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Сахарный диабет

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Нарушения углеводного обмена и другие метаболические изменения при первичном гиперпаратиреозе

https://doi.org/10.14341/DM12436

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Аннотация

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.

Об авторах

Екатерина Евгеньевна Бибик
Национальный медицинский исследовательский центр эндокринологии
Россия

eLibrary SPIN: 8522-9466

117036, Москва, ул. Дм. Ульянова, д. 11

 



Анна Константиновна Еремкина
Национальный медицинский исследовательский центр эндокринологии
Россия

Кандидат медицинских наук

eLibrary SPIN: 8848-2660

Москва

 



Юлия Александровна Крупинова
Национальный медицинский исследовательский центр эндокринологии
Россия

eLibrary SPIN: 6279-8247

Москва



Наталия Владимировна Клементьева
Национальный медицинский исследовательский центр эндокринологии
Россия

Кандидат биологических наук

eLibrary SPIN: 5318-3774

Москва



Екатерина Александровна Добрева
Национальный медицинский исследовательский центр эндокринологии
Россия

Кандидат медицинских наук

eLibrary SPIN: 3405-2467

Москва



Наталья Георгиевна Мокрышева
Национальный медицинский исследовательский центр эндокринологии
Россия

Доктор медицинских наук, профессор, член-корреспондент РАН

eLibrary SPIN: 5624-3875

Москва



Список литературы

1. Procopio M, Barale M, Bertaina S, et al. Cardiovascular risk and metabolic syndrome in primary hyperparathyroidism and their correlation to different clinical forms. Endocrine. 2014;47(2):581-589. https://doi.org/10.1007/s12020-013-0091-z

2. Ljunghall S, Palmer M, Akerstrom G, Wide L. Diabetes mellitus, glucose tolerance and insulin response to glucose in patients with primary hyperparathyroidism before and after parathyroidectomy. Eur J Clin Invest. 1983;13(5):373-377. https://doi.org/10.1111/j.1365-2362.1983.tb00116.x

3. Мокрышева Н.Г., Добрева Е.А., Мирная С.С., Дедов И.И. Нарушения углеводного и жирового обмена у женщин с первичным гиперпаратиреозом: результаты поперечного исследования // Сахарный диабет. — 2019. — Т. 22. — №1. — С. 8-13. [Mokrysheva NG, Dobreva EA, Mirnaya SS, Dedov II. Carbohydrate and lipid metabolism disorders in women with primary hyperparathyroidism: results of cross-sectional study. Diabetes mellitus. 2019;22(1):8-13. (In Russ.). https://doi.org/10.14341/DM9450

4. Procopio M, Borretta G. Derangement of glucose metabolism in hyperparathyroidism. J Endocrinol Invest. 2003;26(11):1136-1142. https://doi.org/10.1007/BF03345264

5. Tassone F, Maccario M, Gianotti L, et al. Insulin sensitivity in normocalcaemic primary hyperparathyroidism. Endocrine. 2013;44(3):812-814. https://doi.org/10.1007/s12020-013-0059-z

6. Temizkan S, Kocak O, Aydin K, et al. Normocalcemic hyperparathyroidism and insulin resistance. Endocr Pract. 2015;21(1):23-29. https://doi.org/10.4158/EP14195.OR

7. Tassone F, Procopio M, Gianotti L, et al. Insulin resistance is not coupled with defective insulin secretion in primary hyperparathyroidism. Diabet Med. 2009;26(10):968-973. https://doi.org/10.1111/j.1464-5491.2009.02804.x

8. Kim H, Kalkhoff RK, Costrini NV, et al. Plasma insulin disturbances in primary hyperparathyroidism. J Clin Invest. 1971;50(12):2596-2605. https://doi.org/10.1172/JCI106760

9. Sun G, Vasdev S, Martin GR, et al. Altered calcium homeostasis is correlated with abnormalities of fasting serum glucose, insulin resistance, and beta-cell function in the Newfoundland population. Diabetes. 2005;54(11):3336-3339. https://doi.org/10.2337/diabetes.54.11.3336

10. Babinsky VN, Hannan FM, Ramracheya RD, et al. Mutant Mice With Calcium-Sensing Receptor Activation Have Hyperglycemia That Is Rectified by Calcilytic Therapy. Endocrinology. 2017;158(8):2486-2502. https://doi.org/10.1210/en.2017-00111

11. Hagstrom E, Hellman P, Lundgren E, et al. Serum calcium is independently associated with insulin sensitivity measured with euglycaemic-hyperinsulinaemic clamp in a community-based cohort. Diabetologia. 2007;50(2):317-324. https://doi.org/10.1007/s00125-006-0532-9

