Parathyroidectomy Tied to Early Improvement in Inflammatory and Cardiovascular Risk Factors in PHPT: Study

"Parathyroidectomy in patients with primary hyperparathyroidism resulted in increased levels of HDL, platelet count, mean platelet volume, and vitamin D within a month following the surgery," the researchers reported in BMC Cardiovascular Disorders. "In contrast, levels of parathyroid hormone, calcium, and inflammatory markers such as the neutrophil-to-lymphocyte ratio and monocyte-to-HDL ratio decreased after the procedure, indicating that PTX can positively impact cardiovascular and inflammatory markers."

While some studies have indicated that parathyroidectomy can reduce cardiovascular risk factors, the findings have been inconsistent. In light of this, Nese Bulbul, Science and Technology University, Gaziantep, Turkey, and colleagues sought to assess inflammatory and cardiovascular risk markers in patients with primary hyperparathyroidism both before and one month following successful parathyroidectomy.

For this purpose, the researchers retrospectively analyzed patients with Primary Hyperparathyroidism who visited the outpatient clinic between 2015 and 2020. They recorded and compared various data points, including patient demographics, hemogram values, calcium, parathyroid hormone (PTH), vitamin D, high-density lipoprotein (HDL), mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-HDL ratio (MHR) before and after surgery.

The study revealed the following findings:

• Postoperative increases were observed in platelet count, MPV, HDL, PLR, and vitamin D levels. Conversely, PTH, calcium, NLR, and MHR levels significantly decreased.
• Correlation analysis showed a negative association between postoperative PTH and vitamin D (r = -0.292**), and a positive association between postoperative PTH and both calcium (r = 0.309**) and NLR (r = 0.227**).
• Multivariable regression analysis revealed that postoperative PTH levels were significantly associated with calcium (B = 39.82, Beta = 0.321, p = 0.0469), NLR (B = 110.02, Beta = 0.428), baseline comorbidity scores (B = -30.54, Beta = -0.287), and preoperative inflammation levels (B = 25.69, Beta = 0.311).

The study highlights a significant link between primary hyperparathyroidism and cardiovascular risk, as evidenced by the positive correlation between postoperative parathormone levels with both serum calcium and the neutrophil-to-lymphocyte ratio. Following successful parathyroidectomy, inflammatory markers such as NLR and the monocyte-to-HDL ratio decreased, while platelet count, mean platelet volume, high-density lipoprotein, 25-OH vitamin D (25-OH-D3), and the platelet-to-lymphocyte ratio increased.

"These findings suggest that parathyroidectomy may swiftly reverse cardiovascular and inflammatory risk factors. However, further research with longer follow-up is needed to evaluate the long-term effects," the researchers concluded.

Reference:

Bulbul, N., Sen, S. & Acibucu, F. Impact of parathyroidectomy on inflammatory and cardiovascular risk parameters in primary hyperparathyroidism: a retrospective analysis. BMC Cardiovasc Disord 25, 87 (2025). https://doi.org/10.1186/s12872-025-04541-x