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World Journal of Surgery
Published in: World Journal of Surgery 7/2007

01-07-2007

Serum Levels of Uric Acid and Diabetes Mellitus Influence Survival after Surgery for Primary Hyperparathyroidism: A Prospective Cohort Study

Authors: Anders Bergenfelz, Anna Bladström, Mark Their, Erik Nordenström, Stig Valdemarsson, Johan Westerdahl

Published in: World Journal of Surgery | Issue 7/2007

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Abstract

Background

Primary hyperparathyroidism (pHPT) is associated with an increased mortality attributable to cardiovascular disease (CVD), suggested to be alleviated by surgery. The exact mechanism of the beneficial influence of parathyroidectomy on survival is unknown. Furthermore, studies suggest that there is no increased mortality compared to the mortality rate in the general population during recent years. This study therefore investigated relative survival (RS), as well overall mortality associated with the clinical and biochemical variables in patients undergoing operation for sporadic pHPT. Furthermore, the influence of surgery on biochemical variables associated with pHPT was analyzed.

Methods

A group of 323 patients with sporadic pHPT operated between September 1989 and July 2003 were followed from surgery over a 10-year period. The median and mean follow-up time was 69 and 70 months, respectively (range: 1–120 months). Relative survival (RS) was calculated, and the impact of clinical and biochemical variables on overall death were evaluated.

Results

Postoperatively, serum levels of triglycerides and uric acid decreased. Glucose levels and glomerular filtration rate remained unchanged. A decreased RS was evident during the latter part of the 10 year follow-up period. In the multivariate Cox-analysis, diabetes mellitus (hazard ratio [HR] = 2.8, 95%; confidence interval [CI] 1.2–6.7), and the combination of an increased level of serum uric acid and cardiovascular disease (CVD) (HR = 8.6, 95%; CI 1.5–49.7) was associated with a higher mortality. The increased risk of death was evident for patients with persistently increased levels of uric acid postoperatively (HR = 4.8, 95%; CI = 1.4–16.01)

Conclusions

Patients undergoing operation for pHPT had a decreased RS during a 10-year follow-up compared to the general population. This decrease in RS is associated with diabetes mellitus and increased levels of uric acid pre-and postoperatively.
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Metadata
Title
Serum Levels of Uric Acid and Diabetes Mellitus Influence Survival after Surgery for Primary Hyperparathyroidism: A Prospective Cohort Study
Authors
Anders Bergenfelz
Anna Bladström
Mark Their
Erik Nordenström
Stig Valdemarsson
Johan Westerdahl
Publication date
01-07-2007
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 7/2007
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-007-9091-6

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