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Abstract：
Parathyroidectomy has ameliorated cardiovascular risk factors in patients with hypercalcemic primary hyperparathyroidism (PHPT), but the effect of parathyroidectomy on normocalcemic PHPT is not exactly known. This case-controlled study aimed to investigate the effect of parathyroidectomy on cardiovascular risk factors in patients with normocalcemic and hypercalcemic PHPT.
Subjects with normocalcemic PHPT (n = 35), age- and sex-matched hypercalcemic PHPT (n = 60) and age- and sex-matched control (n = 60) were included. Cardiometabolic disorders were investigated with traditional cardiometabolic risk factors and the Framingham cardiovascular risk score (CRS) before and 6 months after parathyroidectomy.
Diabetes, dyslipidemia, hypertension, obesity, insulin resistance, osteoporosis, having fractures were similarly increased in the hypercalcemic and normocalcemic PHPT groups (p > 0.05) compared with the controls (p < 0.05). Blood pressures, glucose metabolism (glucose, insulin, HOMA-IR) and lipid profiles were similarly increased in the PHPT groups (p > 0.05) compared with the controls (p < 0.05). After parathyroidectomy, blood pressures, serum total cholesterol, and HOMA-IR were decreased in both PHPT groups (p < 0.05). CRS was lower in the controls (5.74 ± 3.24, p < 0.05). After parathyroidectomy, CRS was decreased in the normocalcemic (11.98 ± 10.11 vs. 7.37 ± 4.48) and hypercalcemic (14.62 ± 11.06 vs. 8.05 ± 7.72) PHPT groups. Increased blood pressures were independent predictors of serum iPTH.
The normocalcemic and hypercalcemic PHPT groups had similarly increased cardiovascular risk factors, even independently of serum calcium. Parathyroidectomy ameliorated the increased cardiovascular risk factors in both normocalcemic and hypercalcemic PHPT.
Subjects with normocalcemic PHPT (n = 35), age- and sex-matched hypercalcemic PHPT (n = 60) and age- and sex-matched control (n = 60) were included. Cardiometabolic disorders were investigated with traditional cardiometabolic risk factors and the Framingham cardiovascular risk score (CRS) before and 6 months after parathyroidectomy.
Diabetes, dyslipidemia, hypertension, obesity, insulin resistance, osteoporosis, having fractures were similarly increased in the hypercalcemic and normocalcemic PHPT groups (p > 0.05) compared with the controls (p < 0.05). Blood pressures, glucose metabolism (glucose, insulin, HOMA-IR) and lipid profiles were similarly increased in the PHPT groups (p > 0.05) compared with the controls (p < 0.05). After parathyroidectomy, blood pressures, serum total cholesterol, and HOMA-IR were decreased in both PHPT groups (p < 0.05). CRS was lower in the controls (5.74 ± 3.24, p < 0.05). After parathyroidectomy, CRS was decreased in the normocalcemic (11.98 ± 10.11 vs. 7.37 ± 4.48) and hypercalcemic (14.62 ± 11.06 vs. 8.05 ± 7.72) PHPT groups. Increased blood pressures were independent predictors of serum iPTH.
The normocalcemic and hypercalcemic PHPT groups had similarly increased cardiovascular risk factors, even independently of serum calcium. Parathyroidectomy ameliorated the increased cardiovascular risk factors in both normocalcemic and hypercalcemic PHPT.
摘要：
甲状旁腺切除术改善了高钙血症性原发性甲状旁腺功能亢进（PHPT）患者的心血管危险因素，但甲状旁腺切除术对正常血钙PHPT的影响尚不清楚。这项病例对照研究旨在探讨甲状旁腺切除术对正常血钙和高血钙PHPT患者心血管危险因素的影响。
患有正常血钙PHPT（n=35）的受试者，纳入年龄和性别匹配的高钙血症PHPT(n=60)和年龄和性别匹配的对照(n=60).在甲状旁腺切除术前和术后6个月，使用传统的心脏代谢危险因素和Framingham心血管风险评分（CRS）对心脏代谢紊乱进行了调查。
糖尿病，血脂异常,高血压,肥胖，胰岛素抵抗，骨质疏松,与对照组(p<0.05)相比,高血钙和正常血钙PHPT组的骨折发生率相似(p>0.05).血压,葡萄糖代谢(葡萄糖，胰岛素，与对照组（p<0.05）相比，PHPT组的HOMA-IR）和脂质分布相似地增加（p>0.05）。甲状旁腺切除术后,血压,血清总胆固醇,PHPT组及HOMA-IR均降低(p<0.05)。对照组的CRS较低(5.74±3.24,p<0.05)。甲状旁腺切除术后,正常血钙的CRS降低（11.98±10.11vs.7.37±4.48）和高钙血症（14.62±11.06vs.8.05±7.72)PHPT组。血压升高是血清iPTH的独立预测因子。
正常血钙和高血钙PHPT组有类似的心血管危险因素增加，甚至独立于血清钙。甲状旁腺切除术改善了正常血钙和高钙血PHPT中心血管危险因素的增加。
患有正常血钙PHPT（n=35）的受试者，纳入年龄和性别匹配的高钙血症PHPT(n=60)和年龄和性别匹配的对照(n=60).在甲状旁腺切除术前和术后6个月，使用传统的心脏代谢危险因素和Framingham心血管风险评分（CRS）对心脏代谢紊乱进行了调查。
糖尿病，血脂异常,高血压,肥胖，胰岛素抵抗，骨质疏松,与对照组(p<0.05)相比,高血钙和正常血钙PHPT组的骨折发生率相似(p>0.05).血压,葡萄糖代谢(葡萄糖，胰岛素，与对照组（p<0.05）相比，PHPT组的HOMA-IR）和脂质分布相似地增加（p>0.05）。甲状旁腺切除术后,血压,血清总胆固醇,PHPT组及HOMA-IR均降低(p<0.05)。对照组的CRS较低(5.74±3.24,p<0.05)。甲状旁腺切除术后,正常血钙的CRS降低（11.98±10.11vs.7.37±4.48）和高钙血症（14.62±11.06vs.8.05±7.72)PHPT组。血压升高是血清iPTH的独立预测因子。
正常血钙和高血钙PHPT组有类似的心血管危险因素增加，甚至独立于血清钙。甲状旁腺切除术改善了正常血钙和高钙血PHPT中心血管危险因素的增加。
