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Abstract：
OBJECTIVE: This pilot study aimed to evaluate differences in glycemic parameters between patients with prediabetes and normocalcemic primary hyperparathyroidism (NPHPT) and controls with prediabetes and normal parathyroid hormone (PTH) and calcium concentrations.
METHODS: 20 patients with NPHPT and prediabetes and 42 age-, gender-, and body mass index-matched controls with prediabetes were included. Glycemic parameters [fasting glucose (fGlu), glycosylated hemoglobin (HbA1c), fasting insulin (fIns)] were evaluated. Homeostasis Model Assessment was used for estimating insulin secretion (HOMA-B) and resistance (HOMA-IR). Participants underwent a 75-g oral glucose tolerance test.
RESULTS: HbA1c (5.9 ± 0.0 vs 5.9 ± 0.0%, p = 0.44), HOMA-IR (3.7 ± 1.2 vs 2.9 ± 0.2, p = 0.48), HOMA-B (117.8 ± 31.8 vs 146.9 ± 22.0%, p = 0.14), fIns (14.0 ± 4.3 vs 12.2 ± 1.1 μIU/ml, p = 0.53) and 2-hour post-load glucose concentrations (157.2 ± 2.2 vs 152.2 ± 2.0 mg/dl, p = 0.07), were nondifferent in the two groups. Higher fGlu levels were evident in the NPHPT, compared to the control group (105.6 ± 2.8 vs 98.2 ± 1.8 mg/dl, p = 0.01). fGlu demonstrated a positive correlation with PTH concentrations (rho = 0.374, p = 0.005).
CONCLUSIONS: Individuals with NPHPT and prediabetes present an unfavorable glycemic profile compared to age-matched people with prediabetes, suggesting a direct adverse effect of elevated PTH on glucose homeostasis.
METHODS: 20 patients with NPHPT and prediabetes and 42 age-, gender-, and body mass index-matched controls with prediabetes were included. Glycemic parameters [fasting glucose (fGlu), glycosylated hemoglobin (HbA1c), fasting insulin (fIns)] were evaluated. Homeostasis Model Assessment was used for estimating insulin secretion (HOMA-B) and resistance (HOMA-IR). Participants underwent a 75-g oral glucose tolerance test.
RESULTS: HbA1c (5.9 ± 0.0 vs 5.9 ± 0.0%, p = 0.44), HOMA-IR (3.7 ± 1.2 vs 2.9 ± 0.2, p = 0.48), HOMA-B (117.8 ± 31.8 vs 146.9 ± 22.0%, p = 0.14), fIns (14.0 ± 4.3 vs 12.2 ± 1.1 μIU/ml, p = 0.53) and 2-hour post-load glucose concentrations (157.2 ± 2.2 vs 152.2 ± 2.0 mg/dl, p = 0.07), were nondifferent in the two groups. Higher fGlu levels were evident in the NPHPT, compared to the control group (105.6 ± 2.8 vs 98.2 ± 1.8 mg/dl, p = 0.01). fGlu demonstrated a positive correlation with PTH concentrations (rho = 0.374, p = 0.005).
CONCLUSIONS: Individuals with NPHPT and prediabetes present an unfavorable glycemic profile compared to age-matched people with prediabetes, suggesting a direct adverse effect of elevated PTH on glucose homeostasis.
摘要：
目的：这项初步研究旨在评估糖尿病前期和血钙正常的原发性甲状旁腺功能亢进（NPHPT）患者与糖尿病前期和甲状旁腺激素（PTH）和钙浓度正常的对照组之间血糖参数的差异。
方法：20例NPHPT和糖尿病前期患者，年龄-42岁，性别-,纳入与体重指数相匹配的糖尿病前期对照。血糖参数[空腹血糖（fGlu），糖化血红蛋白（HbA1c），空腹胰岛素（fIns）]进行了评估。稳态模型评估用于估计胰岛素分泌(HOMA-B)和抗性(HOMA-IR)。参与者接受75克口服葡萄糖耐量试验。
结果：HbA1c（5.9±0.0vs5.9±0.0％，p=0.44)，HOMA-IR（3.7±1.2vs2.9±0.2，p=0.48），HOMA-B（117.8±31.8vs146.9±22.0％，p=0.14)，fIns（14.0±4.3vs12.2±1.1μIU/ml，p=0.53）和负荷后2小时葡萄糖浓度（157.2±2.2vs152.2±2.0mg/dl，p=0.07),两组无差异。较高的fGlu水平在NPHPT中明显，与对照组相比（105.6±2.8vs98.2±1.8mg/dl，p=0.01)。fGlu与PTH浓度呈正相关(rho=0.374,p=0.005)。
结论：与年龄匹配的糖尿病前期患者相比，患有NPHPT和糖尿病前期患者的血糖状况不佳。提示PTH升高对葡萄糖稳态的直接不利影响。
方法：20例NPHPT和糖尿病前期患者，年龄-42岁，性别-,纳入与体重指数相匹配的糖尿病前期对照。血糖参数[空腹血糖（fGlu），糖化血红蛋白（HbA1c），空腹胰岛素（fIns）]进行了评估。稳态模型评估用于估计胰岛素分泌(HOMA-B)和抗性(HOMA-IR)。参与者接受75克口服葡萄糖耐量试验。
结果：HbA1c（5.9±0.0vs5.9±0.0％，p=0.44)，HOMA-IR（3.7±1.2vs2.9±0.2，p=0.48），HOMA-B（117.8±31.8vs146.9±22.0％，p=0.14)，fIns（14.0±4.3vs12.2±1.1μIU/ml，p=0.53）和负荷后2小时葡萄糖浓度（157.2±2.2vs152.2±2.0mg/dl，p=0.07),两组无差异。较高的fGlu水平在NPHPT中明显，与对照组相比（105.6±2.8vs98.2±1.8mg/dl，p=0.01)。fGlu与PTH浓度呈正相关(rho=0.374,p=0.005)。
结论：与年龄匹配的糖尿病前期患者相比，患有NPHPT和糖尿病前期患者的血糖状况不佳。提示PTH升高对葡萄糖稳态的直接不利影响。
