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The oral glucose tolerance test reveals a high frequency of both impaired glucose tolerance and undiagnosed Type 2 diabetes mellitus in primary hyperparathyroidism
Author(s) -
Procopio M.,
Magro G.,
Cesario F.,
Piovesan A.,
Pia A.,
Molineri N.,
Borretta G.
Publication year - 2002
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1046/j.1464-5491.2002.00809.x
Subject(s) - medicine , primary hyperparathyroidism , impaired glucose tolerance , insulin resistance , diabetes mellitus , endocrinology , asymptomatic , type 2 diabetes mellitus , population , glucose tolerance test , body mass index , hyperparathyroidism , impaired fasting glucose , gastroenterology , environmental health
Aims To evaluate the frequency of impaired glucose tolerance (IGT)and undiagnosed diabetes mellitus together with the indices of insulinresistance (IR) in primary hyperparathyroidism (pHPT). Methods Out of 105 consecutive pHPT patients (F/M 78/27, asymptomatic/symptomatic68/37, age (mean ± sd ) 60.7 ± 12.7 years,body mass index 25.2 ± 3.8 kg/m 2 ,ionized calcium (iCa) 1.49 ± 0.16 mmol/l,parathormone 200.4 ± 233.9 pg/ml),59 without known diabetes mellitus and controls ( n = 60)underwent an oral glucose tolerance test (OGTT, 75 g os).As indices of IR, homeostasis model assessment (HOMA IR )or OGTT data (insulin sensitivity index composite (ISI comp)) wereevaluated. Results In pHPT the prevalence of IGT (mean, 95% confidenceintervals (CI), 40.7%, 27.8–53.6) was higher thanin controls (25.0%, 13.7–36.3, P < 0.03). Similarly,the prevalence of undiagnosed diabetes mellitus was higher in pHPT(15.3%, 5.8–24.7) than in controls (5.0%, 0–10.7, P < 0.05). Moreover,the prevalence of IGT and undiagnosed diabetes was higher in pHPTthan that previously reported in the general population of Northern Italy(8.5% and 3.2%, respectively). The indices showedthat insulin resistance was higher in pHPT than in controls: HOMA IR (median, 95% CI,2.6, 2.5–3.9 vs. 1.7, 1.6–2.5, respectively; P < 0.003);ISI comp (3.5, 3.4–4.6 vs. 5.1, 4.9–7.2, respectively; P < 0.002). Conclusions Our data in a large and modern day pHPT series, with a preponderanceof asymptomatic patients, confirm increased insulin resistance andpre‐valence of IGT and undiagnosed diabetes. Diabet. Med. 19, 958–961 (2002)