nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-235-3-183-190nogr-3146Research ArticleМЕТАБОЛИЧЕСКИЙ СИНДРОМMETABOLIC SYNDROMEОсобенности метаболических нарушений при гиперпаратиреозеFeatures of metabolic disorders in hyperparathyroidismhttps://orcid.org/0000-0001-6678-6411ДолгихЮ. А.DolgikhYu. A.yu.a.dolgikh@samsmu.ruhttps://orcid.org/0000-0003-0027-1786БулгаковаС. В.BulgakovaS. V.noemail@neicon.ruhttps://orcid.org/0000-0001-8827-4919ШароноваЛ. А.SharonovaL. A.noemail@neicon.ruhttps://orcid.org/0000-0003-0097-7252ТреневаЕ. В.TrenevaE. V.noemail@neicon.ruhttps://orcid.org/0009-0006-4531-9682КосареваО. В.KosarevaO. V.noemail@neicon.ruhttps://orcid.org/0009-0004-6243-6528МерзловаП. Я.MerzlovaP. Ya.noemail@neicon.ruhttps://orcid.org/0000-0003-4114-5233КурмаевД. П.KurmaevD. P.noemail@neicon.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Самарский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияSamara State Medical UniversityRussian Federation20252910202503183190Copyright © Долгих Ю.А., Булгакова С.В., Шаронова Л.А., Тренева Е.В., Косарева О.В., Мерзлова П.Я., Курмаев Д.П., 20252025Долгих Ю.А., Булгакова С.В., Шаронова Л.А., Тренева Е.В., Косарева О.В., Мерзлова П.Я., Курмаев Д.П.Dolgikh Y.A., Bulgakova S.V., Sharonova L.A., Treneva E.V., Kosareva O.V., Merzlova P.Y., Kurmaev D.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/3146

Метаболический синдром (МС) является распространенным явлением среди населения и является фактором риска сердечно-сосудистых заболеваний и смертности. Основным компонентом МС является висцеральное ожирение, приводящее к инсулинорезистентности, к дополнительным критериям МС относятся артериальная гипертензия, нарушения углеводного и липидного обмена. Нарушение обмена кальция, в частности, гиперкальциемия - достаточно распространенная проблема и встречается почти у 3% населения России. Основной причиной ее является первичный гиперпаратиреоз (ПГПТ), в основе которого лежит гиперпродукция паратиреоидного гормона (ПТГ) паращитовидными железами. К «неклассическим» симптомам ПГПТ относят, в том числе, метаболические нарушения. ПГПТ может быть связан с МС и его компонентами, сопровождается более высокой распространенностью ожирения, нарушений углеводного обмена, дислипидемии и артериальной гипертензии. В структуре сердечно-сосудистых проявлений ПГПТ преобладают гипертрофия левого желудочка, кальцификация клапанов сердца, диастолическая дисфункция, артериальная гипертензия. Смертность от сердечно-сосудистых заболеваний при ПГПТ выше, чем у здоровых лиц даже при «мягкой» форме, в связи с чем необходимо тщательное наблюдение таких пациентов, своевременная диагностика и лечение сердечно-сосудистых осложнений. Атерогенная дислипидемии при ПГПТ повышает риск кардиоваскулярной патологии, но только при клинически выраженной форме заболевания. Хирургическое лечение может снизить кардиоваскулярные риски и улучшить прогноз пациентов, хотя липидный профиль улучшается только у пациентов с «мягкой» формой ПГПТ. Нарушения пуринового и углеводного обменов также встречаются при ПГПТ чаще, чем у здоровых лиц. Паратиреоидэктомия улучшает показатели глюкозы и мочевой кислоты у пациентов с ПГПТ.

