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Liu B, Wei YP, Fan X, Hu X, Chen Z, Liu X, Xu Y, Wang L, Wang T, Ruiz M, Dupuis J, Yuan P, Liu J, Huang S, Zhu L, Jing ZC, Hu Q. Calcium Sensing Receptor Variants Increase Pulmonary Hypertension Susceptibility. Hypertension 2022; 79:1348-1360. [PMID: 35477244 DOI: 10.1161/hypertensionaha.121.18399] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Pulmonary arterial hypertension is an incurable disease, in which the extracellular CaSR (calcium sensing receptor) is mechanistically important. This study was aimed to genetically link the CaSR gene and function to the disease severity. METHODS Sanger sequencing, Sugen/hypoxia pulmonary arterial hypertension rat model, CaSR mutated rat, transcriptional reporter assay and measurement of CaSR activity were used. RESULTS Sanger sequencing identified a significant association between the variant rs1042636(A>G), located in CaSR exon 7, and idiopathic pulmonary arterial hypertension (IPAH) formation in patients. The frequency of 2968G homozygotes was higher in patients with IPAH compared with healthy individuals (23.6% versus 17.5%; P=0.001, OR=1.864), and the minor alleles of rs6776158, rs1048213, and rs9883099, located in CaSR promoter, raised the IPAH odds ratio to 2.173. Patients with IPAH carrying heterozygotes or homozygotes genotype of rs1042636 showed markedly higher pulmonary artery pressure and reduced survival compared with individuals carrying the wild-type allele. The minor alleles of rs6776158, rs1048213, and rs9883099 increased CaSR expression in reporter assay. In Sugen/hypoxia pulmonary arterial hypertension rats, the point mutation replicating rs1042636 found in IPAH exacerbated pulmonary arterial hypertension severity by promoting the overexpression and the enhanced activity of CaSR. CONCLUSIONS Our functional genomic analysis thus indicates that the CaSR minor alleles of rs1042636, rs6776158, rs1048213, and rs9883099 contribute to the development and severity of IPAH. These findings may benefit clinical prognosis and treatment for IPAH.
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Affiliation(s)
- Bingxun Liu
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China (B.L., X.F., Z.C., X.L.,Y.X., L.Z., Q.H.)
| | - Yun-Peng Wei
- Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.-P.W., Z.-C.J.)
| | - Xiaohang Fan
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China (B.L., X.F., Z.C., X.L.,Y.X., L.Z., Q.H.).,Key Laboratory of Pulmonary Diseases of Ministry of Health, Tongji Medical College, HUST, Wuhan, China (B.X., X.F., X.H., Z.C., X.L., Y.X., L.W., T.W., L.Z., Q.H.)
| | - Xiaoyi Hu
- Key Laboratory of Pulmonary Diseases of Ministry of Health, Tongji Medical College, HUST, Wuhan, China (B.X., X.F., X.H., Z.C., X.L., Y.X., L.W., T.W., L.Z., Q.H.).,Department of Respiratory and Critical Care Medicine, Tongji Hospital; Tongji Medical College, HUST, Wuhan, China (X.H., L.W., T.W.)
| | - Zeshuai Chen
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China (B.L., X.F., Z.C., X.L.,Y.X., L.Z., Q.H.).,Key Laboratory of Pulmonary Diseases of Ministry of Health, Tongji Medical College, HUST, Wuhan, China (B.X., X.F., X.H., Z.C., X.L., Y.X., L.W., T.W., L.Z., Q.H.)
| | - Xiaoyuan Liu
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China (B.L., X.F., Z.C., X.L.,Y.X., L.Z., Q.H.).,Key Laboratory of Pulmonary Diseases of Ministry of Health, Tongji Medical College, HUST, Wuhan, China (B.X., X.F., X.H., Z.C., X.L., Y.X., L.W., T.W., L.Z., Q.H.)
| | - Yan Xu
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China (B.L., X.F., Z.C., X.L.,Y.X., L.Z., Q.H.).,Key Laboratory of Pulmonary Diseases of Ministry of Health, Tongji Medical College, HUST, Wuhan, China (B.X., X.F., X.H., Z.C., X.L., Y.X., L.W., T.W., L.Z., Q.H.)