12. Haap M, Heller E, Thamer C, et al. Association of serum phosphate levels with glucose tolerance, insulin sensitivity and insulin secretion in non-diabetic subjects. Eur J Clin Nutr. 2006;60(6):734-739. https://doi.org/10.1038/sj.ejcn.1602375

13. Harter HR, Santiago J V, Rutherford WE, et al. The relative roles of calcium, phosphorus, and parathyroid hormone in glucoseand tolbutamide-mediated insulin release. J Clin Invest. 1976;58(2):359-367. https://doi.org/10.1172/JCI108480

14. Reis JP, Selvin E, Pankow JS, et al. Parathyroid hormone is associated with incident diabetes in white, but not black adults: The Atherosclerosis Risk in Communities (ARIC) Study. Diabetes Metab. 2016;42(3):162-169. https://doi.org/10.1016/j.diabet.2015.12.004

15. Chang E, Donkin SS, Teegarden D. Parathyroid hormone suppresses insulin signaling in adipocytes. Mol Cell Endocrinol. 2009;307(1-2):77-82. https://doi.org/10.1016/j.mce.2009.03.024

16. Thomas DM, Rogers SD, Sleeman MW, et al. Modulation of glucose transport by parathyroid hormone and insulin in UMR 106-01, a clonal rat osteogenic sarcoma cell line. J Mol Endocrinol. 1995;14(2):263-275. https://doi.org/10.1677/jme.0.0140263

17. Reusch JE, Begum N, Sussman KE, Draznin B. Regulation of GLUT-4 phosphorylation by intracellular calcium in adipocytes. Endocrinology. 1991;129(6):3269-3273. https://doi.org/10.1210/endo-129-6-3269

18. Kanazawa I. Interaction between bone and glucose metabolism [Review]. Endocr J. 2017;64(11):1043-1053. https://doi.org/10.1507/endocrj.EJ17-0323

19. Bao Y, Ma X, Yang R, et al. Inverse relationship between serum osteocalcin levels and visceral fat area in Chinese men. J Clin Endocrinol Metab. 2013;98(1):345-351. https://doi.org/10.1210/jc.2012-2906

20. Gianotti L, Piovesan A, Croce CG, et al. Interplay between serum osteocalcin and insulin sensitivity in primary hyperparathyroidism. Calcif Tissue Int. 2011;88(3):231-237. https://doi.org/10.1007/s00223-010-9453-1

21. Mendonca ML, Batista SL, Nogueira-Barbosa MH, et al. Primary Hyperparathyroidism: The Influence of Bone Marrow Adipose Tissue on Bone Loss and of Osteocalcin on Insulin Resistance. Clinics (Sao Paulo). 2016;71(8):464-469. https://doi.org/10.6061/clinics/2016(08)09

22. Putnam R, Dhibar DP, Varshney S, et al. Effect of curative parathyroidectomy on insulin resistance. Indian J Endocrinol Metab. 2016;20(6):784-789. https://doi.org/10.4103/2230-8210.192916

23. Bhadada SK, Bhansali A, Shah VN, Rao DS. Changes in serum leptin and adiponectin concentrations and insulin resistance after curative parathyroidectomy in moderate to severe primary hyperparathyroidism. Singapore Med J. 2011;52(12):890-893.

24. Bergenfelz A, Bladstrom A, Their M, et al. Serum levels of uric acid and diabetes mellitus influence survival after surgery for primary hyperparathyroidism: a prospective cohort study. World J Surg. 2007;31(7):1392-1393. https://doi.org/10.1007/s00268-007-9091-6

25. Kautzky-Willer A, Pacini G, Niederle B, et al. Insulin secretion, insulin sensitivity and hepatic insulin extraction in primary hyperparathyroidism before and after surgery. Clin Endocrinol (Oxf). 1992;37(2):147-155. https://doi.org/10.1111/j.1365-2265.1992.tb02299.x

26. Cvijovic G, Micic D, Kendereski A, et al. The effect of parathyroidectomy on insulin sensitivity in patients with primary hyperparathyroidism — an never ending story? Exp Clin Endocrinol Diabetes. 2015;123(6):336-341. https://doi.org/10.1055/s-0035-1549906

27. Prager R, Schernthaner G, Niederle B, Roka R. Evaluation of glucose tolerance, insulin secretion, and insulin action in patients with primary hyperparathyroidism before and after surgery. Calcif Tissue Int. 1990;46(1):1-4. https://doi.org/10.1007/bf02555816

28. Antonopoulou V, Karras SN, Koufakis T, et al. Rising Glucagon-Like Peptide 1 Concentrations After Parathyroidectomy in Patients With Primary Hyperparathyroidism. J Surg Res. 2020;245:22-30. https://doi.org/10.1016/j.jss.2019.07.019