Metabolic syndrome (MS) is a common phenomenon among the population and is a risk factor for cardiovascular diseases and mortality. The main component of MS is visceral obesity, leading to insulin resistance; additional criteria for MS include arterial hypertension, carbohydrate and lipid metabolism disorders. Calcium metabolism disorders, in particular hypercalcemia, are a fairly common problem and occur in almost 3% of the population of Russia. Its main cause is primary hyperparathyroidism (PHPT), which is based on hyperproduction of parathyroid hormone (PTH) by the parathyroid glands. “Non-classical” symptoms of PHPT include, among other things, metabolic disorders. PHPT can be associated with MS and its components, accompanied by a higher prevalence of obesity, carbohydrate metabolism disorders, dyslipidemia and arterial hypertension. The cardiovascular manifestations of PHPT are dominated by left ventricular hypertrophy, calcification of the heart valves, diastolic dysfunction, and arterial hypertension. Mortality from cardiovascular diseases in PHPT is higher than in healthy individuals, even with a “mild” form, which is why careful monitoring of such patients, timely diagnosis, and treatment of cardiovascular complications are necessary. Atherogenic dyslipidemia in PHPT increases the risk of cardiovascular pathology, but with a clinically expressed form of the disease. Surgical treatment can reduce cardiovascular risks and improve the prognosis of patients, although the lipid profile improves only in patients with a “mild” form of PHPT. Impaired purine and carbohydrate metabolism are also more common in PHPT than in healthy individuals. Parathyroidectomy improves glucose and uric acid levels in patients with PHPT.

метаболический синдромартериальная гипертензиясердечно-сосудистые заболеванияожирениедислипидемиягиперурикемияинсулинорезистентностьнарушение толерантности к глюкозесахарный диабетmetabolic syndromearterial hypertensioncardiovascular diseasesobesitydyslipidemiahyperuricemiainsulin resistanceimpaired glucose tolerancediabetes mellitusReferencesOganov R.G., Simanenkov V.I., Bakulin I.G. et al.Comorbidities in clinical practice. Algorithms for diagnostics and treatment. Cardiovascular Therapy and Prevention. 2019;18(1):5-66. (In Russ.) doi: 10.15829/1728-8800-2019-1-5-56.@@ Оганов Р.Г., Симаненков В.И., Бакулин И.Г. и соавт. Коморбидная патология в клинической практике. Алгоритмы диагностики и лечения. Кардиоваскулярная терапия и профилактика. 2019;18(1):5-66. doi: 10.15829/1728-8800-2019-1-5-56.Oganov R.G., Simanenkov V.I., Bakulin I.G. et al.Comorbidities in clinical practice. Algorithms for diagnostics and treatment. Cardiovascular Therapy and Prevention. 2019;18(1):5-66. (In Russ.) doi: 10.15829/1728-8800-2019-1-5-56.@@ Оганов Р.Г., Симаненков В.И., Бакулин И.Г. и соавт. Коморбидная патология в клинической практике. Алгоритмы диагностики и лечения. Кардиоваскулярная терапия и профилактика. 2019;18(1):5-66. doi: 10.15829/1728-8800-2019-1-5-56.Reznik E.V., Nikitin I.G. Hypertension management in metabolic syndrome. The Russian Archives of Internal Medicine. 2019;9(5):327-347. doi: 10.20514/2226-6704-2019-9-5-327-347.@@ Резник Е.В., Никитин И.Г. Алгоритм ведения больных с артериальной гипертонией при метаболическом синдроме. Архивъ внутренней медицины. 2019;9(5):327-347. doi: 10.20514/2226-6704-2019-9-5-327-347.Reznik E.V., Nikitin I.G. Hypertension management in metabolic syndrome. The Russian Archives of Internal Medicine. 