title: Parathyroidectomy in asymptomatic primary hyperparathyroidism reduces carotid intima-media thickness and arterial stiffness.
abstract: OBJECTIVE
  Although an International Workshop has suggested that cardiovascular assessment in asymptomatic primary hyperparathyroidism (PHPT) patients is not necessary, improvements in risk factors of subclinical atherosclerosis have been shown following parathyroidectomy. The objectives of this study were to determine whether parathyroidectomy in asymptomatic PHPT patients causes any change in carotid intima-media thickness (CIMT), arterial stiffness [pulse wave velocity (PWV)] and soluble CD40 ligand (sCD40L) levels.
  
  
  METHODS
  Prospective study evaluating female patients diagnosed with asymptomatic PHPT in a single centre over a 6-month period.
  
  
  METHODS
  A total of 48 subjects were included: 17 hypercalcaemic (HC, mean age: 51 ± 8 years, Ca: 2·73 ± 0·17 mmol/l) and 16 normocalcaemic (NC, mean age: 58 ± 7 years, Ca: 2·30 ± 0·10 mmol/l) PHPT patients, and 15 healthy controls (mean age: 52 ± 4 years, Ca: 2·27 ± 0·07 mmol/l).
  
  
  METHODS
  Biochemical tests, CIMT, PWV and sCD40L levels were compared at baseline and 6 months after parathyroidectomy (PTx).
  
  
  RESULTS
  At baseline, CIMT and PWV values in the HC and NC patients were higher than in the control group. While there was a significant reduction in CIMT (601 ± 91 μm vs 541 ± 65 μm, P = 0·006) and PWV (9·6 ± 1·8 vs 8·4 ± 1·5 m/s, P = 0·000) in the hypercalcaemic group at the end of the 6th month after PTx, no change was observed in normocalcaemic group (P = 0·686 and P = 0·196 respectively). No differences were observed in sCD40L levels between patient and control groups or between baseline and 6 months in patients undergoing parathyroidectomy.
  
  
  CONCLUSIONS
  Parathyroidectomy leads to an improvement in the structural and functional impairment associated with atherosclerosis in the vascular wall in asymptomatic hypercalcaemic PHPT patients.
authors.affiliation: Division of Endocrinology and Metabolism, Yunusemre State Hospital, Eskişehir, Turkey.
authors.forename: Güven Barış
authors.identifier: http://orcid.org/0000-0003-2606-1103
authors.initials: GB
authors.lastname: Cansu
authors.affiliation: Division of Endocrinology and Metabolism, Şırnak State Hospital, Şırnak, Turkey.
authors.forename: Nusret
authors.initials: N
authors.lastname: Yılmaz
authors.affiliation: Department of Biochemistry, School of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Sebahat
authors.initials: S
authors.lastname: Özdem
authors.affiliation: Division of Endocrinology and Metabolism, School of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Mustafa Kemal
authors.initials: MK
authors.lastname: Balcı
authors.affiliation: Division of Nephrology, School of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Gültekin
authors.initials: G
authors.lastname: Süleymanlar
authors.affiliation: Department of General Surgery, School of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Cumhur
authors.initials: C
authors.lastname: Arıcı
authors.affiliation: Department of Nuclear Medicine, School of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Adil
authors.initials: A
authors.lastname: Boz
authors.affiliation: Division of Endocrinology and Metabolism, School of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Sarı
authors.affiliation: Division of Endocrinology and Metabolism, School of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Hasan Ali
authors.initials: HA
authors.lastname: Altunbaş
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000175:diagnosis / Q000503:physiopathology; D015992:Body Mass Index; D023201:CD40 Ligand / Q000097:blood; D002118:Calcium / Q000097:blood; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis / Q000503:physiopathology; D049950:Hyperparathyroidism, Primary / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D015999:Multivariate Analysis; D016105:Parathyroidectomy / Q000379:methods*; D011446:Prospective Studies; D063177:Pulse Wave Analysis; D012044:Regression Analysis; D059289:Vascular Stiffness
chemical_list: D023201:CD40 Ligand; D002118:Calcium