Beyza Nur Aydın KESKİN, Mahir COŞKUN, Murat ALAY, İbrahim KESKİN, Salim NESELİOĞLU, Ozcan EREL
Van Medical Journal - 2026;33(3):266-276
Introduction: Primary hyperparathyroidism (PHPT) is characterized by excess parathyroid hormone secretion and altered calcium-phosphorus metabolism. Beyond skeletal and renal manifestations, PHPT may influence oxidative balance. This study evaluated serum thiol-disulfide homeostasis and ischemia-modified albumin (IMA) levels in patients with PHPT compared with healthy controls. Materials and Methods: This observational cross-sectional case-control study included 40 patients with PHPT and 40 healthy controls. Serum native thiol, total thiol, disulfide, and IMA levels were measured spectrophotometrically. Between-group comparisons, correlation analyses, and exploratory age-adjusted analysis of covariance were performed. Results: Patients with PHPT were older and had higher parathyroid hormone and calcium levels than controls, whereas IMA levels were unexpectedly lower (0.8 +/- 0.3 vs. 1.0 +/- 0.2 U/mL; p=0.003). In unadjusted analyses, thiol-disulfide parameters did not differ significantly. Albumin-adjusted IMA also remained lower in complete-case sensitivity analysis. In exploratory age-adjusted analysis of covariance, native thiol and total thiol levels were higher in the PHPT group at nominal p<0.05, but these findings were interpreted cautiously after false discovery rate correction. Age was negatively correlated with native thiol and total thiol, while preoperative parathyroid hormone was positively correlated with both parameters. Conclusion: PHPT appears to be associated with a non-uniform oxidative biomarker profile, characterized by unexpectedly lower IMA levels and age-sensitive thiol-related findings. Correlations should be interpreted as associations rather than causal or compensatory mechanisms. Larger studies with prospectively recruited age-matched controls are needed.
