甲状旁腺切除术对原发性甲状旁腺功能亢进症患者血清炎症和代谢功能障碍指标的影响

IF 1.6 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Archives of Endocrinology Metabolism Pub Date : 2024-11-06 eCollection Date: 2024-01-01 DOI:10.20945/2359-4292-2024-0124

Muzaffer Serdar Deniz, Nuriye Ozder, Omer Faik Ersoy, Zubeyde Ilke Narli

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Systemic inflammation was quantified using different indices, including the triglyceride-glucose (TyG) index, Fibrosis-4 (FIB-4) score, systemic immune-inflammation index (SII), monocyte-to-high-density lipoprotein cholesterol ratio (MHR), platelet-to-lymphocyte ratio (PLR), and platelet distribution width (PDW).Results: Significant pre-surgical to post-surgical decreases were observed in serum levels of mean normalized calcium (11 ± 0.65 mg/dL and 9.1 ± 0.42 mg/dL, respectively, p = 0.001) and parathyroid hormone (PTH) (235.5 ± 132.9 and 78.1 ± 60.5 ng/L, respectively, p = 0.001). The inflammatory indices changed substantially, with decreases in SII (from 564.8 ± 257.5 to 516.6 ± 201.1, p = 0.001) and PLR (from 143.0 ± 46.2 to 133.6 ± 38.6, p = 0.001). Additionally, PDW decreased from 52.8 ± 8.2% to 47.5 ± 9.3% (p = 0.001) and MHR increased from 7.19 ± 3.06 to 7.81 ± 3.13 (p = 0.001). 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引用次数: 0

摘要

目的本研究分析了甲状旁腺切除术后甲状旁腺功能亢进症（PHPT）患者血液学和生化指标所反映的全身炎症变化：对 70 例接受甲状旁腺根治性切除术治疗 PHPT 的患者进行回顾性研究。收集了有关临床表现、生化检测、影像学检查和术后结果的数据。采用不同的指数对全身炎症进行量化，包括甘油三酯-葡萄糖（TyG）指数、纤维化-4（FIB-4）评分、全身免疫炎症指数（SII）、单核细胞与高密度脂蛋白胆固醇比值（MHR）、血小板与淋巴细胞比值（PLR）和血小板分布宽度（PDW）：平均正常化钙（11 ± 0.65 mg/dL 和 9.1 ± 0.42 mg/dL，p = 0.001）和甲状旁腺激素（PTH）（分别为 235.5 ± 132.9 和 78.1 ± 60.5 ng/L，p = 0.001）的血清水平在手术前和手术后均显著下降。炎症指数变化很大，SII（从 564.8 ± 257.5 降至 516.6 ± 201.1，p = 0.001）和 PLR（从 143.0 ± 46.2 降至 133.6 ± 38.6，p = 0.001）均有所下降。此外，PDW 从 52.8 ± 8.2% 降至 47.5 ± 9.3% (p = 0.001)，MHR 从 7.19 ± 3.06 升至 7.81 ± 3.13 (p = 0.001)。其他炎症指标，包括 TyG 指数（p = 0.431）和 FIB-4 评分（p = 0.401）均无明显变化。逻辑回归分析发现，PDW（几率比[OR] 0.920，95% 置信区间[CI] 0.879-0.963，p = 0.001）和 PLR（OR 0.991，95% CI 0.983-1，p = 0.042）是预测炎症的重要指标：甲状旁腺切除术对 PHPT 患者的成功治疗可减少全身炎症，PDW 和 PLR 的降低就是证明。我们的研究结果表明，在 PHPT 术后评估中整合 PDW 和 PLR 对监测炎症活动非常重要。

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Effect of parathyroidectomy on serum inflammatory and metabolic dysfunction markers in patients with primary hyperparathyroidism.

Objective: This study analyzed systemic inflammatory changes reflected by hematologic and biochemical indices in patients with hyperparathyroidism (PHPT) after parathyroidectomy.

Materials and methods: Retrospective study of 70 patients who underwent curative parathyroidectomy for PHPT treatment. Data on clinical presentation, biochemical assays, imaging studies, and postoperative outcomes were collected. Systemic inflammation was quantified using different indices, including the triglyceride-glucose (TyG) index, Fibrosis-4 (FIB-4) score, systemic immune-inflammation index (SII), monocyte-to-high-density lipoprotein cholesterol ratio (MHR), platelet-to-lymphocyte ratio (PLR), and platelet distribution width (PDW).

Results: Significant pre-surgical to post-surgical decreases were observed in serum levels of mean normalized calcium (11 ± 0.65 mg/dL and 9.1 ± 0.42 mg/dL, respectively, p = 0.001) and parathyroid hormone (PTH) (235.5 ± 132.9 and 78.1 ± 60.5 ng/L, respectively, p = 0.001). The inflammatory indices changed substantially, with decreases in SII (from 564.8 ± 257.5 to 516.6 ± 201.1, p = 0.001) and PLR (from 143.0 ± 46.2 to 133.6 ± 38.6, p = 0.001). Additionally, PDW decreased from 52.8 ± 8.2% to 47.5 ± 9.3% (p = 0.001) and MHR increased from 7.19 ± 3.06 to 7.81 ± 3.13 (p = 0.001). No significant changes occurred in other inflammatory markers, including the TyG index (p = 0.431) and FIB-4 score (p = 0.401). Logistic regression analysis identified PDW (odds ratio [OR] 0.920, 95% confidence interval [CI] 0.879-0.963, p = 0.001) and PLR (OR 0.991, 95% CI 0.983-1, p = 0.042) as significant predictors of inflammation.

Conclusions: Successful parathyroidectomy in patients with PHPT reduces systemic inflammation, as evidenced by decreased PDW and PLR. Our results indicate the importance of integrating PDW and PLR in the postoperative assessment of PHPT for monitoring inflammatory activity.

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来源期刊

Archives of Endocrinology Metabolism Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

2.90

自引率

5.90%

发文量

107

审稿时长

7 weeks

期刊介绍： The Archives of Endocrinology and Metabolism - AE&M – is the official journal of the Brazilian Society of Endocrinology and Metabolism - SBEM, which is affiliated with the Brazilian Medical Association. Edited since 1951, the AE&M aims at publishing articles on scientific themes in the basic translational and clinical area of Endocrinology and Metabolism. The printed version AE&M is published in 6 issues/year. The full electronic issue is open access in the SciELO - Scientific Electronic Library Online e at the AE&M site: www.aem-sbem.com. From volume 59 on, the name was changed to Archives of Endocrinology and Metabolism, and it became mandatory for manuscripts to be submitted in English for the online issue. However, for the printed issue it is still optional for the articles to be sent in English or Portuguese. The journal is published six times a year, with one issue every two months.