2019;9(5):327-347. doi: 10.20514/2226-6704-2019-9-5-327-347.@@ Резник Е.В., Никитин И.Г. Алгоритм ведения больных с артериальной гипертонией при метаболическом синдроме. Архивъ внутренней медицины. 2019;9(5):327-347. doi: 10.20514/2226-6704-2019-9-5-327-347.Badin Yu.V., Fomin I.V., Belenkov Yu.N. et al. EPOCHA-AH 1998-2017. Dynamics of prevalence, awareness of arterial hypertension, treatment coverage, and effective control of blood pressure in the European part of the Russian Federation. Kardiologiia. 2019;59(1S):34-42. (In Russ.) doi: 10.18087/cardio.2445.@@ Бадин Ю.В., Фомин И.В., Беленков Ю.Н. и соавт. ЭПОХА-АГ 1998-2017 гг.: динамика распространенности, информированности об артериальной гипертонии, охвате терапией и эффективного контроля артериального давления в европейской части РФ. Кардиология. 2019;59(1S):34-42. doi: 10.18087/cardio.2445.Badin Yu.V., Fomin I.V., Belenkov Yu.N. et al. EPOCHA-AH 1998-2017. Dynamics of prevalence, awareness of arterial hypertension, treatment coverage, and effective control of blood pressure in the European part of the Russian Federation. Kardiologiia. 2019;59(1S):34-42. (In Russ.) doi: 10.18087/cardio.2445.@@ Бадин Ю.В., Фомин И.В., Беленков Ю.Н. и соавт. ЭПОХА-АГ 1998-2017 гг.: динамика распространенности, информированности об артериальной гипертонии, охвате терапией и эффективного контроля артериального давления в европейской части РФ. Кардиология. 2019;59(1S):34-42. doi: 10.18087/cardio.2445.Dedov I.I., Shestakova M.V., Vikulova O.K., Isakov M.А., Zheleznyakova A.V. Atlas of Diabetes Register in Russian Federation, status 2018. Diabetes mellitus. 2019;22(2S):4-61. (In Russ.) doi: 10.14341/DM12208.@@ Дедов И.И., Шестакова М.В., Викулова О.К. и соавт. Атлас регистра сахарного диабета Российской Федерации. Статус 2018 г. Сахарный диабет. 2019;22(S2-2):4-61. doi: 10.14341/DM12208.Dedov I.I., Shestakova M.V., Vikulova O.K., Isakov M.А., Zheleznyakova A.V. Atlas of Diabetes Register in Russian Federation, status 2018. Diabetes mellitus. 2019;22(2S):4-61. (In Russ.) doi: 10.14341/DM12208.@@ Дедов И.И., Шестакова М.В., Викулова О.К. и соавт. Атлас регистра сахарного диабета Российской Федерации. Статус 2018 г. Сахарный диабет. 2019;22(S2-2):4-61. doi: 10.14341/DM12208.Bilezikian J.P., Bandeira L., Khan A., Cusano N.E. Hyperparathyroidism. Lancet. 2018;391(10116):168-178. doi: 10.1016/S0140-6736(17)31430-7.Bilezikian J.P., Bandeira L., Khan A., Cusano N.E. Hyperparathyroidism. Lancet. 2018;391(10116):168-178. doi: 10.1016/S0140-6736(17)31430-7.Modica R., Liccardi A., Minotta R. et al. Parathyroid diseases and metabolic syndrome. J Endocrinol Invest. 2023;46(6):1065-1077. doi: 10.1007/s40618-023-02018-2.Modica R., Liccardi A., Minotta R. et al. Parathyroid diseases and metabolic syndrome. J Endocrinol Invest. 2023;46(6):1065-1077. doi: 10.1007/s40618-023-02018-2.Cormier C., Koumakis E. Bone and primary hyperparathyroidism. Joint Bone Spine. 2022;89(1):105129. doi: 10.1016/j.jbspin.2021.105129.Cormier C., Koumakis E. Bone and primary hyperparathyroidism. Joint Bone Spine. 2022;89(1):105129. doi: 10.1016/j.jbspin.2021.105129.Lundgren E., Lind L., Palmér M. et al. Increased cardiovascular mortality and normalized serum calcium in patients with mild hypercalcemia followed up for 25 years. Surgery. 