Effect of curative parathyroidectomy on insulin resistance
Putnam R, Dhibar DP, Varshney S, Behera A, Mittal BR, Bhansali A, Rao SD, and Bhadada SK. Effect of curative parathyroidectomy on insulin resistance. Indian J Endocrinol Metab 2016; 20(6):784-789.
Indian J Endocrinol Metab
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 (
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.