Parathyroid diseases and metabolic syndrome

Abstract

Purpose Parathyroid diseases are related to parathyroid hormone (PTH) dysregulation by parathyroid cells or alteration of PTH function. They include hyperparathyroidism (PTH excess), hypoparathyroidism (PTH deficiency) and pseudohypoparathyroidism (PTH resistance). Little is known about correlation between parathyroid diseases and metabolic syndrome (MetS). Methods An electronic-based search using PubMed was performed until October 2022 and articles were selected based on relevance of title, abstract, English language and publication in peer-reviewed journals. Results Possible association between PTH alterations and the diverse manifestation of MetS have been proposed and it could be supposed that MetS may negatively influence parathyroid diseases. Available data show significant association for hyperparathyroidism and pseudohypoparathyroidism. Conclusions This review highlights the possible implications between MetS and parathyroid diseases. Given the increasing MetS global prevalence and the higher parathyroid diseases awareness and diagnosis, it may be interesting to further explore the possible role of alterations in parathyroid homeostasis in the development of MetS components with dedicated prospective studies.

The Mutual Interplay between Bone, Glucose and Lipid Metabolism: The Role of Vitamin D and PTH

“…As demonstrated in both hypercalcemic and normocalcemic PHPT, mild-to-moderate PTH increases may be associated with higher serum levels of fasting glucose, insulin, HOMA-IR, total and LDL-C and triglycerides; concomitant with normalization in serum PTH after surgery, a significant reduction in glucose and lipid parameters was observed [6,30,31]. Conversely, patients with more severe PHPT and higher serum PTH levels are more prone to weight loss independent of serum calcium, creatinine and nutritional status [7,32,33].…”

“…Conversely, PTH was negatively correlated with all the parameters associated with the adipose tissue in the highest tertile (147.0-2511.7 pg/mL), thus showing an inverted U-shape curve in its relationship with body weight, BMI and visceral area [7]. As far as lipid metabolism, an atherogenic profile is described in patients with PHPT [6]. Lower serum HDL-C, elevated triglycerides, very-low-density lipoprotein (VLDL) and LDL-C levels are described in both hypercalcemic and normocalcemic PHPT [5,6].…”

“…With reference to the parathyroid hormone (PTH), emerging clinical evidence suggests a direct association between the serum levels of the hormone, body weight and body mass index (BMI), as illustrated by studies in patients with primary hyperparathyroidism (PHPT), wherein a higher prevalence of metabolic syndrome is described [5][6][7]. Interestingly, a recent study by Yuan et al showed that these metabolic effects are seen for modest, incident increases in PTH, given that the relationships between this hormone, body weight and visceral adipose tissue are only significant in PHPT patients in the first tertile of PTH levels (21.4-65.8 pg/mL) [7].…”

“…As far as lipid metabolism, an atherogenic profile is described in patients with PHPT [6]. Lower serum HDL-C, elevated triglycerides, very-low-density lipoprotein (VLDL) and LDL-C levels are described in both hypercalcemic and normocalcemic PHPT [5,6]. Moreover, worst lipid profiles were observed in PHPT patients with serum PTH levels within the normal range [8].…”

The Nexus of Hyperparathyroidism and Thyroid Carcinoma: Insights into Pathogenesis and Diagnostic Challenges—A Narrative Review

“…HPT and PTC are common diseases [ 30 , 31 ]. HPT needs to be distinguished from other conditions, such as familial hypocalciuric hypercalcemia [ 32 ].…”