2001;130(6):978-85. doi: 10.1067/msy.2001.118377.Lundgren E., Lind L., Palmér M. et al. Increased cardiovascular mortality and normalized serum calcium in patients with mild hypercalcemia followed up for 25 years. Surgery. 2001;130(6):978-85. doi: 10.1067/msy.2001.118377.Purra S, Lone AA, Bhat MH et al. Cardiac structural and functional abnormalities in primary hyperparathyroidism. J Endocrinol Invest. 2022;45(2):327-335. doi: 10.1007/s40618-021-01645-x.Purra S, Lone AA, Bhat MH et al. Cardiac structural and functional abnormalities in primary hyperparathyroidism. J Endocrinol Invest. 2022;45(2):327-335. doi: 10.1007/s40618-021-01645-x.Lumachi F., Ermani M., Luisetto G. et al. Relationship between serum parathyroid hormone, serum calcium and arterial blood pressure in patients with primary hyperparathyroidism: results of a multivariate analysis. Eur J Endocrinol. 2002;146(5):643-7. doi: 10.1530/eje.0.1460643.Lumachi F., Ermani M., Luisetto G. et al. Relationship between serum parathyroid hormone, serum calcium and arterial blood pressure in patients with primary hyperparathyroidism: results of a multivariate analysis. Eur J Endocrinol. 2002;146(5):643-7. doi: 10.1530/eje.0.1460643.Voronenko I.V., Mokrysheva N.G., Rozhinskaya L. Ya., Syrkin A.L. The cardiovascular system in patients with symptomatic and mild primary hyperparathyroidism. Problems of Endocrinology. 2009;55(3):25-29. (In Russ.) doi: 10.14341/probl200955325-29.@@ Вороненко И.В., Мокрышева Н.Г., Рожинская Л.Я., Сыркин А.Л. Состояние сердечно-сосудистой системы при клинически выраженном и малосимптомном первичном гиперпаратиреозе. Проблемы Эндокринологии. 2009;55(3):25-29. doi: 10.14341/probl200955325-29.Voronenko I.V., Mokrysheva N.G., Rozhinskaya L. Ya., Syrkin A.L. The cardiovascular system in patients with symptomatic and mild primary hyperparathyroidism. Problems of Endocrinology. 2009;55(3):25-29. (In Russ.) doi: 10.14341/probl200955325-29.@@ Вороненко И.В., Мокрышева Н.Г., Рожинская Л.Я., Сыркин А.Л. Состояние сердечно-сосудистой системы при клинически выраженном и малосимптомном первичном гиперпаратиреозе. Проблемы Эндокринологии. 2009;55(3):25-29. doi: 10.14341/probl200955325-29.Andersson P., Rydberg E., Willenheimer R. Primary hyperparathyroidism and heart disease-a review. Eur Heart J. 2004;25(20):1776-87. doi: 10.1016/j.ehj.2004.07.010.Andersson P., Rydberg E., Willenheimer R. Primary hyperparathyroidism and heart disease-a review. Eur Heart J. 2004;25(20):1776-87. doi: 10.1016/j.ehj.2004.07.010.Smogorzewski M. PTH, chronic renal failure and myocardium. Miner Electrolyte Metab. 1995;21:55-62.Smogorzewski M. PTH, chronic renal failure and myocardium. Miner Electrolyte Metab. 1995;21:55-62.Schluter K.D., Piper H.M. Trophic effects of catecholamines and parathyroid hormone on adult ventricular cardiomyocytes. Am J Physiol. 1992;263: H1739-H1746. doi: 10.1152/ajpheart.1992.263.6.H1739.Schluter K.D., Piper H.M. Trophic effects of catecholamines and parathyroid hormone on adult ventricular cardiomyocytes. Am J Physiol. 1992;263: H1739-H1746. doi: 10.1152/ajpheart.1992.263.6.H1739.Gorbacheva A.M., Bibik E.E., Dobreva E.A., Elfimova A.R., Pushkareva A.S., Eremkina A.K., Mokrysheva N.G. Structure of metabolic disorders and cardiovascular disease in patients with primary hyperparathyroidism: a single-center retrospective observational study.Russian Journal of Preventive Medicine. 