Endocrine Abstracts

Introduction: Primary hyperparathyroidism (PHPT) results in alterations in carbohydrate metabolism, characterized by insulin resistance, hyperinsulinemia, and glucose intolerance.

Objective: The aim of our study was to evaluate carbohydrate metabolism status in patients with PHPT.

Methods: One hundred and nine patients with PHPT were investigated, healthy controls included 36 individuals matched by sex age and BMI (BMI=27±5 kg/m²). Blood tests, and 75 g oral glucose tolerance test results were evaluated, HOMA index was adjusted as immunoreactive insulin*glucose/22.

Results: Eight percent patients had type 2 diabetes mellitus (DM), impaired fasting glycemia was observed in 3% and glucose intolerance in 12% of patients with PHPT. Basal glucose level, plasma immunoreactive insulin (IRI) and HOMA index did not differ between groups with mild and severe forms of the disease (P=0.43). Postprandial glucose increased in patients with severe compared to mild form (P<0.06). Thus glucose level was significantly raising in accordance with the PTH level elevation (H=8.2; P=0.04). Postprandial insulin was significantly increased in patients with severe form (P<0.01), we did not find any correlations with PTH level but with ionized serum calcium (r=0.3; P=0.006). The relative risk of type 2 DM in patients with severe PHPT (8.5%) raised by 2.3 times (CI 95% 0.3; 1.8) and is higher than in patients with the mild form (3.7%), which are comparable with control group.

Conclusions: Our work shows that patients with PHPT feature disturbances in carbohydrate metabolism. The incidence and prevalence of type 2 DM is significantly increased in group with severe form PHPT. These results argue for improved screening to identify carbohydrate metabolism status in patients with PHPT.