29. McCallum RW, Parameswaran V, Burgess JR. Multiple endocrine neoplasia type 1 (MEN 1) is associated with an increased prevalence of diabetes mellitus and impaired fasting glucose. Clin Endocrinol (Oxf). 2006;65(2):163-168. https://doi.org/10.1111/j.1365-2265.2006.02563.x

30. van Wijk JPH, Dreijerink KMA, Pieterman CRC, et al. Increased prevalence of impaired fasting glucose in MEN1 gene mutation carriers. Clin Endocrinol (Oxf). 2012;76(1):67-71. https://doi.org/10.1111/j.1365-2265.2011.04166.x

31. Grey AB, Evans MC, Stapleton JP, Reid IR. Body weight and bone mineral density in postmenopausal women with primary hyperparathyroidism. Ann Intern Med. 1994;121(10):745-749. https://doi.org/10.7326/0003-4819-121-10-199411150-00003

32. Bolland MJ, Grey AB, Gamble GD, Reid IR. Association between primary hyperparathyroidism and increased body weight: a meta-analysis. J Clin Endocrinol Metab. 2005;90(3):1525-1530. https://doi.org/10.1210/jc.2004-1891

33. Мокрышева Н.Г. Первичный гиперпаратиреоз. Эпидемиология, клиника, современные принципы диагностики и лечения: Дис. ... док. мед. наук. — М., 2011. Доступно по: https://dlib.rsl.ru/01005084680

34. McCarty MF, Thomas CA. PTH excess may promote weight gain by impeding catecholamine-induced lipolysisimplications for the impact of calcium, vitamin D, and alcohol on body weight. Med Hypotheses. 2003;61(5-6):535-542. https://doi.org/10.1016/s0306-9877(03)00227-5

35. Fan Y, Hanai J-I, Le PT, et al. Parathyroid Hormone Directs Bone Marrow Mesenchymal Cell Fate. Cell Metab. 2017;25(3):661-672. https://doi.org/10.1016/j.cmet.2017.01.001

36. Bravo-Sagua R, Mattar P, Díaz X, et al. Calcium Sensing Receptor as a Novel Mediator of Adipose Tissue Dysfunction: Mechanisms and Potential Clinical Implications. Front Physiol. 2016;7:395. https://doi.org/10.3389/fphys.2016.00395

37. Christensen MHE, Dankel SN, Nordbø Y, et al. Primary Hyperparathyroidism Influences the Expression of Inflammatory and Metabolic Genes in Adipose Tissue. Oresic M, ed. PLoS One. 2011;6(6):e20481. https://doi.org/10.1371/journal.pone.0020481

38. Delfi E, Petramala L, Caliumi C, et al. Circulating leptin and adiponectin levels in patients with primary hyperparathyroidism. Metabolism. 2007;56(1):30-36. https://doi.org/10.1016/j.metabol.2006.08.019

39. Matsunuma A, Horiuchi N. Leptin attenuates gene expression for renal 25-hydroxyvitamin D3-1alpha-hydroxylase in mice via the long form of the leptin receptor. Arch Biochem Biophys. 2007;463(1):118-127. https://doi.org/10.1016/j.abb.2007.02.031

40. Grethen E, Hill KM, Jones R, et al. Serum leptin, parathyroid hormone, 1,25-dihydroxyvitamin D, fi oblast growth factor 23, bone alkaline phosphatase, and sclerostin relationships in obesity. J Clin Endocrinol Metab. 2012;97(5):1655-1662. https://doi.org/10.1210/jc.2011-2280

41. Hoang D, Broer N, Sosa JA, et al. Leptin Is Produced by Parathyroid Glands and Stimulates Parathyroid Hormone Secretion. Ann Surg. 2017;266(6):1075-1083. https://doi.org/10.1097/SLA.0000000000002004

42. Raghay K, García-Caballero T, Nogueiras R, et al. Ghrelin localization in rat and human thyroid and parathyroid glands and tumours. Histochem Cell Biol. 2006;125(3):239-246. https://doi.org/10.1007/s00418-005-0044-6

43. Yamamoto K, Isogai Y, Ishida T, Hagihara K. Enhancement of ghrelin-signaling system by Rikkunshi-To attenuates teriparatideinduced pica in rats. J Pharmacol Sci. 2018;137(2):137-145. https://doi.org/10.1016/j.jphs.2018.05.003

44. Adam MA, Untch BR, Danko ME, et al. Severe obesity is associated with symptomatic presentation, higher parathyroid hormone levels, and increased gland weight in primary hyperparathyroidism. J Clin Endocrinol Metab. 2010;95(11):4917-4924. https://doi.org/10.1210/jc.2010-0666

45. Kuo LE, Wachtel H, Fraker D, Kelz R. Reoperative parathyroidectomy: who is at risk and what is the risk? J Surg Res. 2014;191(2):256-261. https://doi.org/10.1016/j.jss.2014.05.073