| | - Lu Wang
- Key Laboratory of Pulmonary Diseases of Ministry of Health, Tongji Medical College, HUST, Wuhan, China (B.X., X.F., X.H., Z.C., X.L., Y.X., L.W., T.W., L.Z., Q.H.).,Department of Respiratory and Critical Care Medicine, Tongji Hospital; Tongji Medical College, HUST, Wuhan, China (X.H., L.W., T.W.)
| | - Tao Wang
- Key Laboratory of Pulmonary Diseases of Ministry of Health, Tongji Medical College, HUST, Wuhan, China (B.X., X.F., X.H., Z.C., X.L., Y.X., L.W., T.W., L.Z., Q.H.).,Department of Respiratory and Critical Care Medicine, Tongji Hospital; Tongji Medical College, HUST, Wuhan, China (X.H., L.W., T.W.)
| | - Matthieu Ruiz
- Department of Nutrition, Université de Montréal, Canada (M.R.).,Montreal Heart Institute, Québec, Canada (M.R., J.D.)
| | - Jocelyn Dupuis
- Montreal Heart Institute, Québec, Canada (M.R., J.D.).,Department of medicine, Université de Montréal, Québec, Canada (J.D.)
| | - Ping Yuan
- Department of Cardiopulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai' China (P.Y., J.L.)
| | - Jinming Liu
- Department of Cardiopulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai' China (P.Y., J.L.)
| | - Songling Huang
- Department of Clinical Laboratory, the First Affiliate Hospital of Kunming Medical University, Kunming, China (S.H.)
| | - Liping Zhu
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China (B.L., X.F., Z.C., X.L.,Y.X., L.Z., Q.H.).,Key Laboratory of Pulmonary Diseases of Ministry of Health, Tongji Medical College, HUST, Wuhan, China (B.X., X.F., X.H., Z.C., X.L., Y.X., L.W., T.W., L.Z., Q.H.)
| | - Zhi-Cheng Jing
- Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Y.-P.W., Z.-C.J.)
| | - Qinghua Hu
- Department of Pathophysiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China (B.L., X.F., Z.C., X.L.,Y.X., L.Z., Q.H.).,Key Laboratory of Pulmonary Diseases of Ministry of Health, Tongji Medical College, HUST, Wuhan, China (B.X., X.F., X.H., Z.C., X.L., Y.X., L.W., T.W., L.Z., Q.H.)
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Mohammadi A, Shabestari AN, Baghdadabad LZ, Khatami F, Reis LO, Pishkuhi MA, Kazem Aghamir SM. Genetic Polymorphisms and Kidney Stones Around the Globe: A Systematic Review and Meta-Analysis. Front Genet 2022; 13:913908. [PMID: 35846117 PMCID: PMC9280078 DOI: 10.3389/fgene.2022.913908] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: This study explores associations between recurrent kidney stones and genetic polymorphisms. Methods: Meta-analysis of polymorphisms in renal stone cases versus control groups. Four electronic databases (PubMed, SCOPUS, EMBASE, and Web of Science) were searched up to 30 May 2021, using the keywords: “kidney stone” or “kidney calculi,” or “urolithiasis” or “nephrolithiasis” or “urinary calculi” and “genome” or “genetic” or “mutation” or “single nucleotide polymorphism.” Forrest plots, ORs, 95% CI, Chi-square (χ2)-test, and index of heterogeneity (I2) were calculated. Only studies with Newcastle–Ottawa scale (NOS) ≥ 6 were included for quality control, and Funnel, Begg’s, and Eager’s plots assessed publication bias. PROSPERO: CRD42022250427. Results: Among 7,671 searched articles, 72 were included. Polymorphisms in VDR (OR: 1.20; 95% CI: 1.06–1.36), CASR (OR = 1.24; 95% CI: 1.01–1.52), Osteopontin (OR = 1.38; 95% CI: 1.09–1.74), and Urokinase genes (OR = 1.52; 95% CI: 1.02–2.28) showed a significant association with risk of urinary stone formation, while Klotho gene showed a protective effect (OR = 0.75; 95% CI: 0.57–0.99). The VDR gene polymorphism was frequent in Asians, whereas CASR polymorphism was frequent in European and North American populations. Conclusion: Multifactorial nature of the stone formation, emphasizing the role of environmental factors, might explain contradictory results in the literature. While polymorphisms in VDR, CASR, Osteopontin, and Urokinase genes were associated with urinary stone formation, the Klotho gene showed a protective effect.
