The association of adenoma size with the biochemical parameters and cardio-metabolic risk factors in primary hyperparathyroidism

Muhammed Kizilgul; Mustafa Caliskan; Bekir Ucan; Erkam Sencar; Davut Sakiz; Erman Cakal; Mustafa Ozbek

doi:10.21601/ortadogutipdergisi.344895

ORTADOĞU TIP DERGİSİ - ORTADOGU MEDICAL JOURNAL

The association of adenoma size with the biochemical parameters and cardio-metabolic risk factors in primary hyperparathyroidism

Primer hiperparatiroidide adenom hacmi ile laboratuvar parametreleri ve kardiyo-metabolik risk faktörlerinin ilişkisi

Muhammed Kizilgul ¹ ^* , Mustafa Caliskan ¹, Bekir Ucan ¹, Erkam Sencar ¹, Davut Sakiz ¹, Erman Cakal ¹, Mustafa Ozbek ¹

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Ortadogu Tıp Derg, Volume 10, Issue 1, pp. 13-19

https://doi.org/10.21601/ortadogutipdergisi.344895

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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.

Keywords: Primary hyperparathyroidism, adenoma volume, cardio-metabolic risk factors

Öz

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 cm³idi. 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.

Keywords: Primer hiperparatiroidi, adenoma hacmi, kardiyometabolik risk faktörleri

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.

Citation

Kizilgul M, Caliskan M, Ucan B, Sencar E, Sakiz D, Cakal E, et al. The association of adenoma size with the biochemical parameters and cardio-metabolic risk factors in primary hyperparathyroidism. Ortadogu Tıp Derg. 2018;10(1):13-9. https://doi.org/10.21601/ortadogutipdergisi.344895

Kizilgul, M., Caliskan, M., Ucan, B., Sencar, E., Sakiz, D., Cakal, E., & Ozbek, M. (2018). The association of adenoma size with the biochemical parameters and cardio-metabolic risk factors in primary hyperparathyroidism. Ortadoğu Tıp Dergisi, 10(1), 13-19. https://doi.org/10.21601/ortadogutipdergisi.344895

Kizilgul, M., Caliskan, M., Ucan, B., Sencar, E., Sakiz, D., Cakal, E., and Ozbek, M. (2018). The association of adenoma size with the biochemical parameters and cardio-metabolic risk factors in primary hyperparathyroidism. Ortadoğu Tıp Dergisi, 10(1), pp. 13-19. https://doi.org/10.21601/ortadogutipdergisi.344895

Kizilgul M, Caliskan M, Ucan B, et al. The association of adenoma size with the biochemical parameters and cardio-metabolic risk factors in primary hyperparathyroidism. Ortadogu Tıp Derg. 2018;10(1), 13-19. https://doi.org/10.21601/ortadogutipdergisi.344895

Kizilgul, Muhammed, Mustafa Caliskan, Bekir Ucan, Erkam Sencar, Davut Sakiz, Erman Cakal, and Mustafa Ozbek. "The association of adenoma size with the biochemical parameters and cardio-metabolic risk factors in primary hyperparathyroidism". Ortadoğu Tıp Dergisi 2018 10 no. 1 (2018): 13-19. https://doi.org/10.21601/ortadogutipdergisi.344895

Kizilgul, Muhammed et al. "The association of adenoma size with the biochemical parameters and cardio-metabolic risk factors in primary hyperparathyroidism". Ortadoğu Tıp Dergisi, vol. 10, no. 1, 2018, pp. 13-19. https://doi.org/10.21601/ortadogutipdergisi.344895