Endocrine Abstracts

It was previously shown that patients with primary hyperparathyroidism (PHPT) are insulin resistant.

Aim: The aim of our study was to evaluate the effect of surgical treatment on glucose tolerance, insulin secretion and sensitivity (SI) in patients with PHPT.

Material and methods: In 26 patients with PHPT (age: 57.15±9.54 years, BMI 26.00±4.55 kg/m², PTH 276.61±64.83 ng/l, Calcium 2.95±0.19 mmol/l)) AIR and SI were determinated before and 4 months after surgical treatment. Insulin sensitivity was evaluated using euglycemic hyperinsulinemic clamp (M index), while acute insulin response (AIR) was calculated as the mean increment above basal of insulin values measured at 2, 3, 4, 5, 6, 8 and 10 min after intravenous glucose bolus (IVGTT). Glucose and insulin response during OGTT were evaluated as area under the curve (AUC). AUCs was calculated using Trapezoidal rule. Paired t-test and Wilcoxon test were used for statistical analysis, as well Pearson correlation test. Statistical analysis.

Results: After operation PTH (51.47±8.57 ng/l) and serum calcium (2.33±0.12 mmol/l) were normalized. There was significant improvement in insulin sensitivity (M index: 3.91±2.01 vs 6.08±4.88, P<0.05), while there was no significant difference in AIR (44.77±6.71 vs 35.14±9.77, P>0.05), AUC GLUCOSE 855.88±188.37 vs 823.84±139.39, P>0.05) and AUC INSULIN (6270.27±3870.05 vs 6351.55±3820.44, P>0.05) after surgical treatment. There was no change in BMI after operation (26.00±4.55 vs 26.36±4.31, P>0.05). There was no correlation between PTH and M index (r=−0.169, P>0.05), AIR (r=0.160, P<0.05), AUC GLUCOSE (r=0.231, P>0.05) and AUC INSULIN (r=−0.110, P>0.05) as well as between serum calcium levels and M index (r=0.214, P>0.05), AIR (r=−0.167, P>0.05), AUC GLUCOSE (r=0.298, P>0.05) and AUC INSULIN (r=−0.009, P>0.05).

Conclusion: Radical treatment improves SI in patients with PHPT. Non-significance of changes in AIR, AUC GLUCOSE and AUC INSULIN might be due to fact that testing was performed relatively short period after surgical treatment.