Русский
Pathology of carbohydrate metabolism in primary hyperparathyroidism: Epidemiological and clinical characteristics
DOI: https://dx.doi.org/10.18565/therapy.2023.9.62-69
Bibik E.E., Dobreva E.A., Eremkina A.K., Mokrysheva N.G.
National Medical Research Center for Endocrinology, Moscow
Aim: to determine the frequency and describe the clinical features of carbohydrate metabolism disorders in patients with PHPT.
Material and methods. A single-center retrospective study was performed based on medical records of 367 patients with PHPT, assessing the main indicators of mineral and carbohydrate metabolism before surgical treatment of the disease. The frequency of various disorders of carbohydrate metabolism in PHPT, the comparative characteristics of mineral parameters in patients with and without them, as well as the severity of type 2 diabetes mellitus (T2 DM) in PHPT were determined. In addition, potential relationships between the parameters of various types of metabolism have been studied.
Results. The overall incidence of prediabetic disorders was 4,9% (95% CI: 3–8). T2 DM was previously diagnosed in 45 patients (12%; 95% CI: 9–16), there were no cases of first diagnosed DM. Individuals with impaired carbohydrate metabolism had a statistically significantly higher BMI and lower values of osteocalcin: 27,2 [24,2; 30,4] vs. 32,7 [28,1; 39,4] kg/m2 and 48,1 [34; 76,3] vs. 33,1 [20,8; 51,8] ng/ml, respectively (for all parameters p <0,001). Among patients with T2 DM, 36 people (80%) took hypoglycemic therapy, 14 of which received metformin monotherapy and 8 received two-component therapy, including metformin. 5 people were on insulin therapy. Diabetic nephropathy was diagnosed in 36,4% of patients, 15,4% had signs of diabetic retinopathy, symptoms of diabetic distal neuropathy were observed in 61,9% of patients with PHPT. Fasting glucose and HbA1c were negatively correlated with bone metabolism, and also expectedly depended on the glomerular filtration rate.
Conclusion. Among patients with PHPT, T2 DM is more common than in the general population. The likely reason of this may be insulin resistance, that can be caused by the effects of bone metabolites, primarily osteocalcin. In most cases, metformin makes it possible to achieve compensation for T2 DM in PHPT.
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About the Autors
Ekaterina E. Bibik, researcher, endocrinologist at the Department of pathology of the parathyroid glands and mineral metabolism disorders, National Medical Research Center for Endocrinology. Address: 115478, Moscow, 11 Dmitriya Ulyanova St.
E-mail: bibik.ekaterina@endocrincentr.ru
ORCID: http://orcid.org/0000-0001-5952-5846
Ekaterina A. Dobreva, PhD in Medical Sciences, senior researcher at the Department of pathology of the parathyroid glands and mineral metabolism disorders, National Medical Research Center for Endocrinology. Address: 115478, Moscow, 11 Dmitriya Ulyanova St.
E-mail: dobreva.ekaterina@endocrincentr.ru
ORCID: https://orcid.org/0000-0002-8916-7346
Anna K. Eremkina, PhD in Medical Sciences, head of the Department of pathology of the parathyroid glands and mineral metabolism disorders, National Medical Research Center for Endocrinology. Address: 115478, Moscow, 11 Dmitriya Ulyanova St.
E-mail: eremkina.anna@endocrincentr.ru
ORCID: https://orcid.org/0000-0001-6667-062X
Natalya G. Mokrysheva, MD, professor, corresponding-member of RAS, director of National Medical Research Center for Endocrinology. Address: 115478, Moscow, 11 Dmitriya Ulyanova St.
ORCID: https://orcid.org/0000-0002-9717-9742
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