Anthropometric Indices and Markers of Atherothrombotic Risk in Subjects with Primary Hyperpathyroidism

Background. Both primary hyperparathyroidism (PHPT) and chronic hypoparathyroidism (HypoPT) are associated with the onset and development of cardiovascular diseases (CVDs). Especially PHPT is accompanied by the presence of elevated atherothrombotic risk, while the importance of traditional and new anthropometric indices to reflect the cardiovascular risk remains uncertain in this condition. This study aims to investigate whether novel and traditional anthropometric indices distinguish PHPT and their correlation with atherothrombotic risk. Methods. 40 Subjects with HypoPT, 40 PHPT and 40 age- and sex-matched control subjects were consecutively enrolled for the evaluation of flow-mediated vasodilation (FMD) and carotid intimal-media thickness (IMT). A blood sample was collected for calcium-phosphate metabolism, PTH, TSH and 25-hydroxy vitamin D evaluation. Physical examination was performed to obtain traditional anthropometric parameters and derived indices of adiposity and cardiometabolic risk (waist height ratio (WHtR) and waist hip ratio (WHR) and conicity index (CI)). Results. The PHPT group showed higher central adiposity indices (WHtR p=0.002, and CI p=0.008). Among patients with parathyroid disorders, PHPT subjects display the highest reduction of FMD (p<0.001) and a marked increase of IMT (p<0.001). In the Ctrl group, WHtR showed a weak-to-moderate positive association with IMT (r=0.381, p=0.018). In the PHPT group, no anthropometric index was significantly correlated with IMT or FMD (all p>0.05). Conclusions. WHtR and CI provide evidence of increased central fat adiposity in PHPT but do not account for impaired atherothrombotic risk, indicating that anthropometric indices may lack relevance to cardiovascular risk in this condition and emphasising the importance of a specific assessment profile.