Duran Cevdet, Sevinc Barıs, Kutlu Orkide, Karahan Omer
Department of Internal Medicine, Endocrinology and Metabolism, Konya Training and Research Hospital, 42100 Konya, Turkey.
Department of General Surgery, Konya Training and Research Hospital, Konya, Turkey.
Indian J Surg. 2017 Apr;79(2):101-105. doi: 10.1007/s12262-015-1431-4. Epub 2016 Jan 15.
Primary hyperparathyroidism (PHPT) has been considered a cause of insulin resistance (IR) and impaired glucose metabolism. However, there are conflicting results related with the recovery of insulin resistance in patients with PHPT following curative parathyroidectomy. Our aim is to evaluate the effects of curative parathyroidectomy on IR in patients with PHPT. This is a prospective interventional study. Twenty-one consecutive patients with symptomatic PHPT were included into the study. All patients underwent parathyroidectomy. Fasting serum glucose, calcium, phosphorous, parathormone, plasma insulin, and vitamin D levels were measured both at baseline and 2 months after parathyroidectomy. Insulin resistance was calculated by homeostasis of model assessment-insulin resistance (HOMA-IR). Two months after curative parathyroidectomy, serum levels of calcium ( = 0.001), PTH ( < 0.001), insulin ( = 0.003), and HOMA-IR ( = 0.003) decreased, while phosphorous levels increased ( = 0.001). During this period, no changes were observed at vitamin D and glucose levels. We concluded that curative parathyroidectomy decreases HOMA-IR index in patients with PHPT. Studies with larger population and longer follow-up period are required to confirm our results.
原发性甲状旁腺功能亢进症(PHPT)被认为是胰岛素抵抗(IR)和葡萄糖代谢受损的一个原因。然而,关于PHPT患者在进行根治性甲状旁腺切除术后胰岛素抵抗的恢复情况,存在相互矛盾的结果。我们的目的是评估根治性甲状旁腺切除术对PHPT患者胰岛素抵抗的影响。这是一项前瞻性干预研究。连续21例有症状的PHPT患者被纳入研究。所有患者均接受了甲状旁腺切除术。在基线时和甲状旁腺切除术后2个月均测量空腹血清葡萄糖、钙、磷、甲状旁腺激素、血浆胰岛素和维生素D水平。通过模型评估胰岛素抵抗(HOMA-IR)稳态计算胰岛素抵抗。根治性甲状旁腺切除术后2个月,血清钙水平(=0.001)、甲状旁腺激素水平(<0.001)、胰岛素水平(=0.003)和HOMA-IR(=0.003)下降,而磷水平升高(=0.001)。在此期间,维生素D和葡萄糖水平未观察到变化。我们得出结论,根治性甲状旁腺切除术可降低PHPT患者的HOMA-IR指数。需要更大规模人群和更长随访期的研究来证实我们的结果。