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Affiliation(s)
- Abdolreza Mohammadi
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Namazi Shabestari
- Department of Geriatric Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fatemeh Khatami
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Leonardo Oliveira Reis
- UroScience and Department of Surgery (Urology), School of Medical Sciences, University of Campinas, Unicamp, and Pontifical Catholic University of Campinas, PUC-Campinas, Campinas, São Paulo, Brazil
| | - Mahin Ahmadi Pishkuhi
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Science, Tehran, Iran
| | - Seyed Mohammad Kazem Aghamir
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Seyed Mohammad Kazem Aghamir,
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Sood A, Singh G, Singh TG, Gupta K. Pathological role of the calcium-sensing receptor in sepsis-induced hypotensive shock: Therapeutic possibilities and unanswered questions. Drug Dev Res 2022; 83:1241-1245. [PMID: 35689439 DOI: 10.1002/ddr.21959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/13/2022] [Accepted: 05/24/2022] [Indexed: 11/09/2022]
Abstract
Sepsis is a life-threatening disease involving multiorgan dysfunction, prompted by an unregulated host response to infection. Shock is a complication of sepsis in which the circulatory and cellular metabolism anomalies are significant enough to raise the risk of death. Calcium dyshomeostasis occurs during sepsis condition due to imbalance between calcium uptake and excessive release induced by inflammatory cytokines. This calcium imbalance can cause activation of calcium-sensing receptors (CaSRs) located on the surface of T cells and thereby promote release of reactive oxygen species (ROS). The elevated ROS and inflammatory cytokines during sepsis condition have been reported to directly damage the endothelial cells, disrupt the barrier functions that might result in leakage of fluids, and inflammatory cells in tissues Moreover, several evidence have revealed that the calcium mediated activation of CaSR could produce systemic vasodilatory response by stimulating the nitric oxide production and opening of calcium-activated potassium channels, while infusion of its antagonist elevated the blood pressure. These evidence indicate that activation of CaSR during sepsis conditions results in release of ROS and inflammatory cytokines, which could produce an endothelial barrier damage, cardiomyocyte apoptosis. These pathological events could produce loss of fluid in tissues and cardiac dysfunction. Further the direct vasodilatory effects of CaSR activation might add to the shock-like condition. Thus, we hereby propose that inhibition of CaSR could suppress the release of ROS, inflammatory mediators, and thereby prevent the endothelial damage, cardiac dysfunction, and maintain systemic vascular tone.
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Affiliation(s)
- Ankita Sood
- Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Gaaminepreet Singh
- Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Thakur G Singh
- Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Kirti Gupta
- Department of Pharmacology, Maharishi Markandeshwar University, Mullana, Ambala, Haryana, India
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Ngamkam J, Vadcharavivad S, Areepium N, Auamnoy T, Takkavatakarn K, Katavetin P, Tiranathanagul K, Praditpornsilpa K, Eiam-Ong S, Susantitaphong P. The impact of CASR A990G polymorphism in response to cinacalcet treatment in hemodialysis patients with secondary hyperparathyroidism. Sci Rep 2021; 11:18006. [PMID: 34504264 PMCID: PMC8429569 DOI: 10.1038/s41598-021-97587-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 08/27/2021] [Indexed: 11/24/2022] Open
Abstract
The objective of this study was to determine the impact of calcium sensing receptor (CASR) A990G genetic polymorphism on parathyroid hormone (PTH) lowering response to cinacalcet treatment when controlling for significant influencing clinical factors. This retrospective study was conducted on 135 Thai hemodialysis (HD) patients with secondary hyperparathyroidism (SHPT). CASR A990G genotypes were determined. The patients were identified as either G carriers (heterozygous or homozygous CASR 990G allele carriers) or noncarriers (homozygous CASR 990A carriers). Tested covariates were baseline PTH level (bPTH), baseline serum phosphate (bPhos), baseline serum calcium (bCa), baseline calcitriol equivalent dose (bCtriol), baseline ergocalciferol dose (bErgo), and age. The ANCOVA showed that intact PTH levels after 12 weeks of cinacalcet treatment (PTHw12) was significantly lower among G carriers compared with noncarriers after controlling for bPTH, bPhos, bCtriol, and bErgo (F(1, 127) = 15.472, p < 0.001), with the adjusted mean difference of 253.7 pg/mL. The logistic regression analysis revealed that the odds of a G carrier achieving 30% PTH reduction after 12-week cinacalcet treatment were 3.968 times greater than the odds for a noncarrier after adjusting for bPhos, bCtriol, and age. In conclusion, the CASR A990G polymorphism significantly influences cinacalcet response in HD patients with SHPT.
