Serum Lipoprotein Disturbances in Primary and Secondary Hyperparathyroidism and Effects of Parathyroidectomy

Serum lipoprotein disturbances were studied in 86 patients with primary (I°), and 34 hemodialysis patients with severe secondary (II°), hyperparathyroidism (HPTH) before and seven to 14 days after parathyroidectomy (PTx). In addition, a subset of patients had repeat studies more than 12 months after PTx. In patients with I° as well as with II° HPTH, mean ± SEM fasting serum concentrations of total triglycerides (TG) (1.51 ± 0.09 and 2.17 ± 0.19 mmol/L, respectively) were significantly increased when compared with that of 22 age- and sex-matched healthy control subjects (1.01 ± 0.09 mmol/L, P < .001). No consistent anomalies of serum total cholesterol and lipoprotein cholesterol content were observed in I° HPTH patients. In uremic II° HPTH patients, the cholesterol content of high-density lipoprotein (HDL) was significantly (P < .01) depressed, compared with normal subjects. In the short term, PTx normalized serum total TGs (P < .001) in I° HPTH patients from 1.50 ± 0.11 to 1.19 ± 0.07 mmol/L seven days after PTx. The surgical correction of II° HPTH in dialysis patients was also followed by an improvement of hypertriglyceridemia from 2.22 ± 0.21 to 1.46 ± 0.08 mmol/L and 1.46 ± 0.09 mmol/L seven and 14 days, respectively, after PTx (P < .01). Long-term follow-up after PTx shows clearly a persistent decrease in serum TG concentration in I° HPTH patients (1.17 ± 0.11 mmol/L), as well as in II° HPTH patients (1.61 ± 0.18 mmol/L),12 months after PTx by comparison with values determined before PTx. The other lipid parameters that were changed during the short-term follow-up after surgery were not found significantly modified 1 year after PTx. In conclusion, both I° and II° HPTH have associated disturbances of triglyceride metabolism that can be corrected by PTx.