Urate and arteriosclerosis in primary hyperparathyroidism

OBJECTIVE An increased mortality due to cardiovascular disease has been rep orted in patients with primary hyperparathyroidism (pHPT). An association b etween urate and cardiovascular disease has been suggested. Metabolic abnor malities in pHPT may include urate, We therefore evaluated the metabolic ar teriosclerotic risk profile in pHPT with special focus on the role of urate , DESIGN Retrospective analysis of data before and 1 year after surgery for p HPT. PATIENTS 130 consecutive patients, over the age of 44 years, who underwent surgery for pHPT, MEASUREMENTS Biochemical variables known to reflect risk of arteriosclerotic disease (AD) and renal function tests including measure ment of glomerular filtration rate (GFR) were investigated before and 1 yea r after surgery, RESULTS pHPT patients with AD (n = 40) were older and had higher serum leve ls of urate and triglyceride, and more impaired renal function in compariso n with patients without AD. PTH and calcium values did not differ. Multiple logistic regression analysis indicated that urate was an independent risk factor for AD in pHPT (P < 0.01). Three variables were shown to be positive ly associated with urate; male gender (P < 0.01), fasting blood glucose (P < 0.05) and serum level of triglyceride (P < 0.05). CONCLUSIONS Urate was found to be an independent risk factor for arterioscl erotic disease in primary hyperparathyroidism. Serum level of urate could ( in addition to gender) be associated with a metabolic disorder comprising i ncreased glucose and triglyceride levels.