Improving Glucose Homeostasis after Parathyroidectomy for Normocalcemic Primary Hyperparathyroidism with Co-Existing Prediabetes
We have previously described increased fasting plasma glucose levels in patients with normocalcemic primary hyperparathyroidism (NPHPT) and co-existing prediabetes, compared to prediabetes per se. This study evaluated the effect of parathyroidectomy (PTx) (Group A), versus conservative follow-up (Gr...
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MDPI AG
2020-11-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/12/11/3522 |
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| author | Spyridon Karras Cedric Annweiler Dimitris Kiortsis Ioannis Koutelidakis Kalliopi Kotsa |
| author_facet | Spyridon Karras Cedric Annweiler Dimitris Kiortsis Ioannis Koutelidakis Kalliopi Kotsa |
| author_sort | Spyridon Karras |
| collection | DOAJ |
| description | We have previously described increased fasting plasma glucose levels in patients with normocalcemic primary hyperparathyroidism (NPHPT) and co-existing prediabetes, compared to prediabetes per se. This study evaluated the effect of parathyroidectomy (PTx) (Group A), versus conservative follow-up (Group B), in a small cohort of patients with co-existing NPHPT and prediabetes. Sixteen patients were categorized in each group. Glycemic parameters (levels of fasting glucose (fGlu), glycosylated hemoglobin (HbA1c), and fasting insulin (fIns)), the homeostasis model assessment for estimating insulin secretion (HOMA-B) and resistance (HOMA-IR), and a 75-g oral glucose tolerance test were evaluated at baseline and after 32 weeks for both groups. Measurements at baseline were not significantly different between Groups A and B, respectively: fGlu (119.4 ± 2.8 vs. 118.2 ± 1.8 mg/dL, <i>p</i> = 0.451), HbA<sub>1c</sub> (5.84 ± 0.3 %vs. 5.86 ± 0.4%, <i>p</i> = 0.411), HOMA-IR (3.1 ± 1.2 vs. 2.9 ± 0.2, <i>p</i> = 0.213), HOMA-B (112.9 ± 31.8 vs. 116.9 ± 21.0%, <i>p</i> = 0.312), fIns (11.0 ± 2.3 vs. 12.8 ± 1.4 μIU/mL, <i>p</i> = 0.731), and 2-h post-load glucose concentrations (163.2 ± 3.2 vs. 167.2 ± 3.2 mg/dL, <i>p</i> = 0.371). fGlu levels demonstrated a positive correlation with PTH concentrations for both groups (Group A, rho = 0.374, <i>p</i> = 0.005, and Group B, rho = 0.359, <i>p</i> = 0.008). At the end of follow-up, Group A demonstrated significant improvements after PTx compared to the baseline: fGlu ((119.4 ± 2.8 vs. 111.2 ± 1.9 mg/dL, <i>p</i> = 0.021) (−8.2 ± 0.6 mg/dL)), and 2-h post-load glucose concentrations ((163.2 ± 3.2 vs. 144.4 ± 3.2 mg/dL, <i>p</i> = 0.041), (−18.8 ± 0.3 mg/dL)). For Group B, results demonstrated non-significant differences: fGlu ((118.2 ± 1.8 vs. 117.6 ± 2.3 mg/dL, <i>p</i> = 0.031), (−0.6 ± 0.2 mg/dL)), and 2-h post-load glucose concentrations ((167.2 ± 2.7 vs. 176.2 ± 3.2 mg/dL, <i>p</i> = 0.781), (+9.0 ± 0.8 mg/dL)). We conclude that PTx for individuals with NPHPT and prediabetes may improve their glucose homeostasis when compared with conservative follow-up, after 8 months of follow-up. |
| first_indexed | 2024-03-10T14:49:47Z |
| format | Article |
| id | doaj.art-6ad7aaec44d54512a3c7803b91eea57b |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T14:49:47Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-6ad7aaec44d54512a3c7803b91eea57b2023-11-20T21:06:31ZengMDPI AGNutrients2072-66432020-11-011211352210.3390/nu12113522Improving Glucose Homeostasis after Parathyroidectomy for Normocalcemic Primary Hyperparathyroidism with Co-Existing PrediabetesSpyridon Karras0Cedric Annweiler1Dimitris Kiortsis2Ioannis Koutelidakis3Kalliopi Kotsa4Division of Endocrinology and Metabolism, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, 54621 Thessaloniki, GreeceDivision of Geriatric Medicine, Department of Neuroscience, Angers University Hospital, 49035 Angers, FranceDepartment of Nuclear Medicine, University of Ioannina, 45110 Ioannina, GreeceSecond