{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T14:21:01Z","timestamp":1794666061045,"version":"4.9.1"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2009,7,31]],"date-time":"2009-07-31T00:00:00Z","timestamp":1248998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetic Medicine"],"published-print":{"date-parts":[[2009,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Aims\u2002<\/jats:bold> An increased frequency of both impaired glucose tolerance and Type 2 diabetes mellitus (DM) has been reported in primary hyperparathyroidism (pHPT), thus we sought to investigate insulin sensitivity and insulin secretion in a large series of pHPT patients.<\/jats:p><jats:p><jats:bold>Subjects and methods\u2002<\/jats:bold> One hundred and twenty\u2010two consecutive pHPT patients without known DM were investigated [age (mean\u2003\u00b1\u2003<jats:sc>sd<\/jats:sc>) 59.3\u2003\u00b1\u200313.6\u2003years, body mass index (BMI) 25.7\u2003\u00b1\u20034.2\u2003kg\/m<jats:sup>2<\/jats:sup>; serum calcium 2.8\u2003\u00b1\u20030.25\u2003mmol\/l; PTH 203.2\u2003\u00b1\u2003145.4\u2003ng\/l]. Sixty\u2010one control subjects were matched, according to the degree of glucose tolerance, in a 2\u2003:\u20031 patient:control ratio. Fasting\u2010 and oral glucose tolerance test\u2010derived estimates of insulin sensitivity and secretion were determined by means of the quantitative insulin sensitivity check index (QUICKI) and the insulin sensitivity index (ISI) composite.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Both the QUICKI and ISI composite were lower in pHPT patients than control subjects (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.03 and <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.05, respectively) after adjusting for age, systolic blood pressure and BMI. Conversely, all insulin secretion estimates were significantly increased in pHPT patients than in control subjects (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.04 and <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.03, respectively) and after adjusting for age, systolic blood pressure and BMI. Log serum calcium levels were negatively associated with the QUICKI and log ISI composite (<jats:italic>R<\/jats:italic>\u2003=\u2003\u22120.30, <jats:italic>P<\/jats:italic>\u2003=\u20030.001; <jats:italic>R<\/jats:italic>\u2003=\u2003\u22120.23, <jats:italic>P<\/jats:italic>\u2003=\u20030.020, respectively) in pHPT patients. Serum calcium levels significantly and independently contributed to impaired insulin sensitivity in multivariate analysis (QUICKI as dependent variable: \u03b2\u2003=\u2003\u22120.31, <jats:italic>P<\/jats:italic>\u2003=\u20030.004, <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2003=\u20030.15; log ISI composite as dependent variable: \u03b2\u2003=\u2003\u22120.29, <jats:italic>P<\/jats:italic>\u2003=\u20030.005, <jats:italic>R<\/jats:italic><jats:sup>2<\/jats:sup>\u2003=\u20030.16).<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> Our study confirms a reduction in both basal and stimulated insulin sensitivity in primary hyperparathyroidism, in spite of increased insulin secretion. Moreover, our data show for the first time a significant relationship between hypercalcaemia and insulin sensitivity in this condition.<\/jats:p>","DOI":"10.1111\/j.1464-5491.2009.02804.x","type":"journal-article","created":{"date-parts":[[2009,7,31]],"date-time":"2009-07-31T08:08:02Z","timestamp":1249027682000},"page":"968-973","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Insulin resistance is not coupled with defective insulin secretion in primary hyperparathyroidism"],"prefix":"10.1111","volume":"26","author":[{"given":"F.","family":"Tassone","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Procopio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Gianotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Visconti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Pia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Terzolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Borretta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,9,25]]},"reference":[{"key":"e_1_2_8_2_2","first-page":"N68","article-title":"Clinical presentation of primary hyperparathyroidism in Europe\u2014nationwide cohort analysis on mortality from non\u2010malignant causes","volume":"17","author":"Nilsson IL","year":"2002","journal-title":"J Bone Miner Res"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.1991.tb01678.x"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2002.00809.x"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03345264"},{"key":"e_1_2_8_6_2","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1056\/NEJM197503062921003","article-title":"Glucose tolerance and insulin secretion in patients with parathyroid disorders. 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