2022;25(8):54-66. (In Russ.) doi: 10.17116/profmed20222508154.Gorbacheva A.M., Bibik E.E., Dobreva E.A., Elfimova A.R., Pushkareva A.S., Eremkina A.K., Mokrysheva N.G. Structure of metabolic disorders and cardiovascular disease in patients with primary hyperparathyroidism: a single-center retrospective observational study.Russian Journal of Preventive Medicine. 2022;25(8):54-66. (In Russ.) doi: 10.17116/profmed20222508154.Горбачева А.М., Бибик Е.Е., Добрева Е.А. и соавт. Структура метаболических нарушений и сердечно-сосудистых заболеваний у пациентов с первичным гиперпаратиреозом: одноцентровое ретроспективное обсервационное исследование. Профилактическая медицина. 2022;25(8):54-66. doi: 10.17116/profmed20222508154.Горбачева А.М., Бибик Е.Е., Добрева Е.А. и соавт. Структура метаболических нарушений и сердечно-сосудистых заболеваний у пациентов с первичным гиперпаратиреозом: одноцентровое ретроспективное обсервационное исследование. Профилактическая медицина. 2022;25(8):54-66. doi: 10.17116/profmed20222508154.Frey S., Mirallié É., Cariou B., Blanchard C. Impact of parathyroidectomy on cardiovascular risk in primary hyperparathyroidism: A narrative review. Nutr Metab Cardiovasc Dis. 2021;31(4):981-996. doi: 10.1016/j.numecd.2020.12.029.Frey S., Mirallié É., Cariou B., Blanchard C. Impact of parathyroidectomy on cardiovascular risk in primary hyperparathyroidism: A narrative review. Nutr Metab Cardiovasc Dis. 2021;31(4):981-996. doi: 10.1016/j.numecd.2020.12.029.Tomaschitz A., Ritz E., Pieske B. et al. Aldosterone and parathyroid hormone: a precarious couple for cardiovascular disease. Cardiovasc Res. 2012;94(1):10-9. doi: 10.1093/cvr/cvs092.Tomaschitz A., Ritz E., Pieske B. et al. Aldosterone and parathyroid hormone: a precarious couple for cardiovascular disease. Cardiovasc Res. 2012;94(1):10-9. doi: 10.1093/cvr/cvs092.Kalla A., Krishnamoorthy P., Gopalakrishnan A. et al. Primary hyperparathyroidism predicts hypertension: Results from the National Inpatient Sample.Int J Cardiol. 2017;227:335-337. doi: 10.1016/j.ijcard.2016.11.080.Kalla A., Krishnamoorthy P., Gopalakrishnan A. et al. Primary hyperparathyroidism predicts hypertension: Results from the National Inpatient Sample.Int J Cardiol. 2017;227:335-337. doi: 10.1016/j.ijcard.2016.11.080.Heyliger A., Tangpricha V., Weber C., Sharma J. Parathyroidectomy decreases systolic and diastolic blood pressure in hypertensive patients with primary hyperparathyroidism. Surgery. 2009;146(6):1042-7. doi: 10.1016/j.surg.2009.09.024.Heyliger A., Tangpricha V., Weber C., Sharma J. Parathyroidectomy decreases systolic and diastolic blood pressure in hypertensive patients with primary hyperparathyroidism. Surgery. 2009;146(6):1042-7. doi: 10.1016/j.surg.2009.09.024.Broulik P.D., Brouliková A., Adámek S. et al. Improvement of hypertension after parathyroidectomy of patients suffering from primary hyperparathyroidism.Int J Endocrinol. 2011;2011:309068. doi: 10.1155/2011/309068.Broulik P.D., Brouliková A., Adámek S. et al. Improvement of hypertension after parathyroidectomy of patients suffering from primary hyperparathyroidism.Int J Endocrinol. 2011;2011:309068. doi: 10.1155/2011/309068.Graff-Baker A.N., Bridges L.T., Chen Q. et al. Parathyroidectomy for Patients With Primary Hyperparathyroidism and Associations With Hypertension. JAMA Surg. 2020;155(1):32-39. doi: 10.1001/jamasurg.2019.3950.Graff-Baker A.N., Bridges L.T., Chen Q. et al. Parathyroidectomy for Patients With Primary Hyperparathyroidism and Associations With Hypertension. JAMA Surg. 2020;155(1):32-39. doi: 10.1001/jamasurg.2019.3950.Hagstrom E. Metabolic abnormalities in patients with normocalcemic hyperparathyroidism detected at a population-based screening. Eur J Endocrinol. 