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Affiliation(s)
- Jaruwan Ngamkam
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Somratai Vadcharavivad
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
| | - Nutthada Areepium
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Titinun Auamnoy
- Faculty of Pharmaceutical Sciences, Burapha University, Chon Buri, 20131, Thailand
| | - Kullaya Takkavatakarn
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Pisut Katavetin
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Khajohn Tiranathanagul
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Kearkiat Praditpornsilpa
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.,Excellent Center of Geriatrics, King Chulalongkorn Memorial Hospital, Bangkok, 10330, Thailand
| | - Somchai Eiam-Ong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Paweena Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
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Hao Y, Lei Z, Shi N, Yu L, Ji W, Zhang X. Radiofrequency Ablation of Parathyroid Glands to Treat a Patient With Hypercalcemia Caused by a Novel Inactivating Mutation in CaSR. Front Endocrinol (Lausanne) 2021; 12:743517. [PMID: 35095753 PMCID: PMC8795859 DOI: 10.3389/fendo.2021.743517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 12/21/2021] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE We identified a novel inactivating mutation in the calcium-sensing receptor (CaSR) gene in a patient with refractory hypocalciuric hypercalcemia and analyzed its function. The effectiveness of radiofrequency ablation of the parathyroid glands to treat hypercalcemia caused by this mutation was explored. METHODS Clinical data of patients before and after radiofrequency ablation were retrospectively analyzed. The CaSR mutation (D99N) found in the patient was studied in cell lines. HEK-293 cells were transfected with plasmids containing wild-type (WT) or mutant CaSR genes (D99N and W718X). Expression levels of the respective CaSR proteins were measured, and their functions were assessed by examining the effect of NPS R-568 (a CaSR agonist) on intracellular Ca2+ oscillations and that of exogenous parathyroid hormone (PTH) on intracellular cyclic adenosine monophosphate (cAMP) levels. RESULTS The effectiveness of pharmacological treatment was poor, whereas radiofrequency ablation of the parathyroid glands resulted in controlled blood calcium and PTH levels in the patient. In cell lines, upon NPS R-568 administration, the amplitude of intracellular Ca2+ oscillations in the D99N group was lower than that in the WT group and higher than that in the W718X group. Upon administration of PTH, intracellular cAMP levels in the D99N group were higher than those in the WT group and lower than those in the W718X group. CONCLUSION The homozygous mutation D99N reduced CaSR activity and caused more severe hypocalciuric hypercalcemia. For patients with this type of hypercalcemia and poor response to pharmacological treatments, radiofrequency ablation of the parathyroid glands may be a suitable treatment option.
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Affiliation(s)
- Yu Hao
- Department of Endocrinology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhikai Lei
- Department of Ultrasound, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Nanjing Shi
- Department of Endocrinology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lingying Yu
- Department of Endocrinology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weiqin Ji
- Department of Endocrinology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xianfeng Zhang
- Department of Endocrinology, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Xianfeng Zhang,
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Daryanto B, Purnomo BB, Gunawan A, Tamara F, Hutama SA, Mayasari ED, Kusumaningrum AG, Fajar JK. Association between calcium-sensing receptor (CaSR) R990G, CaSR A986S, and CaSR Q1011E gene polymorphisms and the risk of urolithiasis: a meta-analysis. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2019. [DOI: 10.1186/s43042-019-0045-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Abstract
Backgrounds
In the last two decades, studies have been widely carried out to assess the association between single-nucleotide polymorphisms (SNPs) of calcium-sensing receptor (CaSR) gene in exon 7 and the risk of urolithiasis. However, inconsistency across the studies was reported. Therefore, our current study aimed to perform a meta-analysis concerning the association between the risk of urolithiasis and the gene polymorphisms of CaSR R990G, CaSR A986S, and CaSR Q1011E.
Methods
Published papers from PubMed, Embase, Cohcrane, and Web of science were included for the study, and they were analyzed using fixed or random effect model.
Results
A total of 11 papers consisting of eight papers evaluating CaSR R990G, nine papers evaluating CaSR A986S, and five papers evaluating CaSR Q1011E were included in our analysis. Our pooled calculation found that protective effect against urolithiasis was observed in R allele and RR genotype of CaSR R990G and A allele and AA genotype of CaSR A986S. Conversely, increased susceptibility to urolithiasis was found in G allele and RG genotype of CaSR R990G and S allele of CaSR A986S. Interestingly, our findings in sub-group analysis confirmed that the correlation between CaSR R990G and urolithiasis was found in Caucasian population. Meanwhile, in Asian population, the association was observed in CaSR A986S.
