Our Summary

Primary hyperparathyroidism (PHPT) is a disorder that is linked with inflammation throughout the body and changes in metabolism. This study examined changes in two indexes, the Systemic Immune-Inflammation Index (SII) and Prognostic Nutritional Index (PNI), after patients with PHPT underwent a surgery to remove their parathyroid glands, and how these changes compared to healthy individuals.

Between January 2010 and March 2022, the researchers looked at the demographic information, clinical symptoms, and lab results of patients who had been diagnosed with PHPT, had the surgery, and compared them to healthy individuals. They recorded the patients’ health status at least six months after their surgery. They also classified bone mineral density according to World Health Organization standards and checked for kidney stones using imaging techniques.

After excluding certain patients, the study included 415 PHPT patients and 410 healthy individuals. The PHPT patients were generally older and had a higher proportion of women. Compared to the healthy individuals, the PHPT patients had lower levels of certain nutrients and compounds in their blood, including phosphorus, albumin, “good” cholesterol, total cholesterol, hemoglobin, and PNI. On the other hand, they had higher levels of fats, monocytes, platelets, C-reactive protein (an inflammation marker), and SII.

Following the surgery, the patients’ levels of albumin, platelets, total cholesterol, and fats increased, while their levels of calcium, white blood cells, neutrophils, lymphocytes, and C-reactive protein decreased. These changes brought the patients’ levels closer to those seen in the healthy individuals. In comparing similar age and sex groups, the researchers found that platelets and hemoglobin were higher after surgery.

In conclusion, before surgery, PHPT patients had significantly different SII and PNI levels compared to healthy individuals. However, after surgery, these levels and other markers improved significantly, suggesting that the procedure helped reduce inflammation and improve nutritional status in these patients.

FAQs

  1. What is the purpose of this study on parathyroidectomy in PHPT patients?
  2. What changes were observed in PHPT patients after they underwent parathyroidectomy?
  3. How did the preoperative SII and PNI levels in PHPT patients compare to healthy controls?

Doctor’s Tip

A helpful tip a doctor might tell a patient about parathyroidectomy is to closely monitor and follow up on their calcium levels post-surgery. It is important to ensure that calcium levels are within the normal range to prevent complications such as hypocalcemia or hypercalcemia. Additionally, maintaining a healthy diet and lifestyle can help support the healing process and overall well-being after the procedure.

Suitable For

Patients with primary hyperparathyroidism (PHPT) who are recommended parathyroidectomy typically have symptoms such as hypercalcemia, kidney stones, osteoporosis, fatigue, weakness, and other complications related to high levels of parathyroid hormone. They may also have abnormalities in their laboratory results, including high calcium levels, low phosphorus levels, and high levels of parathyroid hormone. Patients with PHPT who do not respond to medical management or have severe symptoms are often candidates for parathyroidectomy.

Timeline

  • Patients are diagnosed with primary hyperparathyroidism (PHPT) based on clinical findings and laboratory results.
  • Patients undergo parathyroidectomy (PTX) surgery to remove the overactive parathyroid gland(s).
  • Postoperatively, patients experience changes in various laboratory values such as phosphorus, albumin, cholesterol levels, hemoglobin, and inflammatory markers.
  • Bone mineral density and presence of nephrolithiasis are also assessed postoperatively.
  • In the months following surgery, patients show improvements in systemic inflammation and nutritional status, as indicated by changes in Systemic Immune-Inflammation Index (SII) and Prognostic Nutritional Index (PNI).
  • These improvements bring patients’ values closer to those of healthy controls, indicating a successful outcome of the parathyroidectomy.

What to Ask Your Doctor

Some questions a patient should ask their doctor about parathyroidectomy include:

  1. What are the potential risks and complications of parathyroidectomy?
  2. How will my calcium levels be monitored after surgery?
  3. How long is the recovery period after parathyroidectomy?
  4. Will I need to take calcium or vitamin D supplements after the surgery?
  5. How will parathyroidectomy affect my bone health and risk of osteoporosis?
  6. Will I need to make any lifestyle changes after the surgery?
  7. What is the success rate of parathyroidectomy for treating primary hyperparathyroidism?
  8. How soon after surgery can I expect to see improvements in my symptoms?
  9. Are there any long-term effects or considerations I should be aware of after parathyroidectomy?
  10. Are there any alternative treatments or approaches to managing primary hyperparathyroidism that I should consider?

Reference

Authors: Karadeniz Y, Karakose M. Journal: Medicina (Kaunas). 2025 Jul 8;61(7):1236. doi: 10.3390/medicina61071236. PMID: 40731865