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The influence of parathyroidectomy on cardiometabolic risk factors in patients with primary hyperparathyroidism: a systematic review and meta-analysis

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Abstract

Purpose

Primary hyperparathyroidism (PHPT) is associated with increased risk of cardiovascular morbidity and mortality. We aim to determine whether parathyroidectomy (PTX) can change cardiometabolic risk factors including serum lipids, glycemic parameters, systolic and diastolic blood pressure, C reactive protein (CRP), and body mass index (BMI).

Methods

MEDLINE, Web of Science, Scopus, and Google Scholar were searched for relevant articles published till June 2020. Fixed-effect or random-effects models were used to estimate the weighted mean difference (WMD) and 95% CI for outcomes where applicable.

Results

In total, 34 studies were eligible to be included in the current meta-analysis. Our results indicated no favorable change in serum triglyceride (n = 13, WMD = −0.06, 95% CI: −0.15, 0.03 mmol/L), total cholesterol (n = 15, WMD = 0.01, 95% CI: −0.14, 0.16 mmol/L), LDL-C (n = 10, WMD = −0.01, 95% CI: −0.17, 0.19 mmol/L), HDL-C (n = 10, WMD = 0.03, 95% CI: −0.001, 0.06 mmol/L), and CRP (n = 5, WMD = 0.82, 95% CI: −0.01, 1.64 mg/L) after PTX in PHPT patients. However, glucose (n = 24, WMD = −0.16, 95% CI: −0.26, −0.06 mmol/L), serum insulin (n = 12, WMD = −1.11, 95% CI: −1.73, −0.49 µIU/mL), systolic (n = 17, WMD = −10.14, 95% CI: −12.27, −8.01 mmHg), and diastolic (n = 16, WMD = −5.21, 95% CI: −7.0, −3.43 mmHg) blood pressures were decreased after PTX, whilst a significant increase was observed in BMI (n = 13, WMD = 0.35, 95% CI: 0.19, 0.51 kg/m2).

Conclusions

PTX could improve glycemic parameters and blood pressure, without any significant change in serum lipoproteins and CRP.

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Data availability

Data will be available on request.

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Acknowledgements

We thank Isfahan University of Medical Sciences, Isfahan, Iran to support this work.

Funding

This work was supported by grants from Isfahan University of Medical Sciences, Isfahan, Iran (No: 299066).

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Authors and Affiliations

  1. Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

    Maryam Yavari & Hassan Rezvanian

  2. Biostatistics and Epidemiology Department, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

    Awat Feizi

  3. Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran

    Fahimeh Haghighatdoost

  4. Department of Nephrology, Hasheminejad Hospital, Iran University of Medical Sciences, Tehran, Iran

    Azin Ghaffari

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M.Y. and H.R. contributed to the concept. M.Y., F.H., and A.G. searched databases, screened articles, and extracted data. A.F. contributed to data synthesis and analysis. M.Y., F.H., and A.G. contributed to paper drafting. All steps were performed under the supervision of H.R. All authors read the final version of paper and approved it.

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Yavari, M., Feizi, A., Haghighatdoost, F. et al. The influence of parathyroidectomy on cardiometabolic risk factors in patients with primary hyperparathyroidism: a systematic review and meta-analysis. Endocrine 72, 72–85 (2021). https://doi.org/10.1007/s12020-020-02519-7

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