Jovanovic Milan, Tausanovic Katarina, Slijepcevic Nikola, Rovcanin Branislav, Jovanovic Ksenija, Buzejic Matija, Ivanis Sara, Zivaljevic Vladan
Clinic for Endocrine Surgery, University Clinical Center of Serbia, Belgrade, Serbia.
Faculty of Medicine, University of Belgrade, Koste Todorovica St. No 8, Belgrade, Serbia.
Updates Surg. 2025 Jun 3. doi: 10.1007/s13304-025-02243-9.
There has been a growing interest in the effects of primary hyperparathyroidism and parathyroidectomy on nonclassic symptoms, including impaired cognitive status. We have evaluated the cognitive status of patients with primary hyperparathyroidism before and after parathyroidectomy and to assess the impact of various factors on cognitive function during the perioperative period. During a two-year period, a panel study was conducted at our institution. The study included patients scheduled for parathyroidectomy without previous parathyroid or thyroid surgery. Basic demographic data of interest and relevant clinical data were collected. Cognitive status was assessed in interviews before surgery, one month, and six months following surgery using a Mini-Mental State Examination (MMSE). A total of 94 patients (83 females) with pHPT were included in the study, with an average age of 60.2 years. The average preoperative calcium and PTH levels were 2.98 mmol/L and 307.9 ng/mL, respectively. There was a significant improvement in MMSE score six months after parathyroidectomy (from 27.93 to 28.87, p < 0.001). Preoperatively, 7.5% of patients had a pathological MMSE score (≤ 25), and six months after parathyroidectomy, only one patient had a mild disorder. Based on the multivariable mixed effect modelling, age and lower level of education were independent predictors. There is a significant improvement in cognition following parathyroidectomy, and this improvement has stable progression up to six months after surgery. Apart from age and level of education, no other variables affect cognitive status during the perioperative period.
原发性甲状旁腺功能亢进症及甲状旁腺切除术对包括认知状态受损在内的非典型症状的影响，已引发越来越多的关注。我们评估了原发性甲状旁腺功能亢进症患者在甲状旁腺切除术前及术后的认知状态，并评估了围手术期各种因素对认知功能的影响。在两年期间，我们机构进行了一项队列研究。该研究纳入了计划接受甲状旁腺切除术且既往未接受过甲状旁腺或甲状腺手术的患者。收集了感兴趣的基本人口统计学数据和相关临床数据。在手术前、术后1个月和6个月的访谈中，使用简易精神状态检查表（MMSE）评估认知状态。共有94例原发性甲状旁腺功能亢进症患者（83例女性）纳入研究，平均年龄为60.2岁。术前平均血钙和甲状旁腺激素水平分别为2.98 mmol/L和307.9 ng/mL。甲状旁腺切除术后6个月，MMSE评分有显著改善（从27.93提高到28.87，p < 0.001）。术前,7.5%的患者MMSE评分病理性降低（≤ 25），甲状旁腺切除术后6个月，只有1例患者有轻度认知障碍。基于多变量混合效应模型，年龄和较低教育水平是独立预测因素。甲状旁腺切除术后认知功能有显著改善，且这种改善在术后6个月内呈稳定进展。除年龄和教育水平外，围手术期没有其他变量影响认知状态。
