Insulin resistance is more severe in patients with primary hyperparathyroidism

Aljehani, Ashwaq; Alahmed, Feras; Nguyen-Thi, Phi-Linh; Bihain, Florence; Nomine-Criqui, Claire; Demarquet, L.; Guerci, Bruno; Ziegler, O.; Brunaud, Laurent

doi:10.1016/j.surg.2022.02.012

Cited by 4 publications

(5 citation statements)

References 40 publications

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“…As far as we are aware, this is the first research to examine the association between WWI and HOMA-IR and to explore the joint association of WWI and PA. BMI and WC are internationally recognized as the two main indicators of obesity. Numerous studies have shown that BMI is positively correlated with HOMA-IR [ 31 – 33 ]. Additionally, the study discovered that that in patients with idiopathic hypogonadism, normal glucose tolerance, and normal body weight, body fat mass was an independent predictor of insulin resistance [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Joint association of weight-adjusted-waist index and physical activity with insulin resistance in adolescents: a cross-sectional study

Zhou,

Tang,

Wang

et al. 2024

BMC Endocr Disord

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Background The weight-adjusted waist index (WWI) is a recently developed obesity metric, and the aim of this study was to investigate the relationship between physical activity (PA) and WWI and the homeostasis model assessment of insulin resistance (HOMA-IR) in adolescents, as well as the joint association of HOMA-IR. Methods This study was based on the National Health and Nutrition Survey conducted between 2013 and 2016 and included 1024 adolescents whose median age was 15.4. Multivariate linear regression was used to examine the associations between HOMA-IR and PA and WWI. Using generalized additive models, a potential nonlinear link between WWI and HOMA-IR was evaluated. Subgroup analysis was also carried out. Results The fully adjusted model revealed a positive association (β: 0.48, 95% CI: 0.43, 0.53) between the WWI and HOMA-IR. The HOMA-IR was lower in physically active (β: -0.16, 95% CI: -0.26, -0.05) participants versus inactive participants. Participants who had higher WWI and were not physically active (β: 0.69; 95% CI: 0.56, 0.82) had the highest levels of HOMA-IR compared to participants who had lower WWI and were physically active. Subgroup analysis revealed that these correlations were similar in males and females. Conclusion Our results demonstrated that higher WWI and PA were associated with a lower HOMA-IR and that WWI and PA had a combined association with HOMA-IR. The findings of this study are informative for the preventing insulin resistance in adolescents.

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Section: Discussionmentioning

confidence: 99%

Joint association of weight-adjusted-waist index and physical activity with insulin resistance in adolescents: a cross-sectional study

Zhou,

Tang,

Wang

et al. 2024

BMC Endocr Disord

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“…When it comes to metabolic syndrome, as the signature of insulin resistance, in subjects confirmed with primary hyperparathyroidism, we identified ten studies [ 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 ] within the timeframe of research in addition to one study that was prior mentioned with respect to insulinoma analysis [ 111 ] and a cohort of primary hyperparathyroidism [ 28 ]. The overall results are still heterogeneous, and no clear conclusion can be drawn yet ( n = 10, N = 1010 subjects with primary hyperparathyroidism, among them, 193 individuals had normocalcemic/mild type [ 152 , 156 , 158 , 159 ]).…”

Section: Pancreas-derivate Insulin Profile With Insulin Resistance An...mentioning

confidence: 99%

“…HOMA-IR was statistically significantly higher than controls ( p < 0.001), similarly to the results of Nomine-Criqui et al [ 151 ]. Calcemic levels were positively correlated with HOMA-IR (r = 0.171, p = 0.023) and body mass index, as well (r = 0.45, p < 0.001), and multivariate analysis confirmed this latest mentioned parameter as being an independent predictor of insulin resistance before parathyroidectomy [ 155 ].…”

Section: Pancreas-derivate Insulin Profile With Insulin Resistance An...mentioning

confidence: 99%

“…Table 7. Original studies regarding pancreas-related insulin profile and associated cardio-metabolic traits, including metabolic syndrome in patients with primary hyperparathyroidism (articles published on PubMed between January 2024 and January 2020) [28,111,[151][152][153][154][155][156][157][158][159][160]. Abbreviations: CKD = chronic kidney disease; DM = diabetes mellitus; GLP-1 = glucagon-like peptide-1; HOMA = homeostatic model assessment of insulin resistance; HBP = high blood pressure; MEN = multiple endocrine neoplasia; N = number of patients; PHP = primary hyperparathyroidism.…”

Section: Pancreas-derivate Insulin Profile With Insulin Resistance An...mentioning

confidence: 99%

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Turning Points in Cross-Disciplinary Perspective of Primary Hyperparathyroidism and Pancreas Involvements: Hypercalcemia-Induced Pancreatitis, MEN1 Gene-Related Tumors, and Insulin Resistance

