Elabela increases in patients with primary hyperparathyroidism, especially in the presence of surgery indication

Patients with primary hyperparathyroidism (PHPT) are known to have structural and functional changes in the vascular system. Bioactive peptides associated with the apelinergic system play a role in ischemic heart disease and atherosclerosis. In this study, we aimed to investigate the changes in serum elabela, a novel apelinergic system peptide, and its relationship with aortic intima media (AIM) measurements in patients with newly diagnosed primary hyperparathyroidism. The study was prospectively conducted with 45 patients with newly diagnosed Primary Hyperparathyroidism who were admitted to the Internal Medicine outpatient clinics of Adana City Training and Research Hospital. Forty people with similar demographic characteristics were included as a healthy control group. Hemogram, biochemistry, parathormone, vitamin D, urinary calcium, dual x-ray absorptiometry (DEXA), Elabela and aortic intima media levels were measured. The study groups were divided into three groups: healthy control group (Group 1: 40 patients), PHPT group without surgical indication (Group 2: 20 patients) and PHPT group with surgical indication (Group 3: 25 patients). Elabela level was found to increase from group 1 to group 3. It was 2.1 (1.3–2.4) ng/mL in group 1, 10.45 (3.7-14.15) ng/mL in group 2 and 12.6 (12.0–14.0) ng/mL in group 3 (p < 0.001). AIM level was found to be statistically significantly higher in group 3 compared to groups 1 and 2. It was 1.2 (1.0-1.4) mm in group 1, 1.3 (1.2–1.6) mm in group 2 and 2.15 (1.95–2.32) mm in group 3 (p < 0.001). Linear regression analysis performed with the parameters significantly correlated with Elabela in group 3 showed that DEXA and AIM levels were independently associated with Elabela. In the multivariate logistic regression analysis performed for the independent determination of patients with surgical indication in the patient group, it was found that Elabela level independently determined the group with surgical indication. According to this analysis, each 1 unit increase in Elabela level increased the probability of surgery by 30.9% in the patient group. In patients with primary hyperparathyroidism, serum Elabela level may be increased due to activation of the Apelinergic system in response to adverse vascular and cardiac effects that may be caused by increased parathormone. Elabela level can be used to determine the indication for surgery in PHPT patients.