2006;155(1):33-39. doi: 10.1530/eje.1.02173.Hagstrom E. Metabolic abnormalities in patients with normocalcemic hyperparathyroidism detected at a population-based screening. Eur J Endocrinol. 2006;155(1):33-39. doi: 10.1530/eje.1.02173.Ejlsmark-Svensson H., Rolighed L., Rejnmark L. Effect of Parathyroidectomy on Cardiovascular Risk Factors in Primary Hyperparathyroidism: A Randomized Clinical Trial. J Clin Endocrinol Metab. 2019;104(8):3223-3232. doi: 10.1210/jc.2018-02456.Ejlsmark-Svensson H., Rolighed L., Rejnmark L. Effect of Parathyroidectomy on Cardiovascular Risk Factors in Primary Hyperparathyroidism: A Randomized Clinical Trial. J Clin Endocrinol Metab. 2019;104(8):3223-3232. doi: 10.1210/jc.2018-02456.Norenstedt S., Pernow Y., Brismar K. et al. Primary hyperparathyroidism and metabolic risk factors, impact of parathyroidectomy and vitamin D supplementation, and results of a randomized double-blind study. Eur J Endocrinol. 2013;169(6):795-804. doi: 10.1530/EJE-13-0547.Norenstedt S., Pernow Y., Brismar K. et al. Primary hyperparathyroidism and metabolic risk factors, impact of parathyroidectomy and vitamin D supplementation, and results of a randomized double-blind study. Eur J Endocrinol. 2013;169(6):795-804. doi: 10.1530/EJE-13-0547.Hagström 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):253-60. doi: 10.1046/j.0300-0664.2001.01468.x.Hagström 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):253-60. doi: 10.1046/j.0300-0664.2001.01468.x.Wannamethee S.G., 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. doi: 10.1161/CIRCHEARTFAILURE.114.001272.Wannamethee S.G., 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. doi: 10.1161/CIRCHEARTFAILURE.114.001272.Querfeld U., Hoffmann M.M., 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. doi: 10.1681/ASN.V10102158.Querfeld U., Hoffmann M.M., 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. doi: 10.1681/ASN.V10102158.Tordjman K.M., Yaron M., Izkhakov E. et al. Cardiovascular risk factors and arterial rigidity are similar in asymptomatic normocalcemic and hypercalcemic primary hyperparathyroidism. Eur J Endocrinol. 2010;162(5):925-933. doi: 10.1530/eje-09-1067Tordjman K.M., Yaron M., Izkhakov E. et al. Cardiovascular risk factors and arterial rigidity are similar in asymptomatic normocalcemic and hypercalcemic primary hyperparathyroidism. Eur J Endocrinol. 2010;162(5):925-933. doi: 10.1530/eje-09-1067Ponvilawan 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. doi: 10.1111/1756-185X.13740.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. doi: 10.1111/1756-185X.13740.Paik J.M., Farwell W.R., Taylor E.N. Demographic, dietary, and serum factors and parathyroid hormone in the National Health and Nutrition Examination Survey. Osteoporos Int. 2012;23(6):1727-1736. doi: 10.1007/s00198-011-1776-x.Paik J.M., Farwell W.R., Taylor E.N. Demographic, dietary, and serum factors and parathyroid hormone in the National Health and Nutrition Examination Survey. Osteoporos Int. 2012;23(6):1727-1736. doi: 10.1007/s00198-011-1776-x.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.doi: 10.1016/j.kint.2016.09.041.