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Nomine-Criqui C, Bihain F, Nguyen-Thi PL, Scheyer N, Demarquet L, Klein M, Guerci B, Brunaud L. Patients with prediabetes improve insulin resistance after surgery for primary hyperparathyroidism. Surgery 2024; 175:180-186. [PMID: 37981555 DOI: 10.1016/j.surg.2023.04.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/14/2023] [Accepted: 04/05/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND The objective of this study was to evaluate the evolution of insulin resistance at 12 months after parathyroidectomy for primary hyperparathyroidism according to the preoperative severity of glucose metabolism abnormalities. METHODS Observational study of patients who underwent parathyroidectomy between 2016 and 2021. Prediabetes and insulin resistance were defined as fasting glucose ≥1.00 g/L (American Diabetes Association) and homeostatic model assessment of insulin resistance >2.5, respectively. RESULTS A total of 231 patients were included. Preoperatively, 75 patients (32%) had prediabetes, and 108 patients (47%) had insulin resistance. At 12 months postoperative, homeostatic model assessment of insulin resistance values significantly decreased in patients with prediabetes (-0.69; P = .04) and in patients with insulin resistance (-0.85; P < .001). In patients with prediabetes, 48/75 (64%) decreased their insulin resistance, including 15/48 (31%) with normalization of fasting glucose. In multivariate analysis, preoperative prediabetes (1.82, 1.03-3.21; P = .037) or preoperative homeostatic model assessment of insulin resistance >2.5 (3.90, 2.23-6.75; P < .001) remained independent predictors for insulin resistance reduction observed between preoperative and 12 months postoperative. CONCLUSION Parathyroidectomy is more likely to reduce insulin resistance in patients with primary hyperparathyroidism and prediabetes or in patients with higher preoperative homeostatic model assessment of insulin resistance values. These data support the use of the preoperative prediabetes criterion in addition to the international workshop criteria for parathyroidectomy to better select patients for surgery.
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Affiliation(s)
- Claire Nomine-Criqui
- University of Lorraine, CHU Nancy - Hospital Brabois Adultes, Department of Surgery (CVMC), Unit of Endocrine and Metabolic Surgery (7ème étage), Nancy, France; University of Lorraine, INSERM NGERE / U1256, "Nutrition, Genetics, Environmental Risks," Faculty of Medicine, Nancy, France
| | - Florence Bihain
- University of Lorraine, CHU Nancy - Hospital Brabois Adultes, Department of Surgery (CVMC), Unit of Endocrine and Metabolic Surgery (7ème étage), Nancy, France; University of Lorraine, INSERM NGERE / U1256, "Nutrition, Genetics, Environmental Risks," Faculty of Medicine, Nancy, France
| | - Phi-Linh Nguyen-Thi
- University of Lorraine, CHU Nancy, Department of Medical Informatics and Evaluation, Nancy, France
| | - Nicolas Scheyer
- University of Lorraine, CHU Nancy, Department of Endocrinology, Diabetology and Nutrition (EDN), Nancy, France
| | - Léa Demarquet
- University of Lorraine, CHU Nancy, Department of Endocrinology, Diabetology and Nutrition (EDN), Nancy, France
| | - Marc Klein
- University of Lorraine, CHU Nancy, Department of Endocrinology, Diabetology and Nutrition (EDN), Nancy, France
| | - Bruno Guerci
- University of Lorraine, CHU Nancy, Department of Endocrinology, Diabetology and Nutrition (EDN), Nancy, France
| | - Laurent Brunaud
- University of Lorraine, CHU Nancy - Hospital Brabois Adultes, Department of Surgery (CVMC), Unit of Endocrine and Metabolic Surgery (7ème étage), Nancy, France; University of Lorraine, INSERM NGERE / U1256, "Nutrition, Genetics, Environmental Risks," Faculty of Medicine, Nancy, France.