Conclusions
CaSR R990G and CaSR A986S, but not CaSR Q1011E, are associated with the risk of urolithiasis.
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Wu Y, Gao L, Guo X, Wang Z, Lian W, Deng K, Lu L, Xing B, Zhu H. Pituitary adenomas in patients with multiple endocrine neoplasia type 1: a single-center experience in China. Pituitary 2019; 22:113-123. [PMID: 30637623 DOI: 10.1007/s11102-019-00939-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE To explore the clinical characteristics of pituitary adenomas in patients with MEN1 and to summarize treatment strategies for MEN1 in a Chinese population. METHODS We retrospectively analyzed 54 MEN1 patients with pituitary adenomas diagnosed at Peking Union Medical College Hospital from March 2003 to January 2017. Clinical data, laboratory testing results, treatments of involved glands and treatment responses were collected and analyzed. RESULTS The mean age at pituitary adenoma diagnosis was 53.9 ± 17.8. The patients initially consulted the Endocrinology, General Surgery and Neurosurgery departments, in descending frequency. The nonfunctioning adenoma, prolactinoma, GH-secreting adenoma, cosecreting adenoma, and ACTH-secreting adenoma subtypes accounted for 48.1%, 27.8%, 9.3%, 9.3% and 5.6% of the cases, respectively. The remission rate for prolactinomas was 46.2% (6/13) treated with bromocriptine. And the remission rates were 87.5% (7/8) and 100% (3/3) for GH-secreting adenomas and ACTH-secreting adenomas respectively achieved by transsphenoidal surgery. Nineteen (35.2%) patients with asymptomatic nonfunctioning pituitary adenomas showed no progression after a 35-month follow-up with close observation. Regarding treatment priority, patients with thymic carcinoid tumors received first-line surgery, 54% of the patients with enteropancreatic tumors had these tumors treated first, and 26% of all patients had their pituitary adenomas treated first. In acromegalic patients, pituitary lesions tended to be treated first (75%, p = 0.002). PHPT and adrenocortical adenomas can be managed with elective surgery. CONCLUSIONS The treatment of MEN1 requires cooperation between multidisciplinary teams. Individualized treatment according to the severity of glandular involvement is needed. GH-secreting and ACTH-secreting pituitary adenomas require active treatment, while nonfunctioning pituitary adenomas can be observed closely.
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Affiliation(s)
- Yanyan Wu
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- China Pituitary Disease Registry Center, Chinese Pituitary Adenoma Specialist Council, Beijing, 100730, China
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Beijing, 100730, China
| | - Lu Gao
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- China Pituitary Disease Registry Center, Chinese Pituitary Adenoma Specialist Council, Beijing, 100730, China
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Beijing, 100730, China
| | - Xiaopeng Guo
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- China Pituitary Disease Registry Center, Chinese Pituitary Adenoma Specialist Council, Beijing, 100730, China
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Beijing, 100730, China
| | - Zihao Wang
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- China Pituitary Disease Registry Center, Chinese Pituitary Adenoma Specialist Council, Beijing, 100730, China
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Beijing, 100730, China
| | - Wei Lian
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- China Pituitary Disease Registry Center, Chinese Pituitary Adenoma Specialist Council, Beijing, 100730, China
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Beijing, 100730, China
| | - Kan Deng
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
- China Pituitary Disease Registry Center, Chinese Pituitary Adenoma Specialist Council, Beijing, 100730, China
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Beijing, 100730, China
| | - Lin Lu
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Bing Xing
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
- China Pituitary Disease Registry Center, Chinese Pituitary Adenoma Specialist Council, Beijing, 100730, China.
- Key Laboratory of Endocrinology of National Health and Family Planning Commission, Beijing, 100730, China.
| | - Huijuan Zhu
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, 100730, China.