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.doi: 10.1016/j.kint.2016.09.041.Girardi A.C., Titan S.M., Malnic G., Reboucas N.A. Chronic effect of parathyroid hormone on NHE3 expression in rat renal proximal tubules. Kidney Int. 2000;58(4):1623-1631. doi: 10.1046/j.1523-1755.2000.00323.x.Girardi A.C., Titan S.M., Malnic G., Reboucas N.A. Chronic effect of parathyroid hormone on NHE3 expression in rat renal proximal tubules. Kidney Int. 2000;58(4):1623-1631. doi: 10.1046/j.1523-1755.2000.00323.x.Carroll R., Matfin G. Endocrine and metabolic emergencies: hypercalcaemia. Ther Adv Endocrinol Metab. 2010;1(5):225-234. doi: 10.1177/2042018810390260.Carroll R., Matfin G. Endocrine and metabolic emergencies: hypercalcaemia. Ther Adv Endocrinol Metab. 2010;1(5):225-234. doi: 10.1177/2042018810390260.Bibik E.E., Dobreva E.A., Elfimova A.R. et al. Primary hyperparathyroidism in young patients is associated with metabolic disorders: a prospective comparative study. BMC Endocr Disord. 2023;23(1):57. doi: 10.1186/s12902-023-01302-9.Bibik E.E., Dobreva E.A., Elfimova A.R. et al. Primary hyperparathyroidism in young patients is associated with metabolic disorders: a prospective comparative study. BMC Endocr Disord. 2023;23(1):57. doi: 10.1186/s12902-023-01302-9.Bergenfelz A., Bladström 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):1393-400; discussion 1401-2. doi: 10.1007/s00268-007-9091-6.Bergenfelz A., Bladström 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):1393-400; discussion 1401-2. doi: 10.1007/s00268-007-9091-6.Bolland M.J., Grey A.B., Gamble G.D., Reid I.R. Association between primary hyperparathyroidism and increased body weight: a meta-analysis. J Clin Endocrinol Metab. 2005;90(3):1525-30. doi: 10.1210/jc.2004-1891.Bolland M.J., Grey A.B., Gamble G.D., Reid I.R. Association between primary hyperparathyroidism and increased body weight: a meta-analysis. J Clin Endocrinol Metab. 2005;90(3):1525-30. doi: 10.1210/jc.2004-1891.McCarty M.F., Thomas C.A. PTH excess may promote weight gain by impeding catecholamine-induced lipolysis-implications for the impact of calcium, vitamin D, and alcohol on body weight. Med Hypotheses. 2003;61(5-6):535-42. doi: 10.1016/s0306-9877(03)00227-5.McCarty M.F., Thomas C.A. PTH excess may promote weight gain by impeding catecholamine-induced lipolysis-implications for the impact of calcium, vitamin D, and alcohol on body weight. Med Hypotheses. 2003;61(5-6):535-42. doi: 10.1016/s0306-9877(03)00227-5.Tran H., Grange J.S., Adams-Huet B. et al. The impact of obesity on the presentation of primary hyperparathyroidism. J Clin Endocrinol Metab. 2014;99(7):2359-64. doi: 10.1210/jc.2013-3903.Tran H., Grange J.S., Adams-Huet B. et al. The impact of obesity on the presentation of primary hyperparathyroidism. J Clin Endocrinol Metab. 2014;99(7):2359-64. doi: 10.1210/jc.2013-3903.Yuan T.J., Chen L.P., Pan Y.L. et al. An inverted U-shaped relationship between parathyroid hormone and body weight, body mass index, body fat. Endocrine. 2021;72(3):844-851. doi: 10.1007/s12020-021-02635-y.Yuan T.J., Chen L.P., Pan Y.L. et al. An inverted U-shaped relationship between parathyroid hormone and body weight, body mass index, body fat. Endocrine. 2021;72(3):844-851. doi: 10.1007/s12020-021-02635-y.Mokrysheva N.G., Dobreva E.A., Mirnaya S.S., Dedov I.I. Carbohydrate and lipid metabolism disorders in women with primary hyperparathyroidism: results of cross-sectional study. Diabetes mellitus. 2019;22(1):8-13. (In Russ.) doi: 10.14341/DM9450.