Parlak Nazim Serhat, Ertekin Süleyman Çağlar, Kırdak Turkay
Uludag University, Department of General Surgery - Bursa, Turkey.
Altinbas University, Department of General Surgery - İstanbul, Turkey.
Rev Assoc Med Bras (1992). 2025 May 2;71(3):e20240989. doi: 10.1590/1806-9282.20240989. eCollection 2025.
The aim of this study was to investigate the influence of body mass index on the diagnostic and surgical outcomes in patients undergoing parathyroidectomy for primary hyperparathyroidism.
A total of 446 patients with primary hyperparathyroidism were divided into four groups according to their body mass index: normal weight (body mass index<25 kg/m2) (n=130), overweight (25≤body mass index<30 kg/m2) (n=166), obese (30≤body mass index<35 kg/m2) (n=112), and morbidly obese (body mass index≥35 kg/m2) (n=38). Perioperative findings were compared between the groups.
The preoperative median parathormone level in the morbidly obese group (204 pg/mL, min:max 72:1,178) was significantly lower than that in the normal-weight (246 pg/mL, min:max 60:4,262) (p=0.026) and obese (251 pg/mL, min:max 74:2,094) (p=0.012) groups. The osteoporosis rate in the normal-weight group (51%) was higher than that in the overweight (35.4%) (p=0.041) and morbidly obese (25%) (p=0.023) groups. The symptomatic hypocalcemia rate in the normal-weight group (10.2%) was significantly higher than that in the obese group (1.8%) (p=0.017).
Normal-weight patients with primary hyperparathyroidism have higher blood parathormone values, higher rates of osteoporosis, and postoperative symptomatic hypocalcemia compared to patients with higher body mass index. For this reason, the surgeon should consider the possibility of symptomatic hypocalcemia after undergoing parathyroidectomy for primary hyperparathyroidism in normal-weight cases.
本研究旨在调查体重指数对原发性甲状旁腺功能亢进症患者行甲状旁腺切除术后诊断及手术结果的影响。
446例原发性甲状旁腺功能亢进症患者根据体重指数分为四组：正常体重（体重指数<25kg/m²）（n = 130）、超重（25≤体重指数<30kg/m²）（n = 166）、肥胖（30≤体重指数<35kg/m²）（n = 112）和病态肥胖（体重指数≥35kg/m²）（n = 38）。比较各组围手术期的各项结果。
病态肥胖组术前甲状旁腺激素中位数水平（204pg/mL，最小值：最大值72:1,178）显著低于正常体重组（246pg/mL，最小值：最大值60:4,262）（p = 0.026）和肥胖组（251pg/mL，最小值：最大值74:2,094）（p = 0.012）。正常体重组骨质疏松率（51%）高于超重组（35.4%）（p = 0.041）和病态肥胖组（25%）（p = 0.023）。正常体重组症状性低钙血症发生率（10.2%）显著高于肥胖组（1.8%）（p = 0.017）。
与体重指数较高的原发性甲状旁腺功能亢进症患者相比，正常体重患者的血甲状旁腺激素值更高、骨质疏松率更高且术后症状性低钙血症发生率更高。因此，外科医生在正常体重的原发性甲状旁腺功能亢进症患者行甲状旁腺切除术后应考虑症状性低钙血症的可能性。
