The impact of body mass index on the diagnostic and surgical outcomes in primary hyperparathyroidism


Parlak N. S., Ertekin S. Ç., Kırdak T.

Revista da Associacao Medica Brasileira, vol.71, no.3, 2025 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 71 Issue: 3
  • Publication Date: 2025
  • Doi Number: 10.1590/1806-9282.20240989
  • Journal Name: Revista da Associacao Medica Brasileira
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, MEDLINE, Veterinary Science Database
  • Keywords: Body mass index, Hyperparathyroidism, Obesity, Parathyroidectomy
  • Bursa Uludag University Affiliated: Yes

Abstract

OBJECTIVE: The aim of this study was to investigate the influence of body mass index on the diagnostic and surgical outcomes in patients undergoing parathyroidectomy for primary hyperparathyroidism. METHODS: A total of 446 patients with primary hyperparathyroidism were divided into four groups according to their body mass index: normal weight (body mass index<25 kg/m2) (n=130), overweight (25≤body mass index<30 kg/m2) (n=166), obese (30≤body mass index<35 kg/m2) (n=112), and morbidly obese (body mass index≥35 kg/m2) (n=38). Perioperative findings were compared between the groups. RESULTS: The preoperative median parathormone level in the morbidly obese group (204 pg/mL, min:max 72:1,178) was significantly lower than that in the normal-weight (246 pg/mL, min:max 60:4,262) (p=0.026) and obese (251 pg/mL, min:max 74:2,094) (p=0.012) groups. The osteoporosis rate in the normal-weight group (51%) was higher than that in the overweight (35.4%) (p=0.041) and morbidly obese (25%) (p=0.023) groups. The symptomatic hypocalcemia rate in the normal-weight group (10.2%) was significantly higher than that in the obese group (1.8%) (p=0.017). CONCLUSION: Normal-weight patients with primary hyperparathyroidism have higher blood parathormone values, higher rates of osteoporosis, and postoperative symptomatic hypocalcemia compared to patients with higher body mass index. For this reason, the surgeon should consider the possibility of symptomatic hypocalcemia after undergoing parathyroidectomy for primary hyperparathyroidism in normal-weight cases.