Primary Hyperparathyroidism Link to Metabolic Syndrome

You got your blood test results back and your doctor says your Calcium levels look high, that’s good, right? On the contrary, this is a signal that it’s time to see an endocrinologist.¹

High blood calcium levels can be an indicator that your parathyroid glands are malfunctioning.

Primary Hyperparathyroidism (PHPT) is a common condition that can lead to kidney malfunction and bone thinning. It ranks third in frequency after diabetes mellitus and thyroid diseases.¹ 

Primary hyperparathyroidism -an association with metabolic syndrome?

A recent study published in BMC Endocrine Disorders by researchers at Endocrinology Research Centre in Moscow, Russia, suggests that primary hyperparathyroidism might be more troubling than was thought, with a link to high cholesterol and elevated markers of insulin resistance. PHPT could be a symptom of or even a contributing factor to metabolic syndrome.²

Metabolic syndrome is a cluster of conditions, including obesity, heart disease, and diabetes. Symptoms include, among others, high blood pressure, high blood sugar, and high cholesterol levels.²

High cholesterol and insulin resistance

The researchers hypothesized that hyperparathyroidism might contribute to the development of metabolic syndrome. They also considered whether parathyroid surgery could alleviate symptoms of both PHPT and metabolic syndrome. ² 

In fact, when they compared PHPT patients to a control group of similar BMI age, and sex, they found little difference in metabolic measures other than that PHPT patients had higher serum triglycerides. PHPT patients also had higher levels of markers associated with insulin resistance. 

The researchers found that patients with PHT had higher levels of low-density lipoprotein (LDL) cholesterol (“bad” cholesterol), and lower levels of high-density lipoprotein (HDL) cholesterol (“good” cholesterol) than the control group.

In fact, abnormal blood lipid levels were seen in more than half of PHT participants.²

Blood glucose regulation was also disrupted in patients with PHPT, potentially increasing the risk of developing diabetes. 

PHTP increases the risk of Type 2 Diabetes

The PHPT patients were tested again a year after having their parathyroid glands surgically removed. Encouragingly this time, the patients had lower levels of fasting glucose and insulin; however, there was no change in body weight or cholesterol levels. 

 It seems that while PHPT might have a contributing effect on developing type 2 diabetes, it is not a cause of metabolic syndrome.

Although more research is needed to fully understand the relationship between hyperparathyroidism and metabolic disorders, it is important that people with hyperparathyroidism know that high BMI and PHPT together increase the risk of developing insulin resistance.

 References

1. Madkhali T, Alhefdhi A, Chen H, Elfenbein D. Primary hyperparathyroidism. Turkish Journal of Surgery. 2016;32(1):58-66. doi:https://doi.org/10.5152/ucd.2015.3032
2. Bibik E, Ekaterina Dobreva, Ajnetdinova AR, et al. Primary hyperparathyroidism in young patients is associated with metabolic disorders: a prospective comparative study. BMC Endocrine Disorders. 2023;23(1). doi:https://doi.org/10.1186/s12902-023-01302-9