Document Detail


Endothelial function in mild primary hyperparathyroidism.
MedLine Citation:
PMID:  22757971     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is not known if endothelial dysfunction, an important early event in the pathogenesis of atherosclerosis, is present in mild primary hyperparathyroidism (PHPT) and if so, whether it improves following parathyroidectomy.
DESIGN: We measured flow-mediated vasodilation (FMD), which estimates endothelial function by ultrasound imaging, in patients prior to and 6 and 12 months after parathyroidectomy.
RESULTS: Forty-five patients with mild PHPT [80% female, 61 ± 1 (mean ± SE) years, serum calcium 2·65 ± 0·03 mm (10·6 ± 0·1 mg/dl), PTH 10·5 ± 0·7 pm (99 ± 7 pg/ml), 25-hydroxyvitamin D (25OHD) 70·3 ± 3·7 nm (28·2 ± 1·5 ng/ml)] were studied. Baseline FMD was normal (4·63 ± 0·51%; reference mean: 4·4 ± 0·1%) and was not associated with serum calcium, PTH or 25OHD levels. In the group as a whole, FMD did not change after surgery (6 months: 4·38 ± 0·83%, P = 0·72; 12 months: 5·07 ± 0·74%, P = 0·49). However, in those with abnormal baseline FMD (<2·2%; n = 15), FMD increased by 350%, normalizing by 6 months after surgery (baseline: 0·81± 0·19%; 6 months: 3·18 ± 0·79%, P = 0·02 vs baseline; 12months: 3·68 ± 1·22%, P = 0·04 vs baseline). Baseline calcium, PTH and 25OHD levels did not differ between those with abnormal vs normal FMD, nor did these indices predict postoperative change in FMD.
CONCLUSIONS: FMD is generally normal in patients with mild PHPT and is unchanged 1 year after parathyroidectomy. Although FMD may normalize after surgery in patients with baseline abnormalities, data do not support using endothelial dysfunction as an indicator for parathyroidectomy.
Authors:
A L Carrelli; M D Walker; M R Di Tullio; S Homma; C Zhang; D J McMahon; S J Silverberg
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Clinical endocrinology     Volume:  78     ISSN:  1365-2265     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-08     Completed Date:  2013-06-06     Revised Date:  2014-02-04    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  England    
Other Details:
Languages:  eng     Pagination:  204-9     Citation Subset:  IM    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
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MeSH Terms
Descriptor/Qualifier:
Adult
Atherosclerosis / etiology
Cardiovascular Diseases / etiology
Endothelium, Vascular / drug effects,  physiopathology*
Female
Humans
Hyperparathyroidism, Primary / complications,  physiopathology*,  surgery
Male
Parathyroidectomy
Risk Factors
Vasodilation
Grant Support
ID/Acronym/Agency:
K24 DK074457/DK/NIDDK NIH HHS; K24 DK074457/DK/NIDDK NIH HHS; R01 DK066329/DK/NIDDK NIH HHS; R01 DK066329/DK/NIDDK NIH HHS
Comments/Corrections

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