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This study is to compare primary hyperparathyroidism (PHPT) patients with different iPTH levels for serum calcium and other laboratory values. In this retrospective study, 212 patients who presented at Robert Wood Johnson Hospital were assessed for metabolic and characteristic features of PHPT. Patients were divided into two groups according to their serum intact parathyroid hormone (iPTH) levels. Student t- tests were used to compare the two groups for differences in age, body mass index (BMI), adenoma weight, and laboratory test values which included serum calcium, iPTH, 25OHD, lipid panel, serum creatinine, ALP, and 24 hr. urinary calcium. Pearson`s correlation coefficient was used to assess the relationship. Of the 212 PHPT patients, 100 (17 males and 83 females) were classified as m-iPTH group (iPTH below 140 pg/ml), whereas 112 patients (25 males and 87 females) were classified as h-iPTH group (iPTH above 140 pg/ml). Higher-iPTH patients are younger than m-iPTH patients. No statistic significant differences in BMI, T-cholesterol and TG were found between the m-iPTH and h-iPTH groups. Higher- iPTH patients compared with m- iPTH, had slightly but significantly higher calcium, lower 25OHD, lower HDL, higher ALP, and very close to have higher adenoma weight. Additionally, we found iPTH was positive correlated with serum calcium, adenoma weight, and triglyceride (TG) levels, and negatively correlated with HDL and 25OHD. Intact PTH did not correlate with BMI and T- cholesterol levels. Furthermore, 24 hr. urinary calcium and serum ALP were positively associated with iPTH levels but not significantly (P = 0.08, P = 0.09) respectively. These correlations were independent of serum calcium and 25OHD levels except TG was dependent of reduced 25OHD, while serum ALP was dependent of calcium levels. These findings from our analysis consistent with previous studies suggesting iPTH levels correlated metabolic syndrome. Additionally, our results suggest that h- iPTH patients tend to be younger ones, with lower HDL, lower 25OHD, and higher ALP. While the underline mechanisms for these changes are unclear, we speculate that the elevated iPTH levels might decrease HDL directly or indirectly through increasing insulin resistance by weight gain, and increases ALP through PTH receptors on osteoblasts. This study supported our hypothesis that iPTH levels are an important factor to contribute in the management of PHPT patients. Intact PTH levels, lipid panel, 25OHD, ALP in addition to calcium levels might also need to be considered in the therapeutic decision for PHPT patients.

ETD_7271

M.S.

Includes bibliographical references

by Haidar Khaioon Al-Hraishawi

doi:10.7282/T3W37ZF8

ETD graduate

The author owns the copyright to this work.