Endothelial functions of the patients with hyperparathyroidism
G. Yorulmaz1, A. Akalin2 & S. Atlanoglu3
Introduction: Primary hyperparathyroidism (PHPT) is associated with increased risk of mortality from cardiovascular disease and this appears to decrease with time after parathyroidectomy. However, data on hyperparathyroid patients are conflicting and there is no data regarding secondary hyperparathyroid patients. Our aim in this study was to determine the association between flow-mediated dilatation (endothelium dependent, FMD), nitroglycerine-induced dilatation (endothelium independent, NID) and carotid artery intima media thickness (IMT) in primary hyperparathyroidism (PHPT), secondary hyperparathyroidism (SHPT) and the control group.
Material and methods: Twenty patients with primary hyperparathyroidism, twenty with secondary hyperparathyroidism and 12 healthy subjects were included in the study. Both groups were matched with respect to age. Serum calcium level, parathormone(PTH) and daily urinary calcium excretion (UCE) were calculated and FMD, NID and IMT were also evaluated for all subjects.
Results: Serum Ca levels were significantly higher in patients with primary hyperparathyroid patients compared to both patients with secondary hyperparathyroidism and the control group (P<0.001 and P<0.001 respectively). As expected, urinary calcium excretion levels of the patients with primary hyperparathyroidism were higher than both the control group and the patients with secondary hyperparathyroidism (P<0.001, P<0.001 respectively). Serum PTH levels were also significantly higher in patients with primary and secondary hyperparathyroidism than the control group (P<0.05 and P<0.05 respectively). FMD, NID and IMT levels were not significantly different between the groups. But there was a negative correlation between serum calcium levels and FMD (r:−0.41 P<0.01).
Conclusion: This finding suggests that the cause of the cardiovascular diseases seen in hyperparathyroid patients is the increased calcium levels rather than the hyperparathyroidism itself.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.