The International Journal of Romanian Society of Endocrinology / Registered in 1938

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October - December 2015, Volume 11, Issue 4
Endocrine Care

Yilmaz BA, Balos Toruner F, Akyel A, Ercin U, Konca Degertekin C, Turhan Iyidir Ö, Tavil Y, Bilgihan A, Arslan M

Endothelial Dysfunction in Patients with Asymptomatic Primary Hyperparathyroidism

Acta Endo (Buc) 2015, 11 (4): 482-488
doi: 10.4183/aeb.2015.482

Context. Impaired flow mediated dilatation (FMD) and increased carotid intima media thickness (CIMT) are the antecedent forms of atherosclerosis. Objective. The aim of this study was to evaluate vascular structural and functional changes in patients with asymptomatic primary hyperparathyroidism (APHPT), and whether biochemical alterations, related with PHPT and oxidative stress marker serum advanced oxidation protein products (AOPPs), may have influence on vascular alterations. Design. This is a cross sectional clinical study. Subject and Methods: Thirty-four patients with APHPT and 29 sex- and age and cardiovascular risk factors matched control cases were included in this study. Endothelial function was evaluated by FMD of the brachial artery; CIMT was measured by ultrasonography; in addition serum AOPPs and biochemical parameters were determined. Results. Serum Ca levels were higher in the patient group [10.93±0.60mg/dL vs. 9.45±0.31; p<0.001]. FMD measurement was significantly lower in patients group [0.07 (0.01-0.26) % vs. 0.14 (0.04-0.22) %; p=0.01]. CIMT measurements were comparable between the groups [52 (35- 69) mm vs. 56 (38-70) mm; p=0.821]. AOPPs levels were significantly higher in the patients [136.43 (55.14-1352) mmol/L vs. 84 (53.18-595.48) mmol/L; p=0.026]. There were significant negative correlations between FMD and serum Ca (r=–0.339, p<0.001); and serum AOPPs levels (r=–0.275, p<0.005). Serum Ca (p=0.007, β=–0.353) and AOPPs (p=0.024, β=–0.243) levels and hyperlipidemia (p=0.024, β=–0.288) were the predictors of FMD. Conclusions. Vascular endothelial function is impaired in patients with APHPT. Hypercalcemia, increased oxidative stress and hyperlipidemia may have role in the pathogenesis of endothelial dysfunction in patients with APHPT.

Keywords: asymptomatic primary hyperparathyroidism, AOPPs, flow mediated dilatation, carotid intima media thickness, vasculary endothelium

Correspondence: Banu Aktas MD, Gazi University School of Medicine - Endocrinology and Metabolism, Department of Endocrinology and Metabolism, Gazi Üniversitesi Tip Fakültesi Endokrinoloji ve Metabolizma Hastaliklari BD 8.kat, Besevler Ankara, Ankara, 06100, Turkey, E-mail: