Effect of parathyroidectomy on epicardial fat thickness as a cardiovascular risk factor in patients with primary hyperparathyroidism
Background/aim
Several  studies  demonstrated  that  primary  hyperparathyroidism  is  related  to  increased  risk  for  cardiovascular  diseases (CVDs), and risk is decreased by parathyroidectomy. Epicardial fat thickness (EFT) has been postulated as a new marker of CVD risk. We evaluated the impact of parathyroidectomy on EFT in patients with primary hyperparathyroidism (PHPT).


Materials and methods
Thirty-four  PHPT  patients  (29  female,  5  male)  and  28  age-  and  sex-matched  controls  (19  female,  9  male)  were included in the study. Demographic, anthropometric, and biochemical data were recorded both before parathyroidectomy and 6 months after the procedure. Epicardial fat thickness was measured by transthoracic echocardiography.


Results
Mean  age  was  53.15  ±  8.44  years.  Mean  preoperative  EFT  was  higher  than  mean  EFT  in  the  control  group  (0.49  ±  0.07  cm  to  0.46  ±  0.08  cm,  P:  0.0005),  and  EFT  decreased  after  parathyroidectomy  (0.49  ±  0.07  cm  to  0.44  ±  0.08  cm,  P:  0.0005).  Systolic  blood pressure and calcium, parathormone, and hsCRP levels decreased after parathyroidectomy (P < 0.05). Vitamin D levels increased (P  <  0.05).  Diastolic  blood  pressure,  body  mass  index,  carotid  intima-media  thickness,  and  HOMA-IR,  fasting  plasma  glucose,  and  phosphorus levels were unchanged after parathyroidectomy (P > 0.05). Preoperatively, EFT was correlated with SBP (r: 0.360, P: 0.0285) and age (r: 0.466, P: 0.0036). Multiple linear regression used to identify independent predictors of change in epicardial fat did not find any predictor of change in epicardial fat (P > 0.05).


Conclusion
EFT was decreased by parathyroidectomy in patients with primary hyperparathyroidism.However, the decrease in EFT was not correlated with any of the cardiovascular risk factors. More comprehensive studies evaluating the potential relation between PHPT and EFT need to be conducted.
['Kızılgül|Muhammed|M|0000-0002-8468-9196', 'Çalışkan|Mustafa|M|0000-0003-0342-571X', 'Beysel|Selvihan|S|0000-0001-6963-1503', 'Özbek|Mustafa|M|0000-0003-1125-3823', 'Çakal|Erman|E|0000-0003-4455-7276']
D052436:Adipose Tissue, White D002318:Cardiovascular Diseases D005260:Female D006801:Humans D049950:Hyperparathyroidism, Primary D008297:Male D008875:Middle Aged D016105:Parathyroidectomy D010496:Pericardium D011446:Prospective Studies D012307:Risk Factors
epicardial fat thickness Primary hyperparathyroidism cardiometabolic risk factors