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Feng W, Li Y, Li X, Li L. Levobupivacaine Infiltration with Midazolam Sedation vs. Propofol-based General Anesthesia for Minimal Invasive Parathyroidectomy. INT J PHARMACOL 2018. [DOI: 10.3923/ijp.2019.84.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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9
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Di Nisio A, Rocca MS, Ghezzi M, Ponce MDR, Taglianetti S, Plebani M, Ferlin A, Foresta C. Calcium-sensing receptor polymorphisms increase the risk of osteoporosis in ageing males. Endocrine 2018; 61:349-352. [PMID: 29019102 DOI: 10.1007/s12020-017-1429-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 09/16/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Andrea Di Nisio
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - Maria Santa Rocca
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - Marco Ghezzi
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - Maurizio De Rocco Ponce
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - Stefano Taglianetti
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - Mario Plebani
- Department of Medicine, Laboratory Medicine, University of Padova, Padova, Italy
| | - Alberto Ferlin
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy
| | - Carlo Foresta
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy.
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Vahe C, Benomar K, Espiard S, Coppin L, Jannin A, Odou MF, Vantyghem MC. Diseases associated with calcium-sensing receptor. Orphanet J Rare Dis 2017; 12:19. [PMID: 28122587 PMCID: PMC5264458 DOI: 10.1186/s13023-017-0570-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 01/13/2017] [Indexed: 12/29/2022] Open
Abstract
The calcium-sensing receptor (CaSR) plays a pivotal role in systemic calcium metabolism by regulating parathyroid hormone secretion and urinary calcium excretion. The diseases caused by an abnormality of the CaSR are genetically determined or are more rarely acquired. The genetic diseases consist of hyper- or hypocalcemia disorders. Hypercalcaemia disorders are related to inactivating mutations of the CASR gene either heterozygous (autosomal dominant familial benign hypercalcaemia, still named hypocalciuric hypercalcaemia syndrome type 1) or homozygous (severe neonatal hyperparathyroidism). The A986S, R990G and Q1011E variants of the CASR gene are associated with higher serum calcium levels than in the general population, hypercalciuria being also associated with the R990G variant. The differential diagnosis consists in the hypocalciuric hypercalcaemia syndrome, types 2 (involving GNA11 gene) and 3 (involving AP2S1 gene); hyperparathyroidism; abnormalities of vitamin D metabolism, involving CYP24A1 and SLC34A1 genes; and reduced GFR. Hypocalcemia disorders, which are more rare, are related to heterozygous activating mutations of the CASR gene (type 1), consisting of autosomal dominant hypocalcemia disorders, sometimes with a presentation of pseudo-Bartter’s syndrome. The differential diagnosis consists of the hypercalciuric hypocalcaemia syndrome type 2, involving GNA11 gene and other hypoparathyroidism aetiologies. The acquired diseases are related to the presence of anti-CaSR antibodies, which can cause hyper- or especially hypocalcemia disorders (for instance in APECED syndromes), determined by their functionality. Finally, the role of CaSR in digestive, respiratory, cardiovascular and neoplastic diseases is gradually coming to light, providing new therapeutic possibilities. Two types of CaSR modulators are known: CaSR agonists (or activators, still named calcimimetics) and calcilytic antagonists (or inhibitors of the CasR). CaSR agonists, such as cinacalcet, are indicated in secondary and primary hyperparathyroidism. Calcilytics have no efficacy in osteoporosis, but could be useful in the treatment of hypercalciuric hypocalcaemia syndromes.
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Affiliation(s)
- C Vahe
- Service d'Endocrinologie et Métabolisme, Hôpital C Huriez Centre Hospitalo-universitaire de Lille, 1 rue Polonovski, 59 037, Lille Cedex, France
| | - K Benomar
- Service d'Endocrinologie et Métabolisme, Hôpital C Huriez Centre Hospitalo-universitaire de Lille, 1 rue Polonovski, 59 037, Lille Cedex, France
| | - S Espiard
- Service d'Endocrinologie et Métabolisme, Hôpital C Huriez Centre Hospitalo-universitaire de Lille, 1 rue Polonovski, 59 037, Lille Cedex, France
| | - L Coppin
- Service de Biochimie et Biologie Moléculaire, Centre de Biologie-Pathologie, Centre Hospitalo-universitaire de Lille, 1 rue Polonovski, 59 037, Lille Cedex, France
| | - A Jannin
- Service d'Endocrinologie et Métabolisme, Hôpital C Huriez Centre Hospitalo-universitaire de Lille, 1 rue Polonovski, 59 037, Lille Cedex, France
| | - M F Odou
- Service de Biochimie et Biologie Moléculaire, Centre de Biologie-Pathologie, Centre Hospitalo-universitaire de Lille, 1 rue Polonovski, 59 037, Lille Cedex, France
| | - M C Vantyghem
- Service d'Endocrinologie et Métabolisme, Hôpital C Huriez Centre Hospitalo-universitaire de Lille, 1 rue Polonovski, 59 037, Lille Cedex, France. .,Equipe INSERM 1190 Prise en charge translationnelle du diabète, Lille Cedex, France. .,Institut EGID (European Genomic Institute for Diabetes), Lille Cedex, France.
