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Hyperparathyroidism: is it really the major factor affecting glucose tolerance in uremia?
F Bergesio1, S Bandini, B Cresci
1Nephrology Department, USL 10/D, University of Florence, Italy.
Mineral and Electrolyte Metabolism
|January 1, 1996
Summary
Secondary hyperparathyroidism (sHPTH) impairs glucose tolerance in dialysis patients. While not always significant, elevated parathyroid hormone (PTH) levels can reduce insulin secretion, suggesting a PTH threshold effect.
Area of Science:
- Nephrology
- Endocrinology
- Metabolic Research
Background:
- Secondary hyperparathyroidism (sHPTH) is common in dialysis patients.
- The impact of sHPTH on glucose metabolism and insulin release requires further elucidation.
Purpose of the Study:
- To investigate the effects of varying parathyroid hormone (PTH) levels on glucose tolerance and insulin secretion in dialysis patients.
- To determine if a threshold exists for PTH's influence on carbohydrate metabolism.
Main Methods:
- Two groups of dialysis patients (normal PTH and elevated PTH) underwent an intravenous glucose tolerance test (IVGTT).
- Glucose (G), immunoreactive insulin (IRI), and C-peptide (C-p) levels were measured.
- Glucose decay constant (K) and relative incremental areas were calculated.
Main Results:
- All patients exhibited impaired glucose tolerance, irrespective of PTH levels.
- No significant differences in insulin secretion or K values were observed between normal and elevated PTH groups overall.
- A subgroup with severe sHPTH showed significantly lower K values and reduced insulin secretion compared to moderate sHPTH or normal PTH groups.
Conclusions:
- A threshold effect of PTH on insulin secretion may exist, impacting glucose tolerance in dialysis patients.
- Other factors beyond PTH levels likely modulate carbohydrate metabolism in this population.