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Updated: Jun 21, 2026

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Published on: July 14, 2023
Endothelial function and endothelial nitric oxide synthase intron 4a/b polymorphism in primary hyperparathyroidism.
A Ekmekci1, N Abaci, N Colak Ozbey
1Department of Medicine, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
Primary hyperparathyroidism (pHT) impairs endothelial function, which improves after parathyroid surgery. The endothelial nitric oxide synthase (eNOS) intron 4a/b polymorphism does not appear to influence this endothelial dysfunction in pHT patients.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Genetics
Background:
- Symptomatic primary hyperparathyroidism (pHT) is linked to increased cardiovascular risks.
- Endothelial nitric oxide synthase (eNOS) intron 4a/b polymorphism is implicated in cardiovascular diseases.
- Endothelial dysfunction is a key factor in cardiovascular morbidity.
Purpose of the Study:
- To assess endothelial function in pHT patients pre- and post-surgery.
- To investigate the role of eNOS intron 4a/b polymorphism in pHT-related endothelial dysfunction.
Main Methods:
- Flow-mediated dilation (FMD) of the brachial artery was used to measure endothelial function.
- Forty pHT patients and 43 healthy controls were included.
- eNOS4a/b polymorphism was analyzed using polymerase chain reaction.
Main Results:
- Pre-operative FMD was significantly lower in pHT patients compared to controls.
- FMD improved significantly post-parathyroidectomy but remained lower than controls.
- Increased serum calcium and PTH levels predicted lower FMD; eNOS4a/b polymorphism did not.
Conclusions:
- Successful parathyroid surgery improves endothelial function in pHT patients.
- eNOS4a/b polymorphism does not appear to significantly modify endothelial function in this patient group.
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