The Influence of Parathyroidectomy on Cardiometabolic Risk Factors in Patients With Primary Hyperparathyroidism: A Systematic Review and Meta-Analysis Publisher Pubmed



Yavari M¹ ; Feizi A² ; Haghighatdoost F³ ; Ghaffari A⁴ ; Rezvanian H¹ Show Affiliations
Source: Endocrine Published:2021

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. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.