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Yang Y, Tseng WJ, Wang B. Abaloparatide Maintains Normal Rat Blood Calcium Level in Part Via 1,25-Dihydroxyvitamin D/osteocalcin Signaling Pathway. Endocrinology 2023; 164:bqad117. [PMID: 37493045 PMCID: PMC10424883 DOI: 10.1210/endocr/bqad117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/01/2023] [Accepted: 07/25/2023] [Indexed: 07/27/2023]
Abstract
The PTH-related peptide(1-34) analog, abaloparatide (ABL), is the second anabolic drug available for the treatment of osteoporosis. Previous research demonstrated that ABL had a potent anabolic effect but caused hypercalcemia at a significantly lower rate. However, the mechanism by which ABL maintains the stability of blood calcium levels remains poorly understood. Our in vivo data showed that ABL treatment (40 µg/kg/day for 7 days) significantly increased rat blood level of 1,25-dihydroxyvitamin D [1,25-(OH)2D] without raising the blood calcium value. ABL also significantly augmented the carboxylated osteocalcin (Gla-Ocn) in the blood and bone that is synthesized by osteoblasts, and increased noncarboxylated Ocn, which is released from the bone matrix to the circulation because of osteoclast activation. The in vitro data showed that ABL (10 nM for 24 hours) had little direct effects on 1,25-(OH)2D synthesis and Gla-Ocn formation in nonrenal cells (rat osteoblast-like cells). However, ABL significantly promoted both 1,25-(OH)2D and Gla-Ocn formation when 25-hydroxyvitamin D, the substrate of 1α-hydroxylase, was added to the cells. Thus, the increased 1,25-(OH)2D levels in rats treated by ABL result in high levels of Gla-Ocn and transient calcium increase in the circulation. Gla-Ocn then mediates calcium ions in the extracellular fluid at bone sites to bind to hydroxyapatite at bone surfaces. This regulation by Gla-Ocn at least, in part, maintains the stability of blood calcium levels during ABL treatment. We conclude that the signaling pathway of ABL/1,25-(OH)2D/Gla-Ocn contributes to calcium homeostasis and may help understand the mechanism of ABL for osteoporosis therapy.
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Affiliation(s)
- Yanmei Yang
- The Center for Translational Medicine, Departments of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Wei-Ju Tseng
- The Center for Translational Medicine, Departments of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Bin Wang
- The Center for Translational Medicine, Departments of Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
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Verdelli C, Tavanti GS, Forno I, Vaira V, Maggiore R, Vicentini L, Dalino Ciaramella P, Perticone F, Lombardi G, Corbetta S. Osteocalcin modulates parathyroid cell function in human parathyroid tumors. Front Endocrinol (Lausanne) 2023; 14:1129930. [PMID: 37065733 PMCID: PMC10098338 DOI: 10.3389/fendo.2023.1129930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/14/2023] [Indexed: 04/01/2023] Open
Abstract
INTRODUCTION The bone matrix protein osteocalcin (OC), secreted by osteoblasts, displays endocrine effects. We tested the hypothesis that OC modulates parathyroid tumor cell function. METHODS Primary cell cultures derived from parathyroid adenomas (PAds) and HEK293 cells transiently transfected with the putative OC receptor GPRC6A or the calcium sensing receptor (CASR) were used as experimental models to investigate γ-carboxylated OC (GlaOC) or uncarboxylated OC (GluOC) modulation of intracellular signaling. RESULTS In primary cell cultures derived from PAds, incubation with GlaOC or GluOC modulated intracellular signaling, inhibiting pERK/ERK and increasing active β-catenin levels. GlaOC increased the expression of PTH, CCND1 and CASR, and reduced CDKN1B/p27 and TP73. GluOC stimulated transcription of PTH, and inhibited MEN1 expression. Moreover, GlaOC and GluOC reduced staurosporin-induced caspase 3/7 activity. The putative OC receptor GPRC6A was detected in normal and tumor parathyroids at membrane or cytoplasmic level in cells scattered throughout the parenchyma. In PAds, the membrane expression levels of GPRC6A and its closest homolog CASR positively correlated; GPRC6A protein levels positively correlated with circulating ionized and total calcium, and PTH levels of the patients harboring the analyzed PAds. Using HEK293A transiently transfected with either GPRC6A or CASR, and PAds-derived cells silenced for CASR, we showed that GlaOC and GluOC modulated pERK/ERK and active β-catenin mainly through CASR activation. CONCLUSION Parathyroid gland emerges as a novel target of the bone secreted hormone osteocalcin, which may modulate tumor parathyroid CASR sensitivity and parathyroid cell apoptosis.
