Endocrine Abstracts

Objective: Primary hyperparathyroidism (PHPT) is systemic disease affecting bone metabolism and glucose homeostasis. Patients with PHPT are insulin resistant and have atherogenic dyslipidaemia. Osteocalcin (OC) is bone biomarker associated with increased insulin secretion and insulin sensitivity and decreased visceral fat The aim of our study was to evaluate the body composition and levels of bone biomarkers (osteocalcin and betaCTx), insulin sensitivity and lipids in patients with PHPT.

Material and methods: In 25 patients with PHPT (Group 1 – age: 55.08±11.62 years, BMI 26.75±4.44 kg/m², PTH 144.27±138.17 ng/l, Calcium 2.94±0.26 mmol/l) and 8 healthy controls (Group 2 – age: 55.00±6.90 years, BMI 224.70±3.94 kg/m², PTH 35.46±10.82 ng/l, Calcium 2.52±0.15 mmol/l) OC(ng/ml), betaCTx(ng/ml), glucose(mmol/l), insulin(IU/ml), phosphate (mmol/l), total cholesterol (TC, mmol/l), HDL-C, LDL-C, triglyceride (TG, mmol/l), ApoA1, ApoA2, ApoB, ApoE, Lp(a) and vitamin D levels were determinated. HOMA IR was calculated as a marker of insulin resistance, body composition was evaluated using DEXA.

Results: There was significant difference between Group 1 and Group 2 in total (35.00±4.84 vs 29.90±4.77%, P<0.05) and truncal fat percent (33.59±6.72 vs 24.60±6.38%, P<0.05), TC (6.47±1.34 vs 5.32±0.88, P<0.05), LDL (4.27±1.14 vs 3.26±0.93, P<0.05), TG (1.83±0.82 vs 1.14±0.61, P<0.05) and Apo B (1.20±0.0.29 vs 0.85±0.23, P<0.05). In Group 1 OC (67.93±14.39 vs 30.08±15.54, P=0.05), betaCTx (1.11±1.00 vs 0.61±0.39, P=0.05) and Apo E (50.17±14.62 vs 40.37±10.79, P=0.05) were also higher than in Group 2. There was no difference in HOMA IR between groups (3.29±1.24 vs 3.12±1.38, P>0.05). There was significant correlation between betaCTx and trunkal fat percent (R=−0.44, P<0.05), insulin (r=−0.42, P<0.05), OC (r=0.95, P<0.01) and PTH levels (r=0.62, P<0.01), as well between OC and phosphate (r=−0.42, P<0.05) and PTH levels (r=0.68, P<0.01).

Conclusion: Patients with PHPT have atherogenic lipid profile, elevated bone biomarkers and more visceral fat in comparision to healthy controls. In our group of patients with PHPT betaCTx (but not the OC) levels suggest possible interrelation between bone, glucose and lipid metabolism.

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 work was supported, however funding details unavailable.