{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T01:41:15Z","timestamp":1791942075042,"version":"4.3.4"},"reference-count":28,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Primary hyperparathyroidism (pHPT) is a common endocrine disorder linked to elevated parathyroid hormone and calcium levels, which may contribute to increased cardiometabolic risk.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the long-term cardiometabolic risks associated with pHPT and to assess whether parathyroidectomy is associated with reduced incidence of these outcomes.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective cohort study used data from Clalit Health Services, Israel\u2019s largest health care organization. A total of 50\u202f199 patients diagnosed with pHPT between January 1, 2000, and November 29, 2023, and 150\u202f265 matched controls (matched 1:3 by age, sex, and socioeconomic status) were included. Patients with secondary hyperparathyroidism were excluded. Among patients with pHPT, 6654 underwent parathyroidectomy. Duration of follow-up was as long as 15 years. Data were analyzed from November 1, 2024, to April 1, 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Diagnosis of pHPT and parathyroidectomy.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Incidence of hypertension, type 2 diabetes (T2D), cardiovascular disease (CVD), and cerebrovascular accidents (CVA). Events were analyzed using Kaplan-Meier curves and multivariable-stratified Cox proportional hazards regression models adjusted for Charlson Comorbidity Index, body mass index, and ethnicity.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 200\u202f464 individuals were included (median age, 66 [IQR, 55-75] years; 136 884 [68.3%] female), comprising 50\u202f199 patients with pHPT and 150\u202f265 matched control individuals. Patients with pHPT exhibited an elevated long-term risk of hypertension (adjusted hazard ratio [AHR], 1.22; 95% CI, 1.17-1.33;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), T2D (AHR, 1.07; 95% CI, 1.01-1.16;\n P<\/jats:italic>\n \u2009=\u2009.02), CVD (AHR, 1.28; 95% CI, 1.21-1.42;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), and CVA (AHR, 1.22; 95% CI, 1.17-1.33;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) compared with controls. Between patients who underwent parathyroidectomy and those who underwent nonsurgical management, parathyroidectomy was associated with a reduced risk of T2D only, with the incidence decreasing from 15.18 (95% CI, 14.58-15.81) to 10.77 (95% CI, 9.80-11.83) per 1000 person-years (AHR, 0.56; 95% CI, 0.30-0.89;\n P<\/jats:italic>\n \u2009=\u2009.002).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n The findings of this cohort study suggest that pHPT is associated with increased long-term cardiometabolic risks. Parathyroidectomy may be associated with reduced incidence of T2D, supporting consideration of surgical intervention in appropriate patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.44623","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T16:30:36Z","timestamp":1763742636000},"page":"e2544623","source":"Crossref","is-referenced-by-count":4,"title":["Parathyroidectomy and Cardiometabolic Risks in Patients With Primary Hyperparathyroidism"],"prefix":"10.1001","volume":"8","author":[{"given":"Nir","family":"Tsur","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Rabin Medical Center\u2013Beilinson Hospital, Petach Tikva, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nofar","family":"Edri","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Rabin Medical Center\u2013Beilinson Hospital, Petach Tikva, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomer","family":"Kerman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Rabin Medical Center\u2013Beilinson Hospital, Petach Tikva, Israel"},{"name":"Joyce & Irving Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be\u2019er-Sheva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeela","family":"Talmor-Barkan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"},{"name":"Department of Cardiology, Rabin Medical Center, Petah Tiqva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shir","family":"Kushnir","sequence":"additional","affiliation":[{"name":"Research Authority, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gideon","family":"Bachar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Rabin Medical Center\u2013Beilinson Hospital, Petach Tikva, Israel"},{"name":"Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"issue":"1","key":"zoi251208r1","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s12872-019-1093-4","article-title":"Parathyroidectomy improves cardiovascular risk factors in normocalcemic and hypercalcemic primary hyperparathyroidism.","volume":"19","author":"Beysel","year":"2019","journal-title":"BMC Cardiovasc 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