Department of Surgery, Gennimatas General Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, GreeceDivision of Endocrinology and Metabolism, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, 54621 Thessaloniki, GreeceWe have previously described increased fasting plasma glucose levels in patients with normocalcemic primary hyperparathyroidism (NPHPT) and co-existing prediabetes, compared to prediabetes per se. This study evaluated the effect of parathyroidectomy (PTx) (Group A), versus conservative follow-up (Group B), in a small cohort of patients with co-existing NPHPT and prediabetes. Sixteen patients were categorized in each group. Glycemic parameters (levels of fasting glucose (fGlu), glycosylated hemoglobin (HbA1c), and fasting insulin (fIns)), the homeostasis model assessment for estimating insulin secretion (HOMA-B) and resistance (HOMA-IR), and a 75-g oral glucose tolerance test were evaluated at baseline and after 32 weeks for both groups. Measurements at baseline were not significantly different between Groups A and B, respectively: fGlu (119.4 ± 2.8 vs. 118.2 ± 1.8 mg/dL, <i>p</i> = 0.451), HbA<sub>1c</sub> (5.84 ± 0.3 %vs. 5.86 ± 0.4%, <i>p</i> = 0.411), HOMA-IR (3.1 ± 1.2 vs. 2.9 ± 0.2, <i>p</i> = 0.213), HOMA-B (112.9 ± 31.8 vs. 116.9 ± 21.0%, <i>p</i> = 0.312), fIns (11.0 ± 2.3 vs. 12.8 ± 1.4 μIU/mL, <i>p</i> = 0.731), and 2-h post-load glucose concentrations (163.2 ± 3.2 vs. 167.2 ± 3.2 mg/dL, <i>p</i> = 0.371). fGlu levels demonstrated a positive correlation with PTH concentrations for both groups (Group A, rho = 0.374, <i>p</i> = 0.005, and Group B, rho = 0.359, <i>p</i> = 0.008). At the end of follow-up, Group A demonstrated significant improvements after PTx compared to the baseline: fGlu ((119.4 ± 2.8 vs. 111.2 ± 1.9 mg/dL, <i>p</i> = 0.021) (−8.2 ± 0.6 mg/dL)), and 2-h post-load glucose concentrations ((163.2 ± 3.2 vs. 144.4 ± 3.2 mg/dL, <i>p</i> = 0.041), (−18.8 ± 0.3 mg/dL)). For Group B, results demonstrated non-significant differences: fGlu ((118.2 ± 1.8 vs. 117.6 ± 2.3 mg/dL, <i>p</i> = 0.031), (−0.6 ± 0.2 mg/dL)), and 2-h post-load glucose concentrations ((167.2 ± 2.7 vs. 176.2 ± 3.2 mg/dL, <i>p</i> = 0.781), (+9.0 ± 0.8 mg/dL)). We conclude that PTx for individuals with NPHPT and prediabetes may improve their glucose homeostasis when compared with conservative follow-up, after 8 months of follow-up.https://www.mdpi.com/2072-6643/12/11/3522normocalcemic primary hyperparathyroidismparathyroidectomyprediabetesfasting glucose |
| spellingShingle | Spyridon Karras Cedric Annweiler Dimitris Kiortsis Ioannis Koutelidakis Kalliopi Kotsa Improving Glucose Homeostasis after Parathyroidectomy for Normocalcemic Primary Hyperparathyroidism with Co-Existing Prediabetes Nutrients normocalcemic primary hyperparathyroidism parathyroidectomy prediabetes fasting glucose |
| title | Improving Glucose Homeostasis after Parathyroidectomy for Normocalcemic Primary Hyperparathyroidism with Co-Existing Prediabetes |
| title_full | Improving Glucose Homeostasis after Parathyroidectomy for Normocalcemic Primary Hyperparathyroidism with Co-Existing Prediabetes |
| title_fullStr | Improving Glucose Homeostasis after Parathyroidectomy for Normocalcemic Primary Hyperparathyroidism with Co-Existing Prediabetes |
| title_full_unstemmed | Improving Glucose Homeostasis after Parathyroidectomy for Normocalcemic Primary Hyperparathyroidism with Co-Existing Prediabetes |
| title_short | Improving Glucose Homeostasis after Parathyroidectomy for Normocalcemic Primary Hyperparathyroidism with Co-Existing Prediabetes |
| title_sort | improving glucose homeostasis after parathyroidectomy for normocalcemic primary hyperparathyroidism with co existing prediabetes |
| topic | normocalcemic primary hyperparathyroidism parathyroidectomy prediabetes fasting glucose |
| url | https://www.mdpi.com/2072-6643/12/11/3522 |
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