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Investigation Of Disulfide, Total Thiol, Native Thiol, And Ischemia-Modified Albumin Levels In Patients Diagnosed With Primary Hyperparathyroidism
Beyza Nur Aydın Keskin1, Mahir Coşkun2, Murat Alay2, İbrahim Keskin3, Ozcan Erel4, Salim Neselioglu41Department Of Internal Diseases, Van Research And Education Hospital, Van, Türkiye2Department Of Endocrinology, Van Yuzuncu Yil University, Van, Turkey
3Departman Of Enfectious Diseases And Clinical Microbiology, Van Yuzuncu Yil University, Van, Turkey
4Department Of Clinical Biochemistry, Faculty Of Medicine, Yildirim Beyazit University, Ankara, Turkey.
INTRODUCTION: Primary hyperparathyroidism (PHPT) is an endocrine disorder with systemic effects, including potential oxidative stress. Although thiol–disulfide homeostasis and ischemia-modified albumin (IMA) assess oxidative processes, their connection with PHPT remains limited. This study evaluated thiol–disulfide homeostasis and IMA levels in PHPT patients compared to healthy controls.
METHODS: Forty PHPT patients and 40 controls were included. Serum thiol–disulfide and IMA levels were measured spectrophotometrically. Intergroup comparisons used Student’s t-test, Mann-Whitney U, and chi-square/Fisher’s exact tests. Pearson correlation assessed intervariable relationships. Analysis of covariance (ANCOVA) adjusted for age.
RESULTS: Age, PTH, and calcium were significantly higher in the PHPT group, while IMA was lower (all p≤0.003). Unadjusted analyses showed no thiol differences; however, age-adjusted ANCOVA revealed significant differences for native (p=0.035) and total thiol (p=0.031). Correlation analysis revealed significant negative relationships between age and thiols, and between PTH, phosphorus, and bone mineral density. Preoperative PTH correlated positively with thiol levels.
DISCUSSION AND CONCLUSION: PHPT is associated with altered oxidative status, characterised by unexpectedly low IMA levels and age-dependent thiol disruptions. These lower IMA levels differ from typical elevations in other oxidative stress conditions, indicating a distinctive metabolic influence. Significant thiol differences emerging only after age adjustment highlights that demographic imbalances can mask these associations. The positive correlation between PTH and thiols may represent a compensatory antioxidant response to increased calcium load. Overall, oxidative stress dynamics in PHPT are complex, highlighting the importance of strictly considering confounding factors like age.
Keywords: Primary hyperparathyroidism, thiol–disulfide homeostasis, ischemia-modified albumin, oxidative stress
Manuscript Language: English