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Milicic Stanic B, Ilincic B, Zeravica R, Milicic Ivanovski D, Cabarkapa V, Mijovic R. The Importance of Correlation between Aldosterone and Parathyroid Hormone in Patients with Primary Hyperparathyroidism. Int J Endocrinol 2022; 2022:3804899. [PMID: 36389124 PMCID: PMC9663215 DOI: 10.1155/2022/3804899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022] Open
Abstract
In primary hyperparathyroidism, an increased risk of developing the cardiovascular disease may exist due to increased activity of the renin-angiotensin-aldosterone system. The aim of this study was to evaluate the relationship between parathyroid hormone and aldosterone in patients with primary hyperparathyroidism. The study included 48 patients with primary hyperparathyroidism and 30 healthy subjects who matched age and gender to the study group. This study was conducted at the Center for Laboratory medicine, Clinical center of Vojvodina, Novi Sad, Serbia. In addition to clinical data and laboratory determination of the concentration of total and ionized calcium, phosphorus, measurements of parathyroid hormone, vitamin D, direct renin, and aldosterone were performed by the method of chemiluminescent technology. Compared to the controls, the study group had statistically significantly higher values of aldosterone (p=0.028), total calcium (p=0.01), ionized calcium (p=0.003) and parathyroid hormone (P ≤ 0.001) Serum aldosterone and parathyroid hormone levels were correlated positively in patients with primary hyperparathyroidism (r=0.509, p < 0.05). A statistically significant positive correlation between renin and parathyroid hormone (r=0.688, p < 0.05) and renin and calcium (r=0.673, p < 0.05) was determined in hyperparathyroid patients. In multivariate regression analysis, the strongest predictive variable of aldosterone secretion was parathyroid hormone (p=0.011). An independent relationship between parathyroid hormone and aldosterone in patients with primary hyperparathyroidism and the correlation between renin and parathyroid hormone as well as with calcium indicate not only the direct but also the indirect associations between parathyroid hormone and aldosterone in primary hyperparathyroidism. These findings may represent another possible model of renin-angiotensin-aldosterone-induced organ damage.
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Affiliation(s)
- Branka Milicic Stanic
- Department of Medicine, Georgetown University Medical Center, 4000 Reservoir Road, NW, Washington, DC 20057, USA
- University of Novi Sad, Faculty of Medicine, Hajduk Veljkova 3, Novi Sad 21000, Serbia
| | - Branislava Ilincic
- University of Novi Sad, Faculty of Medicine, Hajduk Veljkova 3, Novi Sad 21000, Serbia
- Center for Laboratory Medicine, Clinical Center of Vojvodina, Hajduk Veljkova 1–9, Novi Sad 21000, Serbia
| | - Radmila Zeravica
- University of Novi Sad, Faculty of Medicine, Hajduk Veljkova 3, Novi Sad 21000, Serbia
- Center for Laboratory Medicine, Clinical Center of Vojvodina, Hajduk Veljkova 1–9, Novi Sad 21000, Serbia
| | - Dragana Milicic Ivanovski
- Center for Pathophysiology of Breathing and Respiratory Sleep Disorders, The Institute for Pulmonary Diseases of Vojvodina, Put dr Goldmana 4, Sr Kamenica 21204, Serbia
| | - Velibor Cabarkapa
- University of Novi Sad, Faculty of Medicine, Hajduk Veljkova 3, Novi Sad 21000, Serbia
- Center for Laboratory Medicine, Clinical Center of Vojvodina, Hajduk Veljkova 1–9, Novi Sad 21000, Serbia
| | - Romana Mijovic
- University of Novi Sad, Faculty of Medicine, Hajduk Veljkova 3, Novi Sad 21000, Serbia
- Center for Laboratory Medicine, Clinical Center of Vojvodina, Hajduk Veljkova 1–9, Novi Sad 21000, Serbia
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Zavatta G, Di Dalmazi G, Altieri P, Pelusi C, Golfieri R, Mosconi C, Balacchi C, Borghi C, Cosentino ER, Di Cintio I, Malandra J, Pagotto U, Vicennati V. Association Between Aldosterone and Parathyroid Hormone Levels in Patients With Adrenocortical Tumors. Endocr Pract 2021; 28:90-95. [PMID: 34508903 DOI: 10.1016/j.eprac.2021.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Patients with primary aldosteronism (PA) can present with high PTH levels and negative calcium balance, with some studies speculating that aldosterone could directly stimulate PTH secretion. Either adrenalectomy or mineralocorticoid receptor blockers could reduce PTH levels in patients with PA. The aim of this study was to assess the relationship between aldosterone levels and parathyroid hormone (PTH)-vitamin D-calcium axis in a cohort of patients with PA, compared with patients with nonsecreting adrenocortical tumors in conditions of vitamin D sufficiency. METHODS We enrolled a series of 243 patients retrospectively, of whom 66 had PA and 177 had nonsecreting adrenal tumors, and selected those with full mineral metabolism evaluation and 25(OH) vitamin D levels >20 ng/mL at the time of initial endocrine screening. The final cohort was composed of 26 patients with PA and 39 patients, used as controls, with nonsecreting adrenal tumors. The relationships between aldosterone, PTH levels, and biochemistries of mineral metabolism were assessed. RESULTS Aldosterone was positively associated with PTH levels (r = 0.260, P < .05) in the whole cohort and in the PA cohort alone (r = 0.450; P = .02). In the multivariate analysis, both aldosterone concentrations and urinary calcium excretion were significantly related to PTH levels, with no effect of 25(OH) vitamin D or other parameters of bone metabolism. CONCLUSION PTH level is associated with aldosterone, probably independent of 25(OH) vitamin D levels and urinary calcium. Whether aldosterone interacts directly with the parathyroid glands remains to be established.
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Affiliation(s)
- Guido Zavatta
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Guido Di Dalmazi
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Paola Altieri
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Carla Pelusi
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Rita Golfieri
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Cristina Mosconi
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Caterina Balacchi
- Diagnostic and Interventional Radiology Unit, Department of Diagnostic and Preventive Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Claudio Borghi
- Hypertension Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Eugenio Roberto Cosentino
- Hypertension Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Ilaria Di Cintio
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Jennifer Malandra
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Uberto Pagotto
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Valentina Vicennati
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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