Comparison of Profile of Primary Hyperparathyroidism With and Without Type 2 Diabetes Mellitus: Retrospective Analysis From the Indian Primary Hyperparathyroidism Registry

Poonam Kumari; Ashutosh Kumar Arya; Rimesh Pal; Ashwani Sood; Divya Dahiya; Soham Mukherjee; Ashu Rastogi; Sanjay Kumar Bhadada

doi:10.1016/j.eprac.2021.09.012

Comparison of Profile of Primary Hyperparathyroidism With and Without Type 2 Diabetes Mellitus: Retrospective Analysis From the Indian Primary Hyperparathyroidism Registry

Endocr Pract. 2022 Jan;28(1):96-101. doi: 10.1016/j.eprac.2021.09.012. Epub 2021 Sep 30.

Authors

Poonam Kumari¹, Ashutosh Kumar Arya¹, Rimesh Pal¹, Ashwani Sood², Divya Dahiya³, Soham Mukherjee¹, Ashu Rastogi¹, Sanjay Kumar Bhadada⁴

Affiliations

¹ Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
² Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
³ Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
⁴ Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: bhadadask@rediffmail.com.

PMID: 34601115
DOI: 10.1016/j.eprac.2021.09.012

Abstract

Objective: To describe the prevalence and compare the clinicobiochemical profile of patients with primary hyperparathyroidism (PHPT) with and without type 2 diabetes mellitus (T2DM).

Methods: We conducted a retrospective observational study wherein the details of patients with PHPT with T2DM (PHPT-T2DM) and without T2DM were retrieved from the Indian PHPT Registry (www.indianphptregistry.com) between 2005 and 2019. We compared the clinical, biochemical, and postoperative findings of patients with PHPT-T2DM with age-, sex-, and body mass index-matched patients with PHPT without T2DM (in 1:2 ratio).

Results: Of the 464 patients with PHPT, 54 (11.6%) had T2DM. We observed an increase in the prevalence of PHPT-T2DM cases over time; only 7 (7.1%) of the total patients with PHPT had T2DM between 2005 and 2009 that increased to 31 (12.8%) in the last half decade (2015-2019). Patients with PHPT-T2DM had a significantly lower prevalence of nephrolithiasis (18.5% vs 36.1%, respectively; P = .03) and a higher prevalence of pancreatitis (22.2% vs 5.6%, respectively; P = .007) than those without T2DM. Furthermore, intact parathyroid hormone (203 pg/mL [139.8-437.3 pg/mL] vs 285 pg/mL [166-692 pg/mL], respectively; P = .04) and serum creatinine (0.90 mg/dL [0.67-1.25 mg/dL] vs 1.10 mg/dL [0.73-1.68 mg/dL], respectively; P = .03) levels were significantly lower in patients with PHPT-T2DM than those without T2DM. Also, tumor weight tended to be lower in patients with PHPT-T2DM than in the non-T2DM counterparts (1.05 g [0.5-2.93 g] vs 2.16 g [0.81-7.0 g], respectively; P = .06).

Conclusion: The prevalence of T2DM in Asian Indians with PHPT is 11.6%. Patients with PHPT-T2DM are characterized by a higher prevalence of pancreatitis, a lower prevalence of nephrolithiasis, and lower levels of intact parathyroid hormone/creatinine. Part of the clinical picture can possibly be explained by early detection of PHPT in patients with T2DM consequent to more frequent screening.

Keywords: body mass index; hypercalcemia; primary hyperparathyroidism; type 2 diabetes.

Publication types

Observational Study

MeSH terms

Calcium
Diabetes Mellitus, Type 2* / complications
Diabetes Mellitus, Type 2* / epidemiology
Humans
Hyperparathyroidism, Primary* / complications
Hyperparathyroidism, Primary* / epidemiology
Parathyroid Hormone
Registries
Retrospective Studies

Substances

Parathyroid Hormone
Calcium