title: Biomarkers of hypercoagulability and inflammation in primary hyperparathyroidism.
abstract: BACKGROUND
  Severe primary hyperparathyroidism (PHP) has been associated with increased cardiovascular morbidity. Hypertension, dyslipidemia and impaired glucose metabolism were demonstrated in severe PHP, with improvement after surgery in these variables. Such an association in mild PHP is not known. The study was conducted to determine biomarkers of hypercoagulability and inflammation for cardiovascular disease in patients with primary hyperparathyroidism.
  
  
  METHODS
  Patients (n=35) without CVD were evaluated. Patients were subdivided into two groups, severe (n=15) and mild (n=20) hyperparathyroidism, based on disease severity and whether they had indications for surgery. Results were compared with those obtained in 25, age and weight matched controls. Participants were examined in the hospital endocrine clinic and had measurement of fasting blood levels of calcium, phosphate, alkaline phosphatase, PTH, C-reactive protein, Serum IL-6, D-dimers, Fibrinogen, plasminogen activator inhibitor 1 [PAI-1], and white blood cells (WBC) count.
  
  
  RESULTS
  PAI-1 was significantly higher in symptomatic patients (41.4 g/L +/-20) vs. controls (32.5 g/L +/-13.0); (p=0.009). Levels of fibrinogen, d-dimers, IL-6, CRP and leukocytes were similar in patients and controls. Across all subjects PAI-1 was significantly correlated with PTH levels (f=8.44;p=0.005).
  
  
  CONCLUSIONS
  Patients with severe primary hyperparathyroidism have increased risk for cardiovascular disease, mainly due to the effect of PTH and also the duration and severity of disease. Elevated PAI-1 levels may imply that hypercoagulability may be involved in the pathogenesis of CVD in these patients.
authors.affiliation: Endocrine institute, Haemek Medical Center, Afula, Israel.
authors.forename: Elena
authors.initials: E
authors.lastname: Chertok-Shacham
authors.forename: Avraham
authors.initials: A
authors.lastname: Ishay
authors.forename: Idit
authors.initials: I
authors.lastname: Lavi
authors.forename: Rafael
authors.initials: R
authors.lastname: Luboshitzky
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers