GLUCOSE AND LIPOPROTEIN METABOLISM IN PRIMARY HYPERPARATHYROIDISM. EFFECTS OF PARATHYROIDECTOMY

Abstract

Patients [15] with primary hyperparathyroidism due to parathyroid adenoma were subjected to an investigation on glucose and lipoprotein metabolism before operation and 3 and 12 mo. later. Hypercalcemia, hypophosphatemia and an increased urinary excretion of cyclic AMP were normalized after operation. The early insulin response to an i.v. glucose tolerance test was significantly lower after operation than before, but fasting serum-insulin levels did not differ. This change of the early insulin response was not reflected in any changes of the fasting blood-glucose concentration or the elimination rate of injected glucose. Subjects (11) had increased levels of very-low-density lipoproteins [VLDLP] before operation. The 1st change in lipoprotein concentrations after operation was a significant increase of high-density lipoproteins, occurring during the 1st 3 mo. Only thereafter did the VLDLP decrease to normal values and concomitant and low density lipoproteins increase. As lipoprotein lipase activity of adipose tissue did not change after the operation, the elevation of VLDLP before operation was probably caused by an increased production rate due to an increased lipolysis. This sequence of events, primarily due to a disorder of the metabolism of the VLDLP, was reflected in the whole serum lipids only as an increase of the cholesterol but not the triglyceride concentration.