Carsote,

Nistor,

Gheorghe

et al. 2024

IJMS

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We aimed to provide an in-depth analysis with respect to three turning points in pancreas involvement in primary hyperparathyroidism (PHP): hypercalcemia-induced pancreatitis (HCa-P), MEN1 (multiple endocrine neoplasia)-related neuroendocrine tumors (NETs), and insulin resistance (IR). This was a comprehensive review conducted via a PubMed search between January 2020 and January 2024. HCa-P (n = 9 studies, N = 1375) involved as a starting point parathyroid NETs (n = 7) or pancreatitis (n = 2, N = 167). Case report-focused analysis (N = 27) showed five cases of pregnancy PHP-HCa-P and three reports of parathyroid carcinoma (female/male ratio of 2/1, ages of 34 in women, men of 56). MEN1-NET studies (n = 7) included MEN1-related insulinomas (n = 2) or MEN1-associated PHP (n = 2) or analyses of genetic profile (n = 3), for a total of 877 MEN1 subjects. In MEN1 insulinomas (N = 77), the rate of associated PHP was 78%. Recurrence after parathyroidectomy (N = 585 with PHP) was higher after less-than-subtotal versus subtotal parathyroidectomy (68% versus 45%, p < 0.001); re-do surgery was 26% depending on surgery for pancreatic NETs (found in 82% of PHP patients). MEN1 pathogenic variants in exon 10 represented an independent risk factor for PHP recurrence. A single pediatric study in MEN1 (N = 80) revealed the following: a PHP rate of 80% and pancreatic NET rate of 35% and 35 underlying germline MEN1 pathogenic variants (and 3/35 of them were newly detected). The co-occurrence of genetic anomalies included the following: CDC73 gene variant, glucokinase regulatory protein gene pathogenic variant (c.151C>T, p.Arg51*), and CAH-X syndrome. IR/metabolic feature-focused analysis identified (n = 10, N = 1010) a heterogeneous spectrum: approximately one-third of adults might have had prediabetes, almost half displayed some level of IR as reflected by HOMA-IR > 2.6, and serum calcium was positively correlated with HOMA-IR. Vitamin D deficiency was associated with a higher rate of metabolic syndrome (n = 1). Normocalcemic and mildly symptomatic hyperparathyroidism (n = 6, N = 193) was associated with a higher fasting glucose and some improvement after parathyroidectomy. This multilayer pancreas/parathyroid analysis highlighted a complex panel of connections from pathogenic factors, including biochemical, molecular, genetic, and metabolic factors, to a clinical multidisciplinary panel.

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“…Al-Jehani et al [ 20 ] note that in primary hyperparathyroidism, HOMA-IR is positively correlated with both calcium and BMI (p < 0.001), but negatively associated with phosphate. Haap et al [ 21 ] further demonstrate (in healthy subjects without a diagnosis of diabetes mellitus) a negative correlation between phosphate and post-prandial two-hour glucose (r = -0.13, p < 0.0001), in addition to a positive correlation between insulin sensitivity and phosphate (r = 0.10, p = 0.0006); a plausible explanation for these significant associations is that low phosphate leads to depleted intracellular adenosine triphosphate, which may alter intracellular energy metabolism.…”

Section: Reviewmentioning

confidence: 99%

Association Between Primary Hyperparathyroidism and Secondary Diabetes Mellitus: Findings From a Scoping Review

Barnett¹

2023

Cureus

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An ill-defined association exists between diabetes mellitus (insulin resistance) and primary hyperparathyroidism. This article explores this phenomenon while providing an explanation for such a relationship and reviewing the evidence regarding the response to insulin sensitivity following a parathyroidectomy. Primary hyperparathyroidism may increase the risk of developing insulin resistance; peculiarly, this is not present in all patients. It is likely that both intracellular hypercalcemia and hypophosphatemia alter the insulin receptor expression and response; the contribution of parathyroid hormone is less clear. Following parathyroidectomy, patients may demonstrate improvement in their insulin sensitivity, while others have no response or a detrimental effect. A varied phenotype exists among patients, and furthermore, it is unclear why certain patients demonstrate improvement in insulin sensitivity following a parathyroidectomy, whereas others fail to do so. While this review provides a broad overview of the general endocrine community, it is imperative to note that clinical applicability is limited until further studies address these remaining uncertainties. Due to the lack of understanding regarding this endocrinological enigma, the presence of insulin resistance, at this present time, should not be a criterion for a parathyroidectomy.

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Insulin resistance is more severe in patients with primary hyperparathyroidism

Cited by 4 publications

References 40 publications

Joint association of weight-adjusted-waist index and physical activity with insulin resistance in adolescents: a cross-sectional study

Joint association of weight-adjusted-waist index and physical activity with insulin resistance in adolescents: a cross-sectional study

Turning Points in Cross-Disciplinary Perspective of Primary Hyperparathyroidism and Pancreas Involvements: Hypercalcemia-Induced Pancreatitis, MEN1 Gene-Related Tumors, and Insulin Resistance

Association Between Primary Hyperparathyroidism and Secondary Diabetes Mellitus: Findings From a Scoping Review

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