Abstract
Background/aimSeveral studies demonstrated that primary hyperparathyroidism is related to increased risk for cardiovascular diseases (CVDs), and risk is decreased by parathyroidectomy. Epicardial fat thickness (EFT) has been postulated as a new marker of CVD risk. We evaluated the impact of parathyroidectomy on EFT in patients with primary hyperparathyroidism (PHPT).Materials and methodsThirty-four PHPT patients (29 female, 5 male) and 28 age- and sex-matched controls (19 female, 9 male) were included in the study. Demographic, anthropometric, and biochemical data were recorded both before parathyroidectomy and 6 months after the procedure. Epicardial fat thickness was measured by transthoracic echocardiography.Results Mean age was 53.15 ± 8.44 years. Mean preoperative EFT was higher than mean EFT in the control group (0.49 ± 0.07 cm to 0.46 ± 0.08 cm, P: 0.0005), and EFT decreased after parathyroidectomy (0.49 ± 0.07 cm to 0.44 ± 0.08 cm, P: 0.0005). Systolic blood pressure and calcium, parathormone, and hsCRP levels decreased after parathyroidectomy (P < 0.05). Vitamin D levels increased (P < 0.05). Diastolic blood pressure, body mass index, carotid intima-media thickness, and HOMA-IR, fasting plasma glucose, and phosphorus levels were unchanged after parathyroidectomy (P > 0.05). Preoperatively, EFT was correlated with SBP (r: 0.360, P: 0.0285) and age (r: 0.466, P: 0.0036). Multiple linear regression used to identify independent predictors of change in epicardial fat did not find any predictor of change in epicardial fat (P > 0.05).ConclusionEFT was decreased by parathyroidectomy in patients with primary hyperparathyroidism.However, the decrease in EFT was not correlated with any of the cardiovascular risk factors. More comprehensive studies evaluating the potential relation between PHPT and EFT need to be conducted.
Highlights
Primary hyperparathyroidism (PHPT) is described as increased serum calcium and nonsuppressed parathyroid hormone (PTH) levels [1]
Mean preoperative Epicardial fat thickness (EFT) was higher than mean EFT in the control group (0.49 ± 0.07 cm to 0.46 ± 0.08 cm, P: 0.0005), and EFT decreased after parathyroidectomy (0.49 ± 0.07 cm to 0.44 ± 0.08 cm, P: 0.0005)
Systolic blood pressure and calcium, parathormone, and hsCRP levels decreased after parathyroidectomy (P < 0.05)
Summary
Primary hyperparathyroidism (PHPT) is described as increased serum calcium and nonsuppressed parathyroid hormone (PTH) levels [1]. The incidence of PHPT is increasing significantly as laboratory screening tests become more widely available [2]. Accumulating data show that even mild PHPT leads to an elevated risk for cardiovascular diseases (CVDs), many of which improve after parathyroidectomy [3,4,5,6,7]. Epicardial fat (EF) is present between the outer layer of the myocardium and the inner layer of the pericardium. Increasing thickness of EF is related to higher risk of CVD [8]. Epicardial fat thickness (EFT) can be measured by transthoracic echocardiography [9] and is considered a novel marker of CVD risk [10].
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