title: Changes in serum leptin and adiponectin concentrations and insulin resistance after curative parathyroidectomy in moderate to severe primary hyperparathyroidism.
abstract: BACKGROUND
  Primary hyperparathyroidism (PHPT) is considered a state of insulin resistance. However, it is unclear whether the state of insulin resistance and adverse levels of adipocytokines are reversed in PHPT patients who have undergone curative parathyroidectomy.
  
  
  METHODS
  Ten consecutive patients with PHPT were studied at baseline and three months after curative parathyroid surgery in this prospective interventional study. Fasting blood calcium, intact parathyroid hormone (PTH), glucose, insulin, adiponectin and leptin concentrations were measured. Insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA- IR) and insulin sensitivity, by the quantitative insulin sensitivity check index (QUICKI).
  
  
  RESULTS
  Four out of the ten patients were male. The mean age of the patients was 32.40 +/- 11.42 years, and the mean body mass index was 23.70 +/- 5.19 kg/m2. The HOMA-IR value was found to be higher, while the QUICKI value was significantly lower before surgery in patients with PHPT compared to the published reference ranges. Serum leptin concentrations were higher in patients with PHPT than in normal healthy individuals; however, there was no difference in the adiponectin concentrations. There was no statistical difference in the mean values of fasting plasma glucose, plasma insulin, leptin, adiponectin, as well as the HOMA-IR and QUICKI estimates three months postoperatively, as compared to the preoperative measures.
  
  
  CONCLUSIONS
  Peripheral insulin resistance/sensitivity and the concentrations of leptin and adiponectin did not change three months after curative parathyroidectomy.
authors.affiliation: Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012, India. bhadadask@gmail.com
authors.forename: S K
authors.initials: SK
authors.lastname: Bhadada
authors.forename: A
authors.initials: A
authors.lastname: Bhansali
authors.forename: V N
authors.initials: VN
authors.lastname: Shah
authors.forename: D S
authors.initials: DS
authors.lastname: Rao
mesh_terms: D054392:Adipokines / Q000378:metabolism; D052242:Adiponectin / Q000097:blood* / Q000378:metabolism; D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002118:Calcium / Q000097:blood; D005260:Female; D005947:Glucose / Q000378:metabolism; D006801:Humans; D006961:Hyperparathyroidism / Q000097:blood* / Q000601:surgery*; D007328:Insulin / Q000097:blood / Q000378:metabolism; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood* / Q000378:metabolism; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy / Q000379:methods*
chemical_list: D054392:Adipokines; D052242:Adiponectin; D001786:Blood Glucose; D007328:Insulin; D020738:Leptin; D010281:Parathyroid Hormone; D005947:Glucose; D002118:Calcium