Endocrine Abstracts

Introduction: Primary Hyperparathyroidism (PHPT) is a frequent endocrine disease which requires surgical excision for definitive cure. Apart from genetic role in its pathogenesis, there are conflicting reports about role of immunomodulation in literature. In this context, we set out study the role of Pro- inflammatory cytokines in PHPT in South Indian population.

Material and methods: This prospective case-control study was conducted on surgically managed PHPT patients. Institutional ethical committee approval was obtained. Diagnosis of PHPT was based on biochemical confirmation, imaging, MIBI scanning and later confirmed by histopathology. Exclusion criteria were subjects with any systemic or chronic inflammatory disease or any medication which interferes with the normal function of the hypothalamic-pituitary-gonadal axis. Serum samples were collected from 21 PHPT subjects and 20 age matched healthy controls. Interleukin-6 (IL-6), Tumour necrosis factor-alpha (TNF-α) and high sensitive C reactive protein (hsCRP), leptin levels were measured in all serum samples. Statistical analysis was performed by one way ANOVA with Dunnet’s test and Pearson correlation tests.

Results: The mean hSCRP level in PHPT and controls were 12.3±3.6 mg/mL and 6.7±1.3 mg/mL respectively. The mean TNF-α level and IL-6 level and Leptin levels were 189±22.5 pg/mL, 16.4±2.9 pg/mL and 3.1±1.4 ng/mL respectively. Serum leptin level in controls was 3.7±2.1 ng/mL. There was statistically significant difference of hsCRP and IL-6 level (P value < 0.05). There was no statistically significant difference of TNF-α and leptin between cases and controls (P value > 0.05).

Conclusions: This study shows raised titers of pro-inflammatory markers – IL-6 and hsCRP, while TNF-α and Leptin levels had neutral association with PHPT. But, the exact immuno-modulatory role and pathogenetic mechanism needs more investigational research.

Keywords: Hyperparathyroidism, Tumour necrosis factor, Interleukin-6, Hypercalcemia, Auto-immunity, Leptin