FIB-4 INDEX IN PATIENTS WITH PRIMARY HYPERPARATHYROIDISM: A CASE-CONTROL STUDY

Abstract

Objective: Although the target organs for primary hyperparathyroidism (PHPT) are the renal and skeletal systems, hyperparathyroidism has also been linked with metabolic syndrome as well as non-alcoholic fatty liver disease (NAFLD). This study aimed to evaluate metabolic parameters, and the fibrosis-4 index (FIB-4) among patients with PHPT. Material and Methods: This study included 30 patients with PHPT and 30 healthy controls. FIB-4 index was calculated for all participants whose metabolic parameters were recorded. In addition, according to the FIB-4 index, participants were divided into low and medium-high risk categories for fibrosis using a cut-off value of 1.3. The participants’ metabolic parameters and the FIB-4 indices were compared. Results: PHPT patients had a median age of 58 years (25–65), and 90% of them were female. Metabolic parameters (fasting plasma glucose, homeostasis model assessment of insulin resistance [HOMA-IR], and lipid parameters) did not vary across the groups (p>0.05). The PHPT group had a FIB-4 index value of 0.99 (0.36–1.51), and the control group 0.66 (0.41– 1.57) (p=0.030). The number of patients in the medium-high risk category was higher in the PHPT group than in the control group (p=0.040). Conclusion: PHPT patients showed higher FIB-4 index values and a greater frequency of medium-to-high non-invasive fibrosis risk than controls. However, as FIB-4 is an indirect surrogate marker, these findings should not be interpreted as confirmed hepatic fibrosis. Further prospective studies using direct or imaging-based methods are warranted.

Keywords

• Primary hyperparathyroidism
• parathyroid hormone
• fibrosis-4 index
• metabolic syndrome

Primer Hiperparatiroidizm Hastalarında FIB-4 İndeksi: Bir Vaka-Kontrol Çalışması

Abstract

Amaç: Primer hiperparatiroidizm (PHPT) başlıca renal ve iskelet sistemlerini etkilemekle birlikte, metabolik sendrom ve non-alkolik yağlı karaciğer hastalığı (NAFLD) ile de ilişkilendirilmiştir. Bu çalışmada, PHPT’li hastalarda metabolik parametrelerin ve fibrosis-4 indeksinin (FIB-4) değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya PHPT tanısı olan 30 hasta ve 30 sağlıklı kontrol dahil edildi. Tüm katılımcıların metabolik parametreleri kaydedildi ve FIB-4 indeksi hesaplandı. Katılımcılar, 1,3 kesim değeri temel alınarak düşük ve ortayüksek fibrozis riski kategorilerine ayrıldı. Bulgular: PHPT hastalarının medyan yaşı 58 yıl (25-65) olup, hastaların %90’ı kadındı. Açlık plazma glukozu, HOMA-IR ve lipid profili dahil olmak üzere metabolik parametreler gruplar arasında benzerdi (p>0,05). FIB-4 indeksi, kontrol grubuna kıyasla PHPT grubunda anlamlı olarak daha yüksekti (0,99 (0,36-1,51) ve 0,66 (0,41-1,57), p=0,030). Orta-yüksek risk kategorisindeki katılımcı oranı da PHPT grubunda daha yüksekti (p=0,040). Sonuç: PHPT hastalarında, kontrollere kıyasla daha yüksek FIB-4 indeks değerleri ve orta-yüksek non-invaziv fibrozis riski sıklığı gözlendi. Bununla birlikte, FIB-4 hepatik fibrozisi dolaylı olarak yansıtan bir belirteç olduğundan, bu bulgular doğrulanmış hepatik fibrozis kanıtı olarak değerlendirilmemelidir. Doğrudan ya da görüntüleme temelli yöntemlerin kullanıldığı ileri prospektif çalışmalara ihtiyaç vardır.

Keywords

• Primer hiperparatiroidizm
• paratiroid hormonu
• fibrosis-4 indeksi
• metabolik sendrom

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