Primary Hyperparathyroidism

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Among endocrine disorders inducing weight change, and theoretically weight loss, primary hyperparathyroidism (PHPT) must be mentioned. PHPT is a common endocrine disorder that predominantly affects post-menopausal women [43]. It is mostly caused by solitary adenomas of the parathyroid gland and is characterised by hypersecretion of parathyroid hormone (PTH) and consequently by hypercalcaemia. In addition to regu lating calcium concentrations, PTH exerts metabolic effects, including a stimulatory effect on lipolysis. This effect has been demonstrated both in animal and in human adipose tissue [44, 45]. However, PHPT is not commonly characterised by significant weight loss and there is contrasting evidence in the literature concerning this effect. For instance, it has been reported that PTH excess may promote weight gain by impeding cate-cholamine-induced lipolysis [46]. In a study by Grey et al., it was reported that post-menopausal women with mild untreated PHPT are markedly heavier than age-matched controls [47]. Thus, PHPT cannot be definitively considered as an endocrine cause of weight loss, although a lipolyt-ic effect of PTH has been described.

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