46. Hedesan OC, Fenzl A, Digruber A, et al. Parathyroid hormone induces a browning program in human white adipocytes. Int J Obes (Lond). 2019;43(6):1319-1324. https://doi.org/10.1038/s41366-018-0266-z

47. He Y, Liu R-X, Zhu M-T, et al. The browning of white adipose tissue and body weight loss in primary hyperparathyroidism. EBioMedicine. 2019;40:56-66. https://doi.org/10.1016/j.ebiom.2018.11.057

48. Wannamethee SG, Welsh P, Papacosta O, et al. Elevated parathyroid hormone, but not vitamin D deficiency, is associated with increased risk of heart failure in older men with and without cardiovascular disease. Circ Heart Fail. 2014;7(5):732-739 https://doi.org/10.1161/CIRCHEARTFAILURE.114.001272

49. Querfeld U, Hoffmann MM, Klaus G, et al. Antagonistic effects of vitamin D and parathyroid hormone on lipoprotein lipase in cultured adipocytes. J Am Soc Nephrol. 1999;10(10):2158-2164.

50. Hagstrom E, Lundgren E, Lithell H, et al. Normalized dyslipidaemia after parathyroidectomy in mild primary hyperparathyroidism: population-based study over five years. Clin Endocrinol (Oxf). 2002;56(2):253-260. https://doi.org/10.1046/j.0300-0664.2001.01468.x

51. Hagstrom E, Lundgren E, Rastad J, Hellman P. Metabolic abnormalities in patients with normocalcemic hyperparathyroidism detected at a population-based screening. Eur J Endocrinol. 2006;155(1):33-39. https://doi.org/10.1530/eje.1.02173

52. Beysel S, Caliskan M, Kizilgul M, et al. Parathyroidectomy improves cardiovascular risk factors in normocalcemic and hypercalcemic primary hyperparathyroidism. BMC Cardiovasc Disord. 2019;19(1):106. https://doi.org/10.1186/s12872-019-1093-4

53. Godang K, Lundstam K, Mollerup C, et al. The effect of surgery on fat mass, lipid and glucose metabolism in mild primary hyperparathyroidism. Endocr Connect. 2018;7(8):941-948. https://doi.org/10.1530/EC-18-0259

54. Ponvilawan B, Charoenngam N, Ungprasert P. Primary hyperparathyroidism is associated with a higher level of serum uric acid: A systematic review and meta-analysis. Int J Rheum Dis. 2020;23(2):174-180. https://doi.org/10.1111/1756-185X.13740

55. Paik JM, Farwell WR, Taylor EN. Demographic, dietary, and serum factors and parathyroid hormone in the National Health and Nutrition Examination Survey. Osteoporos Int. 2012;23(6):1727-1736. https://doi.org/10.1007/s00198-011-1776-x

56. Sugimoto R, Watanabe H, Ikegami K, et al. Downregulation of ABCG2, a urate exporter, by parathyroid hormone enhances urate accumulation in secondary hyperparathyroidism. Kidney Int. 2017;91(3):658-670. https://doi.org/10.1016/j.kint.2016.09.041

57. Girardi AC, Titan SM, Malnic G, Reboucas NA. Chronic effect of parathyroid hormone on NHE3 expression in rat renal proximal tubules. Kidney Int. 2000;58(4):1623-1631. https://doi.org/10.1046/j.1523-1755.2000.00323.x

58. Carroll R, Matfin G. Endocrine and metabolic emergencies:hypercalcaemia. Ther Adv Endocrinol Metab. 2010;1(5):225-234. https://doi.org/10.1177/2042018810390260

59. Christensson T. Serum urate in subjects with hypercalcaemic hyperparathyroidism. Clin Chim Acta. 1977;80(3):529-533. https://doi.org/10.1016/0009-8981(77)90147-4

60. Yoneda M, Takatsuki K, Tomita A. [Parathyroid function and uric acid metabolism]. Nihon Naibunpi Gakkai Zasshi. 1983;59(11):1738-1751. https://doi.org/10.1507/endocrine1927.59.11_1738


Дополнительные файлы

Для цитирования:


Бибик Е.Е., Еремкина А.К., Крупинова Ю.А., Клементьева Н.В., Добрева Е.А., Мокрышева Н.Г. Нарушения углеводного обмена и другие метаболические изменения при первичном гиперпаратиреозе. Сахарный диабет. 2020;23(5):459-466. https://doi.org/10.14341/DM12436

For citation:


Bibik E.E., Eremkina [.K., Krupinova J.A., Klementieva N.V., Dobreva E.A., Mokrysheva N.G. Impaired glucose metabolism and other metabolic disorders in patients with primary hyperparathyroidism. Diabetes mellitus. 2020;23(5):459-466. (In Russ.) https://doi.org/10.14341/DM12436

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