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;22(1):8-13. doi: 10.14341/DM9450.Mokrysheva N.G., Dobreva E.A., Mirnaya S.S., Dedov I.I. Carbohydrate and lipid metabolism disorders in women with primary hyperparathyroidism: results of cross-sectional study. Diabetes mellitus. 2019;22(1):8-13. (In Russ.) doi: 10.14341/DM9450.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;22(1):8-13. doi: 10.14341/DM9450.Hedesan O.C., 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. doi: 10.1038/s41366-018-0266-z.Hedesan O.C., 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. doi: 10.1038/s41366-018-0266-z.Khaleeli A.A., Johnson J.N., Taylor W.H. Prevalence of glucose intolerance in primary hyperparathyroidism and the benefit of parathyroidectomy. Diabetes Metab Res Rev. 2007;23(1):43-8. doi: 10.1002/dmrr.637.Khaleeli A.A., Johnson J.N., Taylor W.H. Prevalence of glucose intolerance in primary hyperparathyroidism and the benefit of parathyroidectomy. Diabetes Metab Res Rev. 2007;23(1):43-8. doi: 10.1002/dmrr.637.Procopio M., Magro G., Cesario F. et al. The oral glucose tolerance test reveals a high frequency of both impaired glucose tolerance and undiagnosed Type 2 diabetes mellitus in primary hyperparathyroidism. Diabet Med. 2002;19(11):958-61. doi: 10.1046/j.1464-5491.2002.00809.x.Procopio M., Magro G., Cesario F. et al. The oral glucose tolerance test reveals a high frequency of both impaired glucose tolerance and undiagnosed Type 2 diabetes mellitus in primary hyperparathyroidism. Diabet Med. 2002;19(11):958-61. doi: 10.1046/j.1464-5491.2002.00809.x.Temizkan S., Kocak O., Aydin K. et al. Normocalcemic hyperparathyroidism and insulin resistance. Endocr Pract. 2015;21(1):23-29. doi: 10.4158/ep14195.or.Temizkan S., Kocak O., Aydin K. et al. Normocalcemic hyperparathyroidism and insulin resistance. Endocr Pract. 2015;21(1):23-29. doi: 10.4158/ep14195.or.Kumar S., Olukoga A.O., Gordon C. et al. Impaired glucose tolerance and insulin insensitivity in primary hyperparathyroidism. Clin Endocrinol (Oxf). 1994;40(1):47-53. doi: 10.1111/j.1365-2265.1994.tb02442.x.Kumar S., Olukoga A.O., Gordon C. et al. Impaired glucose tolerance and insulin insensitivity in primary hyperparathyroidism. Clin Endocrinol (Oxf). 1994;40(1):47-53. doi: 10.1111/j.1365-2265.1994.tb02442.x.Taylor W.H., Khaleeli A.A. Coincident diabetes mellitus and primary hyperparathyroidism. Diabetes Metab Res Rev. 2001;17(3):175-180. doi: 10.1002/dmrr.199.Taylor W.H., Khaleeli A.A. Coincident diabetes mellitus and primary hyperparathyroidism. Diabetes Metab Res Rev. 2001;17(3):175-180. doi: 10.1002/dmrr.199.Schiffl H., Sitter T., Lang S.M. Noradrenergic blood pressure dysregulation and cytosolic calcium in primary hyperparathyroidism. Kidney Blood Press Res. 1997;20(5):290-296. doi: 10.1159/000174161.Schiffl H., Sitter T., Lang S.M. Noradrenergic blood pressure dysregulation and cytosolic calcium in primary hyperparathyroidism. Kidney Blood Press Res. 1997;20(5):290-296. doi: 10.1159/000174161.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. doi: 10.1111/j.1464-5491.2009.02804.x.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. doi: 10.1111/j.1464-5491.2009.02804.x.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):734-9. doi: 10.1038/sj.ejcn.1602375.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):734-9. doi: 10.1038/sj.ejcn.1602375.

The authors declare that there are no conflicts of interest present.