Effects of Parathyroidectomy on Muscle Mass, Strength, and Physical Function in Uremia-Associated Secondary Hyperparathyroidism.

Objective

To investigate the effects of parathyroidectomy (PTX) on muscle mass, muscle strength, and motor function at different postoperative stages in uremic patients with secondary hyperparathyroidism (SHPT).

Methods

A total of 47 uremic patients with SHPT who underwent PTX were enrolled in this study. General clinical data, including age and blood biochemical parameters, were collected. Pre- and postoperative measurements of lean body mass, the appendicular skeletal muscle index (ASMI), skinfold thickness, grip strength, and 6-m walk time were recorded. Patients were divided into three groups-short-term, mid-term, and long-term-based on the timing of postoperative follow-up, and the patterns of change in muscle mass, strength, and function at different time points following PTX were analyzed.

Results

In the short-term postoperative period, patients' grip strength increased significantly, and their 6-m walk time decreased significantly (p < 0.05), whilst lean body mass, the ASMI and skinfold thickness showed no significant changes compared with preoperative levels (p > 0.05). In the mid-term postoperative period, lean body mass, the ASMI and grip strength all increased significantly, whilst the 6-m walk time decreased significantly (p < 0.05); there was no significant change in skinfold thickness (p > 0.05). In the long-term postoperative period, skinfold thickness and grip strength increased significantly, and the 6-m walk time was significantly reduced (p < 0.05), whilst lean body mass and the ASMI showed no statistically significant difference compared to preoperative levels (p > 0.05).

Conclusions

PTX can effectively improve muscle strength and lower limb motor function in uremic patients with SHPT, and these improvements persist during long-term postoperative follow-up; improvements in muscle mass-related indicators exhibit a phased pattern, with significant increases observed in the mid-postoperative period, suggesting that the improvement in muscle mass following PTX is subject to a certain time-dependent effect.