Нарушения углеводного обмена и другие метаболические изменения при первичном гиперпаратиреозе

В клинической картине первичного гиперпаратиреоза (ПГПТ), обусловленного опухолевой трансформацией околощитовидных желез (ОЩЖ), все чаще наблюдаются проявления метаболического синдрома, приводящие к развитию сердечно-сосудистых заболеваний. Согласно клиническим исследованиям, у пациентов с ПГПТ, независимо от формы и степени тяжести основного заболевания, определяется повышенная частота сахарного диабета, инсулинорезистентности, ожирения, дислипидемии, гиперурикемии и других нарушений, значимо влияющих на продолжительность и качество жизни. Фундаментальные научные работы свидетельствуют о неклассических эффектах, которые паратгормон и кальций в повышенных концентрациях могут оказывать на жировую ткань, поджелудочную железу, желудочно-кишечный тракт, почки. Однако патогенетические механизмы формирования нарушений углеводного и других видов обмена при гиперфункции ОЩЖ остаются до конца не ясны ввиду отсутствия адекватных экспериментальных моделей и неоднородности выборок пациентов. Кроме того, неоднозначно влияние хирургического лечения ПГПТ на метаболические изменения. На сегодняшний день необходимо более глубокое изучение данной проблемы, что впоследствии может помочь в разработке оптимальных алгоритмов диагностики и лечения пациентов. В представленной обзорной статье освещены различные аспекты метаболических нарушений на фоне ПГПТ, а также рассмотрены потенциальные ключевые факторы их развития.

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