Parathyroidectomy Restores Muscle Strength and Transcriptome in Individuals With Primary Hyperparathyroidism.

Area of Science:

• Endocrinology and Musculoskeletal Health

Background:

• Primary hyperparathyroidism causes hypercalcemia and muscle dysfunction, increasing morbidity and mortality.
• Skeletal muscle weakness is often overlooked in surgical guidelines for primary hyperparathyroidism.
• Parathyroidectomy is the only cure, but its effects on muscle are not well understood.

Purpose of the Study:

• To investigate the functional and molecular changes in skeletal muscle before and after parathyroidectomy in postmenopausal women with primary hyperparathyroidism.

Main Methods:

• A prospective observational study involving 15 postmenopausal women with primary hyperparathyroidism.
• Muscle function tests, muscle biopsies, MRI, and biochemical panels were assessed pre- and post-parathyroidectomy.
• Analysis included muscle composition, leg strength, and transcriptomic profiling of muscle biopsies.

Main Results:

• Parathyroidectomy normalized serum calcium levels and significantly improved muscle strength.
• Muscle volume increased and fat fraction decreased post-surgery, with no change in physical activity levels.
• Transcriptomic analysis revealed 981 differentially expressed genes, indicating pathways similar to exercise-induced adaptations.

Conclusions:

• Parathyroidectomy positively impacts skeletal muscle function and molecular profile.
• Muscle assessments should be considered in surgical referral criteria for primary hyperparathyroidism.
• Addressing muscle decline through surgical intervention can improve long-term patient outcomes.