Effect of curative parathyroidectomy on insulin resistance
Background: Primary hyperparathyroidism (PHPT) is characterized by inappropriately elevated serum parathyroid hormone (PTH) level despite elevated serum calcium. Insulin resistant is the basic pathophysiology, behind the higher prevalence of diabetes mellitus in patients with PHPT. However, the impr...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2016-01-01
|
| Series: | Indian Journal of Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.ijem.in/article.asp?issn=2230-8210;year=2016;volume=20;issue=6;spage=784;epage=789;aulast=Putnam |
| _version_ | 1819262662961266688 |
|---|---|
| author | Rachel Putnam Deba Prasad Dhibar Shweta Varshney Arunanshu Behera B R Mittal Anil Bhansali Sudhaker D Rao Sanjay Kumar Bhadada |
| author_facet | Rachel Putnam Deba Prasad Dhibar Shweta Varshney Arunanshu Behera B R Mittal Anil Bhansali Sudhaker D Rao Sanjay Kumar Bhadada |
| author_sort | Rachel Putnam |
| collection | DOAJ |
| description | Background: Primary hyperparathyroidism (PHPT) is characterized by inappropriately elevated serum parathyroid hormone (PTH) level despite elevated serum calcium. Insulin resistant is the basic pathophysiology, behind the higher prevalence of diabetes mellitus in patients with PHPT. However, the improvement in insulin resistance (IR) after curative parathyroidectomy (CPTX) has not been established yet, as the study results are conflicting. Materials and Methods: In this prospective interventional study, ten patients with mild PHPT (Group 1) and another ten patients with moderate to severe PHPT (Group 2) were undergone CPTX. The IR was assessed by homeostasis model assessment-IR (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), fasting plasma glucose (FPG), and fasting serum insulin (FSI), before and 3 months after CPTX. Results: There was no significant change of FPG and FSI, before and after CPTX in Group 1 (P = 0.179 and P = 0.104) and Group 2 (P = 0.376 and P = 0.488). Before surgery, HOMA-IR was higher, and QUICKI was significantly lower, in both Group 1 (P = 0.058 and P = 0.009) and Group 2 (P = 0.023 and P = 0.005) as compared to published normal reference mean, with no significant difference between the groups. Three months after surgery HOMA-IR increased further and QUICKI remained unchanged as compared to baseline, in both Group 1 (P = 0.072 and 0.082) and Group 2 (P = 0.54 and 0.56), but statistically insignificant. Conclusion: IR remained unchanged after CPTX in mild as well as moderate to severe PHPT. Asymptomatic PHPT with abnormal IR should not be used as criteria for parathyroidectomy. |
| first_indexed | 2024-12-23T20:01:16Z |
| format | Article |
| id | doaj.art-63895651fdb54101a6f5d94883c34e03 |
| institution | Directory Open Access Journal |
| issn | 2230-8210 |
| language | English |
| last_indexed | 2024-12-23T20:01:16Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Endocrinology and Metabolism |
| spelling | doaj.art-63895651fdb54101a6f5d94883c34e032022-12-21T17:33:05ZengWolters Kluwer Medknow PublicationsIndian Journal of Endocrinology and Metabolism2230-82102016-01-0120678478910.4103/2230-8210.192916Effect of curative parathyroidectomy on insulin resistanceRachel PutnamDeba Prasad DhibarShweta VarshneyArunanshu BeheraB R MittalAnil BhansaliSudhaker D RaoSanjay Kumar BhadadaBackground: Primary hyperparathyroidism (PHPT) is characterized by inappropriately elevated serum parathyroid hormone (PTH) level despite elevated serum calcium. Insulin resistant is the basic pathophysiology, behind the higher prevalence of diabetes mellitus in patients with PHPT. However, the improvement in insulin resistance (IR) after curative parathyroidectomy (CPTX) has not been established yet, as the study results are conflicting. Materials and Methods: In this prospective interventional study, ten patients with mild PHPT (Group 1) and another ten patients with moderate to severe PHPT (Group 2) were undergone CPTX. The IR was assessed by homeostasis model assessment-IR (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), fasting plasma glucose (FPG), and fasting serum insulin (FSI), before and 3 months after CPTX. Results: There was no significant change of FPG and FSI, before and after CPTX in Group 1 (P = 0.179 and P = 0.104) and Group 2 (P = 0.376 and P = 0.488). Before surgery, HOMA-IR was higher, and QUICKI was significantly lower, in both Group 1 (P = 0.058 and P = 0.009) and Group 2 (P = 0.023 and P = 0.005) as compared to published normal reference mean, with no significant difference between the groups. Three months after surgery HOMA-IR increased further and QUICKI remained unchanged as compared to baseline, in both Group 1 (P = 0.072 and 0.082) and Group 2 (P = 0.54 and 0.56), but statistically insignificant. Conclusion: IR remained unchanged after CPTX in mild as well as moderate to severe PHPT. Asymptomatic PHPT with abnormal IR should not be used as criteria for parathyroidectomy.http://www.ijem.in/article.asp?issn=2230-8210;year=2016;volume=20;issue=6;spage=784;epage=789;aulast=PutnamHomeostasis model assessment-insulin resistanceinsulin resistanceparathyroidectomyprimary hyperparathyroidismquantitative insulin sensitivity check index |
| spellingShingle | Rachel Putnam Deba Prasad Dhibar Shweta Varshney Arunanshu Behera B R Mittal Anil Bhansali Sudhaker D Rao Sanjay Kumar Bhadada Effect of curative parathyroidectomy on insulin resistance Indian Journal of Endocrinology and Metabolism Homeostasis model assessment-insulin resistance insulin resistance parathyroidectomy primary hyperparathyroidism quantitative insulin sensitivity check index |
| title | Effect of curative parathyroidectomy on insulin resistance |
| title_full | Effect of curative parathyroidectomy on insulin resistance |
| title_fullStr | Effect of curative parathyroidectomy on insulin resistance |
| title_full_unstemmed | Effect of curative parathyroidectomy on insulin resistance |
| title_short | Effect of curative parathyroidectomy on insulin resistance |
| title_sort | effect of curative parathyroidectomy on insulin resistance |
| topic | Homeostasis model assessment-insulin resistance insulin resistance parathyroidectomy primary hyperparathyroidism quantitative insulin sensitivity check index |
| url | http://www.ijem.in/article.asp?issn=2230-8210;year=2016;volume=20;issue=6;spage=784;epage=789;aulast=Putnam |
| work_keys_str_mv | AT rachelputnam effectofcurativeparathyroidectomyoninsulinresistance AT debaprasaddhibar effectofcurativeparathyroidectomyoninsulinresistance AT shwetavarshney effectofcurativeparathyroidectomyoninsulinresistance AT arunanshubehera effectofcurativeparathyroidectomyoninsulinresistance AT brmittal effectofcurativeparathyroidectomyoninsulinresistance AT anilbhansali effectofcurativeparathyroidectomyoninsulinresistance AT sudhakerdrao effectofcurativeparathyroidectomyoninsulinresistance AT sanjaykumarbhadada effectofcurativeparathyroidectomyoninsulinresistance |