Does Obesity Affect the Clinical Course and Accompanying Metabolic Disorders in Primary Hyperparathyroidism?

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice Pub Date : 2025-08-18 DOI:10.1155/ijcp/3021166

Işılay Kalan Sarı, Mehmet Aksoy

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Abstract

Several studies suggest an increased prevalence of obesity among patients with primary hyperparathyroidism (PHPT). Proposed mechanisms include parathyroid hormone (PTH) resistance, resistance to adipokines, and reduced lipolysis. Obesity may influence the clinical severity and presentation of PHPT. In addition to obesity, metabolic disorders such as diabetes mellitus and hypertension are also frequently observed in PHPT; however, the specific contribution of obesity to these comorbidities remains unclear. This study aimed to determine the prevalence of obesity in PHPT and to investigate its association with clinical presentation, laboratory parameters, and comorbid conditions. We retrospectively analyzed data from 152 patients with surgically confirmed PHPT. Patient records were reviewed for body mass index (BMI), laboratory values, coexisting metabolic conditions, and PHPT-related complications such as nephrolithiasis, osteoporosis, and fracture history. Among the patients, 20.4% had prediabetes, 13.8% had diabetes, and 34.9% had hypertension. Obesity (BMI ≥ 30 kg/m²) was present in 27%, and 36.8% were overweight. Thyroid nodules were found in 50.7%, and anti–thyroid peroxidase (anti-TPO) positivity was detected in 16.4%. Serum calcium and PTH levels were significantly higher in obese patients compared to those with normal BMI (p ≤ 0.001 and p = 0.017, respectively). There was no significant difference in the incidence of fractures, osteoporosis, or nephrolithiasis between the obese and nonobese groups. While diabetes was more prevalent in the nonobese group overall, subgroup analysis revealed a higher frequency of diabetes in overweight and obese patients compared to those with normal BMI. The prevalence of obesity in PHPT was higher than that in the general population. Although obesity was not associated with an increased frequency of osteoporosis, nephrolithiasis, or fractures, elevated serum calcium and PTH levels in obese patients may suggest a relationship with disease severity.

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肥胖是否影响原发性甲状旁腺功能亢进的临床病程和伴随的代谢紊乱？

一些研究表明，原发性甲状旁腺功能亢进（PHPT）患者中肥胖的患病率增加。提出的机制包括甲状旁腺激素（PTH）抵抗，对脂肪因子的抵抗和脂肪分解减少。肥胖可能影响PHPT的临床严重程度和表现。除了肥胖，代谢紊乱如糖尿病和高血压也经常在PHPT中观察到；然而，肥胖对这些合并症的具体影响尚不清楚。本研究旨在确定PHPT中肥胖的患病率，并探讨其与临床表现、实验室参数和合并症的关系。我们回顾性分析了152例手术确诊的PHPT患者的资料。回顾了患者的身体质量指数（BMI）、实验室值、共存的代谢状况和phpt相关的并发症，如肾结石、骨质疏松症和骨折史。其中糖尿病前期20.4%，糖尿病13.8%，高血压34.9%。27%的人肥胖（BMI≥30 kg/m2）， 36.8%的人超重。甲状腺结节占50.7%，抗甲状腺过氧化物酶（anti-thyroid peroxidase, tpo）阳性占16.4%。肥胖患者血清钙和甲状旁腺激素水平明显高于BMI正常患者（p≤0.001和p = 0.017）。肥胖组和非肥胖组在骨折、骨质疏松或肾结石的发生率上没有显著差异。虽然糖尿病在非肥胖组总体上更为普遍，但亚组分析显示，与BMI正常的患者相比，超重和肥胖患者患糖尿病的频率更高。PHPT患者的肥胖患病率高于普通人群。虽然肥胖与骨质疏松症、肾结石或骨折的发生频率增加无关，但肥胖患者血清钙和甲状旁腺激素水平升高可能与疾病严重程度有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Clinical Practice 医学-医学：内科

CiteScore

5.30

自引率

0.00%

发文量

274

审稿时长

3-8 weeks

期刊介绍： IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.