Abstract
Background/objective
Loss of renal function may induce secondary hyperparathyroidism (s-HPT), which triggers several complications leading to an extreme decline in quality of life and increased mortality in affected patients. We evaluated whether parathyroidectomy (PTx), as surgical treatment for s-HPT, modifies body composition, and hormones involved in the protein-energy metabolism of affected patients.
Subjects/methods
Overall, 30 s-HPT patients were evaluated at two times, before PTx (pre PTx) and 6 months after PTx (post PTx). Patients were evaluated by biochemistry analysis, anthropometry, electrical bioimpedance (BIA), food intake diary, handgrip strength, and modified global subjective nutritional assessment (SGA).
Results
After PTx, patients showed decreased serum levels of total and ionic calcium, as well as decreased alkaline phosphatase and PTH, and increased 25 (OH) vitamin D. These results demonstrate that PTx was efficient to correct part of the mineral disorder. We also observed an increase in caloric intake, body weight, body mass index (BMI), phase angle, handgrip strength, SGA score, and a decreasing in the percentage of weight loss. The osteocalcin concentration of both carboxylated (cOC) and undercarboxylated form was diminished post PTx. The cOC correlated with bone metabolism markers and SGA score.
Conclusions
PTx modified body composition improving nutritional status and preventing the progression of weight loss with increased of energy intake, BMI, handgrip strength, phase angle of BIA, and SGA score. The present study also suggests an association of cOC with bone markers and SGA score. Further studies are needed to better clarify these associations with larger sample size.
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Acknowledgements
The authors wish to acknowledge Rackel Mota da Costa for their active participation during the data collection.
Funding
This study was supported by grants from the Fundação de Amparo à Pesquisa do Estado de São Paulo (São Paulo State Research Foundation—grant number 2015/13126-8).
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VJ conceived and design research. WVD and LMR performed experiments. FRS and CAMT analyzed the data. FRS interpreted results of experiments. FRS prepared figures and drafted the manuscript. FRS, KCO, and VJ edited and revised the manuscript. All authors read and approved the final version of the manuscript.
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Siqueira, F.R.d., Oliveira, K.C.d., Dominguez, W.V. et al. Effect of parathyroidectomy on bone tissue biomarkers and body composition in patients with chronic kidney disease and secondary hyperparathyroidism. Eur J Clin Nutr 75, 1126–1133 (2021). https://doi.org/10.1038/s41430-020-00829-7
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DOI: https://doi.org/10.1038/s41430-020-00829-7
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