The influence of parathyroidectomy on cardiometabolic risk factors in patients with primary hyperparathyroidism: a systematic review and meta-analysis

Abstract

Purpose Primary hyperparathyroidism (PHPT) is associated with increased risk of cardiovascular morbidity and mortality. We aim to determine whether parathyroidectomy (PTX) can change cardiometabolic risk factors including serum lipids, glycemic parameters, systolic and diastolic blood pressure, C reactive protein (CRP), and body mass index (BMI). Methods MEDLINE, Web of Science, Scopus, and Google Scholar were searched for relevant articles published till June 2020. Fixed-effect or random-effects models were used to estimate the weighted mean difference (WMD) and 95 CI for outcomes where applicable. Results In total, 34 studies were eligible to be included in the current meta-analysis. Our results indicated no favorable change in serum triglyceride (n = 13, WMD = -0.06, 95 CI: -0.15, 0.03 mmol/L), total cholesterol (n = 15, WMD = 0.01, 95 CI: -0.14, 0.16 mmol/L), LDL-C (n = 10, WMD = -0.01, 95 CI: -0.17, 0.19 mmol/L), HDL-C (n = 10, WMD = 0.03, 95 CI: -0.001, 0.06 mmol/L), and CRP (n = 5, WMD = 0.82, 95 CI: -0.01, 1.64 mg/L) after PTX in PHPT patients. However, glucose (n = 24, WMD = -0.16, 95 CI: -0.26, -0.06 mmol/L), serum insulin (n = 12, WMD = -1.11, 95 CI: -1.73, -0.49 mu IU/mL), systolic (n = 17, WMD = -10.14, 95 CI: -12.27, -8.01 mmHg), and diastolic (n = 16, WMD = -5.21, 95 CI: -7.0, -3.43 mmHg) blood pressures were decreased after PTX, whilst a significant increase was observed in BMI (n = 13, WMD = 0.35, 95 CI: 0.19, 0.51 kg/m(2)). Conclusions PTX could improve glycemic parameters and blood pressure, without any significant change in serum lipoproteins and CRP.