Carotid Intima-Media Thickness, Adrenomedullin, and Pentraxin-3 as Indicators of Subclinical Cardiovascular Risk in Primary Hyperparathyroidism: Early Response to Parathyroidectomy

Abstract

Objective: Primary hyperparathyroidism (PHPT) has been linked to adverse cardiovascular (CV) remodeling and atherosclerosis. We assessed subclinical CV disease in PHPT using carotid intima-media thickness (CIMT), and serum adrenomedullin (ADM) and pentraxin‑3 (PTX3) concentrations, and explored early changes after parathyroidectomy.
Methods: In this case–control study, adults with PHPT (n=40) and healthy controls (n=23) underwent clinical assessment, laboratory testing, and high‑resolution carotid ultrasound. A subset of PHPT patients who had surgery (n=22) were reassessed 3 months post‑parathyroidectomy. Serum ADM and PTX3 were measured by ELISA. Group differences and pre/post comparisons used parametric or non‑parametric tests as appropriate; correlations used Spearman’s rho. Significance was set at p<0.05.
Results: Compared with controls, the PHPT group had higher CIMT and PTX3 and lower ADM (p=0.009, p=0.029 and p<0.001, respectively). Post‑parathyroidectomy, ADM increased significantly versus preoperative values (p=0.004), whereas CIMT and PTX3 showed no significant short‑term change (p=0.632 and p=0.547, respectively). Changes in ADM didn’t correlate with CIMT or biochemical variables.
Conclusions: PHPT was associated with alterations in CIMT, ADM, and PTX3, suggesting a potential increase in subclinical CV risk. ADM increased 3 months after surgery, while CIMT and PTX3 were unchanged at this early time point. These markers may have potential utility in the assessment of subclinical CV alterations in PHPT; however, their predictive value requires confirmation in larger, adequately powered studies.

Keywords

• Primary hyperparathyroidism
• Carotid intima-media thickness
• Adrenomedullin
• Pentraxin-3
• Cardiovascular disease
• Parathyroidectomy

Supporting Institution

This work was supported by the Scientific Research Fund of Necmettin Erbakan University.

Ethical Statement

This study was approved by the Ethics Committee of Necmettin Erbakan University (NEU) Medical Faculty (Approval No: 2024/4772, Date: 02.02.2024).

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