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The Influence of Hyperparathyroidism on Glucose Metabolism in Uremia^*

ROBERT H. K. MAK, ALBERTO BETTINELLI, CHARLES TURNER, GEORGE B. HAYCOCK and CYRIL CHANTLER

Evelina Department of Paediatrics, Guy's Hospital London, United Kingdom

Address all correspondence and requests for reprints to: Prof. C. Chantler, Evelina Department of Paediatrics, 12th floor, Tower Block, Guy's Hospital, London SEl 9RT, United Kingdom

We studied glucose metabolism in a group of adolescents and young adults with uremia using the hypergly-cemic clamp technique. In eight adolescent patients, the glucose metabolic rate correlated negatively with PTH levels and positively with the glomerular filtration rate. Six patients, one adolescent and five adults on regular hemodialysis with severe hyperparathyroidism, had low glucose metabolic rates and reduced insulin sensitivity compared to normal subjects. After parathyroidectomy, the glucose metabolic rate improved by 47%; plasma insulin concentrations during hyperglycemia increased by 37%, and insulin sensitivity did not change significantly. Thus, correction of hyperparathyroidism was associated with normalization of glucose metabolic rates and increased insulin secretion, but insulin resistance did not change. (J Clin Endo-crinol Metab 60: 229, 1985)

^* This work was supported by the Guy's Hospital Medical School, University of London, from grants donated by the Legacy of Leslie Larkins, and by the National Kidney Research Fund. We are also grateful to the National Medical Research Fund for extensive support.

Recipien t of a Wellcome Lectureship.

Received March 6, 1984.

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