Groundbreaking Research Links Parathyroid Surgery to Lower Diabetes Risk

A pioneering study led by the School of Clinical Medicine at the University of Hong Kong (HKUMed) has unveiled that surgical removal of the diseased parathyroid gland, known as parathyroidectomy, may reduce diabetes risk by an astonishing 30% in patients suffering from primary hyperparathyroidism (PHPT). This exciting finding adds to a growing body of evidence suggesting that such surgeries can deliver metabolic benefits beyond just calcium regulation. The research was published in the prestigious JAMA Surgery.

Understanding PHPT: A Hidden Epidemic

Primary hyperparathyroidism is the third most common endocrine disorder, following diabetes and thyroid diseases. It impacts thousands in Hong Kong alone and millions globally. Despite its prevalence, many remain unaware of PHPT and its potential ties to metabolic disorders like diabetes. This condition is marked by elevated calcium levels in the bloodstream, which can lead to kidney stones and osteoporosis, yet few realize it might also disrupt blood sugar regulation.

The Role of Parathyroid Hormone in Blood Sugar Control

Dr. David Lui Tak-wai, Clinical Assistant Professor of Endocrinology at HKUMed, emphasizes the critical function of parathyroid glands, which are distinct from the thyroid glands. These small glands are essential in maintaining blood calcium levels. "When calcium levels drop, parathyroid glands release parathyroid hormone (PTH), prompting calcium release from bones and enhancing absorption. While the risks of PHPT typically focus on kidney and bone health, our study highlights its often-overlooked impact on metabolism and diabetes risk," he explains.

Significant Findings from HKUMed's Analysis

Researchers at HKUMed conducted a comprehensive analysis of electronic health records from Hong Kong, examining over 3,100 adults diagnosed with PHPT from 2006 to 2023. With a median follow-up of nearly three years, they meticulously tracked the patients through medical diagnoses and blood tests to observe the onset of diabetes. The results were striking—participants who underwent parathyroidectomy had a 30% reduced risk of developing diabetes compared to those who did not have the surgery.

The Surgical Advantage: A Revelation for Younger Patients

Dr. Liu Xiaodong from the Division of Endocrine Surgery at HKUMed remarked, "The association between parathyroidectomy and reduced diabetes risk was consistently observed, and our results remained strong after rigorous validation. The benefits were especially pronounced in younger patients and those with more severe forms of PHPT." This discovery opens the door for new treatment avenues.

Raising Awareness: The Need for Early Intervention

Experts like Dr. Matrix Fung Man-him stress the importance of recognizing PHPT and its implications. "Parathyroidectomy not only protects bones and kidneys but may also offer crucial metabolic benefits. Elevated parathyroid hormone levels can increase cellular calcium, reduce insulin sensitivity, and elevate blood sugar levels. By correcting this hormonal imbalance, surgery can improve blood glucose control. Our findings provide clinicians with solid evidence to better inform treatment strategies."