title: The impact of parathyroidectomy on serum ADAMTS1, ADAMTS4 levels, insulin resistance, and subclinical cardiovascular disease in primary hyperparathyroidism.
abstract: OBJECTIVE
  Primary hyperparathyroidism has been associated with increased incidence of morbidity and mortality of the cardiovascular system. The etiopathogenetic mechanisms underlying this association are still not completely clear. Accumulating evidence suggested that a disintegrin and metalloproteinase with thrombospondin-like motifs (ADAMTS) has a role in the development of inflammation and atherosclerosis. In this study, we aimed to determine whether there is a change in serum levels of ADAMTS1, ADAMTS4, carotid intima-media thickness, and cardiovascular risk score after the surgery and also whether there is a relationship between ADAMTS levels and cardiovascular risk score in hypercalcemic primary hyperparathyroidism patients.
  
  
  METHODS
  The study included the 48 consecutive newly diagnosed patients with primary hyperparathyroidism. The patients were evaluated before and six months after parathyroidectomy. The Framingham score is used to calculate cardiovascular risk. Serum ADAMTS levels were determined by a human enzyme-linked immunoassay in all subjects.
  
  
  RESULTS
  The fasting glucose, fasting insulin levels and HOMA values were decreased significantly in all patients after surgery compared to the pretreatment values (p < 0.05). ADAMTS1, ADAMTS4, and carotid intima-media thickness levels were significantly lower after surgical correction of primary hyperparathyroidism compared to the preoperative values (p < 0.05). cardiovascular risk score was decreased after parathyroidectomy however, the difference were not statistical significant (p > 0.05). There were statistically significant relationship between cardiovascular risk score and waist/hip ratio, calcium, LDL-cholesterol, carotid intima-media thickness, ADAMTS4 values.
  
  
  CONCLUSIONS
  Based on the results of the present study, fasting glucose, fasting insulin levels, ADAMTS1, ADAMTS4, and carotid intima-media thickness might be an additional parameters during the management of patients with primary hyperparathyroidism, since these factors might improve after surgery.
authors.affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey. meliakarakose@yahoo.com.
authors.forename: Melia
authors.initials: M
authors.lastname: Karakose
authors.affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Caliskan
authors.affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Muyesser Sayki
authors.initials: MS
authors.lastname: Arslan
authors.affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Taner
authors.initials: T
authors.lastname: Demirci
authors.affiliation: Department of Nephrology, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Suleyman
authors.initials: S
authors.lastname: Karakose
authors.affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
authors.forename: Erman
authors.initials: E
authors.lastname: Cakal
mesh_terms: D000071097:ADAMTS1 Protein / Q000097:blood*; D000071121:ADAMTS4 Protein / Q000097:blood*; D000328:Adult; D001786:Blood Glucose; D002318:Cardiovascular Diseases / Q000097:blood*; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000097:blood / Q000601:surgery*; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D010281:Parathyroid Hormone; D000071097:ADAMTS1 Protein; D000071121:ADAMTS4 Protein
keywords: ADAMTS; Atherosclerosis; Insulin resistance; Parathyroidectomy; Primary hyperparathyroidism