Endocrine Abstracts (2008) 16 S30.4

Evaluation of endothelial function and endothelial nitric oxide synthase intron 4a/b polymorphism in primary hyperparathyroidism

Ahmet Ekmekci1, Neslihan Abaci2, Ayaz Agayev3, Nihat Aksakal4, Huseyin Oflaz5, Nihan Erginel Unaltuna2, Yesim Erbil4 & Nese Colak Ozbey6


1Department of Medicine, Istanbul Faculty of Medicine, Istanbul, Turkey; 2Department of Genetics, Institute for Experimental Medical Research, Istanbul, Turkey; 3Department of Radiology, Istanbul, Turkey; 4Department of Surgery, Istanbul, Turkey; 5Division of Endocrinology, Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey; 6Division of Endocrinology, Department of Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.


The aim of this study is to evaluate endothelial function in patients with primary hyperparathyroidism (pHT) during the preoperative hypercalcemic and postoperative normocalcemic periods and to determine whether intron 4a/b polymorphism of eNOS gene influences endothelial function. Forty-one patients with pHT (28 women, 12 men; age: 48.4±11.6 years, serum calcium: 11.4±1.0 mg/dl, parathyroid hormone: 373.3±394.5 pg/ml) who fulfilled the criteria for parathyroid surgery according to 2002 NIH guidelines, were examined preoperatively and reexamined 5.8±1.9 months after parathyroidectomy. All patients were normocalcemic after surgery. Forty-seven healthy subjects (30 women, 17 men, age: 48.03±8.9 years) were served as control group. Early atherosclerotic changes were determined by flow-mediated dilation of brachial artery (FMD). eNOS4a/b polymorphism was detected by polymerase chain reaction. FMD was significantly lower in patients with pHT preoperatively compared with controls (8.48±1.78% vs 19.52±2.26%, P<0.001). FMD improved significantly after parathyroidectomy (16.19±2.16%, P<0.001 compared with preoperative measurements), but still significantly lower than controls (P<0.01). The distribution of eNOS4a/b genotype frequencies were not significantly different between patients and controls. FMD was not significantly different among patients and controls carrying a allele or b/b genotype. Logistic regression analysis showed that presence of hypercalcemia (>10.5 mg/dl) was the only significant independent predictor of lower FMD (<9.4%). eNOS4a/b polymorphism did not enter in this model. Impaired endothelial function in patients with pHT improves after succesfull parathyroid surgery. No compelling data are evident to suggest that eNOS4a/b polymorphism modify the atherosclerotic process in patients with pHT.

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