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Affiliation(s)
- Chiara Verdelli
- Laboratory of Experimental Endocrinology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Giulia Stefania Tavanti
- Laboratory of Experimental Endocrinology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Irene Forno
- Division of Pathology, Fondazione IRCCS Ca` Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Vaira
- Division of Pathology, Fondazione IRCCS Ca` Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | | | | | | | | | - Giovanni Lombardi
- Laboratory of Experimental Biochemistry and Molecular Biology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Athletics, Strenght and Conditioning, Poznań University of Physical Education, Poznań, Poland
| | - Sabrina Corbetta
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
- Endocrinology and Diabetology Service, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- *Correspondence: Sabrina Corbetta,
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Safari A, Fadakar N, Borhani-Haghighi A. The Association Between Inflammatory Biomarkers and Vitamin D Level With the Evolution and Severity of Stroke. Basic Clin Neurosci 2022; 13:807-814. [PMID: 37323962 PMCID: PMC10262286 DOI: 10.32598/bcn.2021.1971.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 12/14/2019] [Accepted: 02/10/2020] [Indexed: 11/02/2023] Open
Abstract
Introduction Vitamin D deficiency has been linked to the evolution of ischemic stroke, but the data regarding the association between stroke severity and vitamin D level is scarce. Methods Patients with first-ever ischemic stroke in the middle cerebral artery territory, within seven days after the stroke, were recruited. The control group included age- and gender-matched individuals. We compared 25-OH vitamin D (vitamin D), high sensitive C-reactive protein (hsCRP), serum amyloid A (SAA), and osteopontin levels between stroke patients and the control group. The association between stroke severity according to the National Institutes of Health Stroke Scale (NIHSS) and the Alberta stroke program early CT score (ASPECTS) and levels of vitamin D and inflammatory biomarkers were also studied. Results There was an association between hypertension (P=0.035), diabetes mellitus (P=0.043), smoking (P=0.016), history of ischemic heart disease (P=0.002), higher SAA (P<0.001), higher hsCRP (P<0.001), and lower vitamin D levels (P=0.002) and stroke evolution in a case-control study. Meanwhile, in stroke patients, its severity was associated with higher SAA (P=0.04) and hsCRP (P=0.001), and lower vitamin D levels (P=0.043) according to clinical scale (higher admission NIHSS). According to the ASPECT score, higher SAA (P=0.017) and hsCRP (P=0.007), but not lower vitamin D levels, were associated with more infarct areas (P=0.149). Conclusion Vitamin D may play a role in both the evolution and severity of stroke.
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Affiliation(s)
- Anahid Safari
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nima Fadakar
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Ziemińska M, Pawlak D, Sieklucka B, Chilkiewicz K, Pawlak K. Vitamin K-Dependent Carboxylation of Osteocalcin in Bone-Ally or Adversary of Bone Mineral Status in Rats with Experimental Chronic Kidney Disease? Nutrients 2022; 14:nu14194082. [PMID: 36235734 PMCID: PMC9572286 DOI: 10.3390/nu14194082] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 11/09/2022] Open
Abstract
Chronic kidney disease (CKD) commonly occurs with vitamin K (VK) deficiency and impaired bone mineralization. However, there are no data explaining the metabolism of endogenous VK and its role in bone mineralization in CKD. In this study, we measured serum levels of phylloquinone (VK1), menaquinone 4 and 7 (MK4, MK7), and VK-dependent proteins: osteocalcin, undercarboxylated osteocalcin (Glu-OC), and undercarboxylated matrix Gla protein (ucMGP). The carboxylated osteocalcin (Gla-OC), Glu-OC, and the expression of genes involved in VK cycle were determined in bone. The obtained results were juxtaposed with the bone mineral status of rats with CKD. The obtained results suggest that the reduced VK1 level observed in CKD rats may be caused by the accelerated conversion of VK1 to the form of menaquinones. The bone tissue possesses all enzymes, enabling the conversion of VK1 to menaquinones and VK recycling. However, in the course of CKD with hyperparathyroidism, the intensified osteoblastogenesis causes the generation of immature osteoblasts with impaired mineralization. The particular clinical significance seems to have a finding that serum osteocalcin and Glu-OC, commonly used biomarkers of VK deficiency, could be inappropriate in CKD conditions, whereas Gla-OC synthesized in bone appears to have an adverse impact on bone mineral status in this model.
