ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1629719
The Relationship Between Postoperative Parathormone Suppression And Surgical Cure In Primary Hyperparathyroidism
Provisionally accepted
- 1Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Türkiye
- 2Umraniye Training and Research Hospital, Istanbul, Türkiye
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction: In primary hyperparathyroidism(pHPT), suppression in other glands due to autonomy of pathological gland is frequently observed. In this retrospective study, we aimed to evaluate contribution of suppression of remaining parathyroid glands in pHPT in predicting surgical cure. Methods: We retrospectively analyzed data from patients diagnosed with pHPT and operated at our institution between 2014 and 2022. Patients who demonstrated either a decrease of more than 50% in intraoperative parathormone levels or a normal parathormone (PTH) level at the 6th postoperative hour were included. Patients were categorized into two groups based on their PTH levels at the 6th postoperative hour: those with PTH suppression (PTH < 15 ng/L) and those without (PTH > 15 ng/L). We analyzed the outcomes in terms of persistent disease and biochemical markers.Results: Among 196 patients who met the inclusion criteria, 124 exhibited PTH suppression while 72 did not. Persistent disease was significantly more common in the non-suppressed group (19.4% vs. 5.65%, p<0.001). Furthermore, postoperative PTH suppression strongly correlated with surgical cure, indicated by a significant difference in the rate of normocalcemia after 6 months. Excised parathyroid tissue volumes were determined significantly lower in group 1 compared to group (0.85±0.88cm3vs2.04±3.79cm3,p=0.035, respectively).There was no significant difference between two groups in terms of gender, preoperative Ca, magnesium, vitamin D and postoperative Ca levels.Conclusion: Early postoperative PTH suppression is highly associated with surgical cure. The rate of pPHPT is significantly higher in non-suppressed patients. Therefore, in follow-up strategies of postoperative patients, the possibility of a remnant pathological gland should be considered especially in those without early PTH suppression.
Keywords: Primary hyperparathyreoidism (pHPT), Persistent disease, Parathyreoidectomy, Parathormone Suppression, Parathyroid adenoma, Surgical cure
Received: 16 May 2025; Accepted: 14 Jul 2025.
Copyright: © 2025 Ünlü, Aygun, Kostek, Caliskan and Uludag. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mehmet Taner Ünlü, Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Türkiye
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.