Effect of Surgery on Cardiovascular Risk Factors in Mild Primary Hyperparathyroidism

Context: Mild primary hyperparathyroidism (pHPT) seems to have a good prognosis, and indications for active treatment (surgery) are widely discussed. The extraskeletal effects of PTH, such as insulin resistance, arterial hypertension, and cardiovascular (CV) risk, may however be reversible by operation. Objective: Our aim was to study biochemical markers of bone turnover, indices of the metabolic syndrome, and various risk markers for CV disease in patients with mild pHPT randomized to observation without surgery or operative treatment and followed for 2 yr. Design/Setting/Patients: A total of 116 patients (mean age, 63 ± 8 yr; 19 men and 97 women) who on May 1, 2008, had performed the 2-yr visit in a randomized study on mild pHPT (serum calcium at baseline, 2.69 ± 0.11 mmol/liter) and where frozen samples were available from baseline and follow-up participated in the study. Results: Calcium and PTH levels were normalized after surgery, and biochemical markers of bone turnover decreased by 35%, followed b...