MR et al. Plasma parathyroid hormone and cardiovascular disease in treatment-naive patients with primary hyperparathyroidism: The EPATH trial. J Clin Hypertens 2017;Aug 20. [Epub ahead of print]
- Akhabue E, Thiboutot J, Cheng J-W et al. New and emerging risk factors for coronary heart disease. Am J Med Sci 2014; 347: 151–8.
- Cannon CP. Cardiovascular disease and modifiable cardiometabolic risk factors. Clin Cornerstone 2007; 8: 11–28.
- Andersson P, Rydberg E, Willenheimer R. Primary hyperparathyroidism and heart disease--a review. Eur Hear J 2004; 25: 1776–87.
- Walker MD, Fleischer J, Rundek T et al. Carotid vascular abnormalities in primary hyperparathyroidism. J Clin Endocrinol Metab 2009; 94: 3849–56.
- Ljunghall S, Palmer M, Akerstrom G, Wide L. Diabetes mellitus, glucose tolerance and insulin response to glucose in patients with primary hyperparathyroidism before and after parathyroidectomy. Eur J Clin Invest 1983; 13: 373–7.
- Almqvist EG, Bondeson AG, Bondeson L, Svensson J. Increased markers of inflammation and endothelial dysfunction in patients with mild primary hyperparathyroidism. Scand J Clin Lab Invest 2011; 71: 139–44.
- Luigi P, Chiara FM, Laura Z et al. Arterial hypertension, metabolic syndrome and subclinical cardiovascular organ damage in patients with asymptomatic primary hyperparathyroidism before and after parathyroidectomy: Preliminary results. Int J Endocrinol 2012; 2012: 408295
- Rao DS, Honasoge M, Divine GW et al. Effect of vitamin D nutrition on parathyroid adenoma weight: Pathogenetic and clinical implications. J Clin Endocrinol Metab 2000; 85: 1054–8.
- Moosgaard B, Vestergaard P, Heickendorff L, Melsen F, Christiansen P, Mosekilde L. Vitamin D status, seasonal variations, parathyroid adenoma weight and bone mineral density in primary hyperparathyroidism. Clin Endocrinol (Oxf) 2005; 63: 506–13.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | Original article |
| Authors | |
| Publication Date | December 1, 2018 |
| Published in Issue | Year 2018 Volume: 10 Issue: 1 |
e-ISSN: 2548-0251
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