Insulin sensitivity and acute insulin response in pateints with primary hyperparathyroidism before and after surgical treatment
Goran Cvijovic, Dragan Micic, Aleksandra Kendereski, Svetlana Zoric, Mirjana Sumarac-Dumanovic, Danica Stamenkovic-Pejkovic & Danka Jeremic
It was reported that patients with primary hyperparathyroidism (PHPT) are insulin resistant, and that surgical treatment may improve insulin sensitivity in this group of patients. The aim of our study was to evaluate the effect of surgical treatment on insulin sensitivity and acute insulin response (AIR) in patients with PHPT.
Methods: In patients with PHPT (n=37; age: 57.72±8.29 years, BMI 26.22±4.37 kg/m2) euglycemichyperinsulinemic clamp (for calculation of M value), standard OGTT (for calculation of areas under the curve (AUC) for glucose and insulin), and IVGTT (for calculation of AIR) were performed before and 4 months after surgical treatment.
Results: After operation serum calcium (2.33±0.15 vs 2.99±0.23, P<0.05) and PTH (50.00±37.59 vs 259.45±54.52, P>0.05) were normalized and there was no change in BMI (26.22±4.37 vs 26.60±3.92 kg/m2, P>0.05) before and 4 months after operation. We have observed significant improvement in insulin sensitivity using clamp technique (M value: 5.69±4.35 vs 3.96±2.76, P<0.05) after surgical treatment of PHPT. There was mild, but not significant improvement in AUC insulin (6428.73±3714.45 vs 6027.97±3708.57, P>0.05), and AUC glucose (924.06±367.98 vs 908.19±330.36, P>0.05), while there was no change in AIR (44.30±30.95 vs 35.30±42.76, P>0.05) before and after operation. In conclusion, surgical treatment improves insulin sensitivity in patients with PHPT. This improvement was not associated with changes i AIR.