Endocrine Abstracts

Introduction: Primary hyperparathyroidism (pHPT) is characterized by an increased frequency of glucose tolerance abnormalities associated with insulin-resistance. Few studies evaluated the relationship between insulin resistance and others cardiovascular risk factors in pHPT.

Subjects and methods: In 255 consecutive pHPT patients (M/F=66/189, age (mean±S.D.): 59.9±13.7 years, PTH: 215.6±219.4 pg/ml, calcium: 11.2±1.2 mg/dl, asymptomatic/symptomatic: 115/140) we assessed insulin resistance by means of homeostasis model assessment of insulin resistance (HOMA-IR). Then we evaluated biochemical and clinical features of pHPT subdividing our case series in two groups basing on median HOMA-IR (1.68).

Results: pHPT patients more insulin-resistant showed significantly higher systolic blood pressure values (142.5±20.6 vs 134.8±16.7 mmHg, P<0.002), BMI (27.3±4.7 vs 23.1±3.8 kg/m², P<0.000001), PTH (238.2±262.9 vs 193.0±162.9 pg/ml, P<0.04), calcium levels (11.35±1.27 vs 11.05±1.06 mg/dl, P<0.04) and triglycerides (142.8±63.8 vs 105.6±40.8 mg/dl, P<0.00001) than patients with lower HOMA-IR. HDL-cholesterol was lower in patients with higher HOMA-IR (51.6±16.2 vs 63.2±17.4, P<0.00005).

Conclusions: In PHPT increased insulin resistance is associated with a more severe alteration of biochemical indices of the disease and a worsening of overall cardiovascular risk profile.

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.