Zhang Ying, Yang Min, Wu Yinqiong, Wang Qin
Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Endocrine. 2025 Apr;88(1):295-303. doi: 10.1007/s12020-024-04141-3. Epub 2024 Dec 19.
Primary hyperparathyroidism (PHPT) is characterized by elevated parathyroid hormone (PTH) levels and hypercalcemia. Although research suggests a potential link between PTH and lipid metabolism, the evidence remains inconclusive. This study investigated lipid metabolism and fat distribution in PHPT patients.
We studied 157 PHPT patients and strictly matched 1:1 controls based on sex, age, and BMI from our hospital (2020-2023). We recorded clinical data and used quantitative computed tomography (QCT) to measure lumbar spine bone mineral density and assess visceral and subcutaneous fat areas. Mendelian randomization analysis, utilizing genome-wide association study (GWAS) data, investigated the causal relationships between PHPT and various anthropometric measures, including body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC). Additionally, the analysis examined the associations between PTH levels and these same anthropometric traits: BMI, WHR, and WC.
The study included 47 males and 110 females in each group. There were no statistically significant differences between the two groups regarding BMI, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total fat area (TFA), abdominal visceral fat area (VFA), subcutaneous fat area (SFA), or the VFA/SFA ratio (P > 0.05). After adjusting for albumin-corrected calcium, estimated glomerular filtration rate (eGFR), and 25-hydroxyvitamin D (25OHD), correlations between PTH and BMI, TG, TC, HDL-C, LDL-C, and the VFA/SFA ratio were not significant in either group (P > 0.05). Furthermore, when all the study subjects were divided into three groups based on PTH tertiles, correlations between PTH and the aforementioned indices remained nonsignificant after adjusting for albumin-corrected calcium, eGFR, and 25OHD (P > 0.05). In a two-sample Mendelian randomization study, no significant associations were observed between PHPT and BMI, WHR, or WC. Similarly, no significant associations were identified between PTH levels and BMI, WHR, or WC.
No statistically significant disparities were discerned in lipid metabolism markers or fat distribution between PHPT patients and controls. No significant correlation exists between PTH levels and lipid metabolism or fat distribution. Furthermore, no causal relationship was established between PHPT and BMI, WHR, or WC, nor between PTH levels and these anthropometric measures.
原发性甲状旁腺功能亢进症（PHPT）的特征是甲状旁腺激素（PTH）水平升高和高钙血症。尽管研究表明PTH与脂质代谢之间可能存在联系，但证据仍不确凿。本研究调查了PHPT患者的脂质代谢和脂肪分布情况。
我们研究了157例PHPT患者，并根据性别、年龄和体重指数（BMI）从我院（2020 - 2023年）严格按照1:1的比例匹配了对照组。我们记录了临床数据，并使用定量计算机断层扫描（QCT）测量腰椎骨密度，评估内脏和皮下脂肪面积。利用全基因组关联研究（GWAS）数据进行孟德尔随机化分析，研究PHPT与各种人体测量指标之间的因果关系，包括体重指数（BMI）、腰臀比（WHR）和腰围（WC）。此外，该分析还研究了PTH水平与这些相同人体测量特征（BMI、WHR和WC）之间的关联。
每组包括47名男性和110名女性。两组在BMI、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL - C）、低密度脂蛋白胆固醇（LDL - C）、总脂肪面积（TFA）、腹部内脏脂肪面积（VFA）、皮下脂肪面积（SFA）或VFA/SFA比值方面均无统计学显著差异（P＞0.05）。在调整了白蛋白校正钙、估计肾小球滤过率（eGFR）和25 - 羟基维生素D（25OHD）后，两组中PTH与BMI、TG、TC、HDL - C、LDL - C和VFA/SFA比值之间的相关性均不显著（P＞0.05）。此外，当根据PTH三分位数将所有研究对象分为三组时，在调整了白蛋白校正钙、eGFR和25OHD后，PTH与上述指标之间的相关性仍然不显著（P＞0.05）。在一项两样本孟德尔随机化研究中，未观察到PHPT与BMI、WHR或WC之间存在显著关联。同样，在PTH水平与BMI、WHR或WC之间也未发现显著关联。
在PHPT患者和对照组之间，脂质代谢标志物或脂肪分布方面未发现统计学显著差异。PTH水平与脂质代谢或脂肪分布之间不存在显著相关性。此外，在PHPT与BMI、WHR或WC之间，以及PTH水平与这些人体测量指标之间均未建立因果关系。