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Affiliation(s)
- Marta Ziemińska
- Department of Monitored Pharmacotherapy, Medical University of Bialystok, Mickiewicza 2C Str., 15-222 Bialystok, Poland
| | - Dariusz Pawlak
- Department of Pharmacodynamics, Medical University of Bialystok, Mickiewicza 2C Str., 15-222 Bialystok, Poland
| | - Beata Sieklucka
- Department of Pharmacodynamics, Medical University of Bialystok, Mickiewicza 2C Str., 15-222 Bialystok, Poland
| | - Katarzyna Chilkiewicz
- Department of Monitored Pharmacotherapy, Medical University of Bialystok, Mickiewicza 2C Str., 15-222 Bialystok, Poland
| | - Krystyna Pawlak
- Department of Monitored Pharmacotherapy, Medical University of Bialystok, Mickiewicza 2C Str., 15-222 Bialystok, Poland
- Correspondence: ; Tel.: +48-85-7485600
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Okudan B, Seven B, Çağrı Karcı A, Fevzi Kılınçkaya M, Çapraz M, Turhan T, Cüneyt Murat Gülaldı N, Gulaldi NCM. Parathyroid Hormone on Osteoprotegerin Levels in Patients with Primary Hyperparathyroidism. Eurasian J Med 2022; 54:225-228. [PMID: 35950821 PMCID: PMC9797781 DOI: 10.5152/eurasianjmed.2021.21197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Osteoprotegerin is a glycoprotein that plays a major role in the regulation of bone turnover. The influence of parathyroid hormone, an important regulator of bone remodeling, on osteoprotegerin production is controversial. The purpose of the study was to assess the influence of parathyroid hormone on the circulating level of osteoprotegerin in patients with primary hyperparathyroidism by comparing it with healthy controls. MATERIALS AND METHODS Forty-four patients with biochemical verification of primary hyperparathyroidism scheduled for the surgical cure and 38 healthy subjects were included. Blood samples of the study group were taken before surgery. Levels of serum parathyroid hormone, osteoprotegerin, calcium, 25-hydroxyvitamin D [25(OH)D], and alkaline phosphatase were analyzed. Bone mineral density at the L1-L4 vertebrae and femoral neck was calculated by dual-energy X-ray absorptiometry. RESULTS Osteoprotegerin levels and bone mineral density values were significantly lower in patients than in the healthy subjects (P=.002 and P > .0001, respectively). There was no correlation between osteoprotegerin and parathyroid hormone in the groups. Osteoprotegerin was weakly correlated with bone mineral density in patients. No correlation was noted between osteoprotegerin and bone mineral density in the control group. Furthermore, osteoprotegerin levels were not correlated with calcium, 25(OH)D, and alkaline phosphatase levels in each group. CONCLUSION The production of osteoprotegerin appears to be inhibited by parathyroid hormone in patients with primary hyperparathyroidism. A weak positive correlation found among osteoprotegerin and bone mineral density recommends that osteoprotegerin may be a molecule that impacts bone metabolism and finally bone mineral density.
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Affiliation(s)
- Berna Okudan
- Department of Nuclear Medicine, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Bedri Seven
- Department of Nuclear Medicine, Sabuncuoğlu Şerefeddin Training and Research Hospital, Amasya, Turkey,Corresponding author: Bedri Seven E-mail:
| | - Alper Çağrı Karcı
- Division of Endocrinology, Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey
| | | | - Mustafa Çapraz
- Department of Internal Medicine, University of Amasya Faculty of Medicine, Amasya, Turkey
| | - Turan Turhan
- Department of Biochemistry, Ankara City Hospital, Ankara, Turkey
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Assessment of Clinical Utility of Assaying FGF-23, Klotho Protein, Osteocalcin, NTX, and Sclerostin in Patients with Primary Hyperparathyroidism. J Clin Med 2021; 10:jcm10143089. [PMID: 34300255 PMCID: PMC8303928 DOI: 10.3390/jcm10143089] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/09/2021] [Accepted: 07/11/2021] [Indexed: 12/28/2022] Open
Abstract
The purpose of this study was to assess the clinical usefulness of assaying the fibroblast growth factor (FGF-23), Klotho, osteocalcin, N-terminal telopeptide of type I collagen (NTX), and sclerostin levels in patients with primary hyperparathyroidism (PHPT) as markers of bone damage as well as for surgical treatment success. Seventeen patients with hypercalcemic PHPT and normal kidney function were studied. In all patients, PTH (parathormone), serum calcium, and creatinine were performed before and six months after parathyroidectomy (PTX). The studied group included patients whose PTH and calcium concentrations normalized post-operatively and with confirmed histopathological diagnosis. The control group consisted of nine age-matched healthy volunteers. The PHPT patients had elevated concentrations of FGF-23, osteocalcin, and NTX and reduced levels of sclerostin, as compared to the control group. After PTX, osteocalcin, NTX, and sclerostin levels normalized. The plasma values of FGF-23 decreased significantly, but remained higher than in healthy subjects. Serum Klotho protein levels did not differ significantly in the two groups. These results suggest that osteocalcin and NTX may potentially be considered as markers of PHPT progression. Additionally, serum normalization of osteocalcin, NTX, and sclerostin might be considered as indicators of PTX success. On the other hand, FGF-23 can represent a parameter reflecting the degree of calcium–phosphate imbalance in PHPT patients, but its usefulness in monitoring the effects of PTX requires further research. The clinical utility of assaying Klotho in PHPT remains to be confirmed.
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