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Urate and arteriosclerosis in primary hyperparathyroidism
J Westerdahl1, S Valdemarsson, P Lindblom
1Departments of Surgery and Internal Medicine, Lund University Hospital, Lund, Sweden. johan.westerdahl@kir.lu.se
Objective:
An increased mortality due to cardiovascular disease has been reported in patients with primary hyperparathyroidism (pHPT). An association between urate and cardiovascular disease has been suggested. Metabolic abnormalities in pHPT may include urate. We therefore evaluated the metabolic arteriosclerotic risk profile in pHPT with special focus on the role of urate.
Design:
Retrospective analysis of data before and 1 year after surgery for pHPT.
Patients:
130 consecutive patients, over the age of 44 years, who underwent surgery for pHPT.
Measurements:
Biochemical variables known to reflect risk of arteriosclerotic disease (AD) and renal function tests including measurement of glomerular filtration rate (GFR) were investigated before and 1 year after surgery.
Results:
pHPT patients with AD (n = 40) were older and had higher serum levels of urate and triglyceride, and more impaired renal function in comparison with patients without AD. PTH and calcium values did not differ. Multiple logistic regression analysis indicated that urate was an independent risk factor for AD in pHPT (P < 0.01). Three variables were shown to be positively associated with urate; male gender (P < 0.01), fasting blood glucose (P < 0.05) and serum level of triglyceride (P < 0.05).
Conclusions:
Urate was found to be an independent risk factor for arteriosclerotic disease in primary hyperparathyroidism. Serum level of urate could (in addition to gender) be associated with a metabolic disorder comprising increased glucose and triglyceride levels.