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Kirdak T, Canturk NZ, Korun N, Ocakoglu G. Characteristics of patients operated for primary hyperparathyroidism at university hospitals in Türkiye: differences among Türkiye's geographical regions. Ann Surg Treat Res 2016; 91:8-16. [PMID: 27433459 PMCID: PMC4942541 DOI: 10.4174/astr.2016.91.1.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/25/2016] [Accepted: 05/16/2016] [Indexed: 11/30/2022] Open
Abstract
Purpose The aim of this study was to define the clinical and laboratory characteristics of patients operated on for primary hyperpatathyroidism (PHPT) at university hospitals in Türkiye, and to investigate the differences in the clinical presentations of the disease between different geographical regions. Methods Patients operated on for PHPT in the university hospitals of Türkiye were included in the study. The demographic, clinical, and laboratory findings and the operational data of the patients were investigated according to the whole country and to different geographical regions. Comparisons were performed according to whole country and regions. Results A total of 1,162 cases were included in the study from different regions and 20 university hospitals. The mean age of patients was 52.4 ± 0.38 (mean ± standard error) in the general population of Türkiye. The rates of hypertension, urolithiasis, bone disease and 25-hydroxyvitamin D insufficiency were 35%, 18.6%, 67.6%, and 63%, respectively. The median parathormone (PTH), serum total calcium (Ca+2) and phosphorus value were 220 pg/mL (range, 70–2,500 pg/mL), 11.2 mg/dL (range, 9.5–11.2 mg/dL), and 2.4 mg/dL (range, 1–4.7 mg/dL), respectively. The median size of the adenomas resected was 16 mm (range, 4–70 mm). Significant differences were observed in the clinical and laboratory findings of the patients operated on due to PHPT between different geographical regions of Türkiye (P < 0.05). Conclusion The clinical and laboratory characteristics of the patients with PHPT in different geographical regions of Türkiye differ. Furthermore, the general findings of the cases in Türkiye give us a hint that the severity of the disease here is somewhere between Eastern and Western countries.
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Affiliation(s)
- Turkay Kirdak
- Department of Surgery, Uludag University Faculty of Medicine, Bursa, Türkiye
| | - Nuh Zafer Canturk
- Department of Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye
| | - Nusret Korun
- Department of Surgery, Uludag University Faculty of Medicine, Bursa, Türkiye
| | - Gokhan Ocakoglu
- Department of Biostatistics, Uludag University Faculty of Medicine, Bursa, Türkiye
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Jeong S, Kim IW, Oh KH, Han N, Joo KW, Kim HJ, Oh JM. Pharmacogenetic analysis of cinacalcet response in secondary hyperparathyroidism patients. DRUG DESIGN DEVELOPMENT AND THERAPY 2016; 10:2211-25. [PMID: 27468225 PMCID: PMC4944925 DOI: 10.2147/dddt.s103370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Secondary hyperparathyroidism (SHPT) is one of the major risk factors of morbidity and mortality in end-stage renal disease. Cinacalcet effectively controls SHPT without causing hypercalcemia and hyperphosphatemia. However, there is significant inter-individual response variance to cinacalcet treatment. Therefore, we aimed to evaluate the genetic effects related with parathyroid hormone regulation as factors for cinacalcet response variance. Methods Patients with a diagnosis of SHPT based on intact parathyroid hormone (iPTH) >300 pg/mL on dialysis were included in this study. They were over 18 years and have been treated by cinacalcet for more than 3 months. Responders and nonresponders were grouped by the serum iPTH changes. Twenty-four single nucleotide polymorphisms of CASR, VDR, FGFR1, KL, ALPL, RGS14, NR4A2, and PTHLH genes were selected for the pharmacogenetic analysis. Results After adjusting for age, sex, and calcium level, CASR rs1042636 (odds ratio [OR]: 0.066, P=0.027) and rs1802757 (OR: 10.532, P=0.042) were associated with cinacalcet response. The association of haplotypes of CASR rs1042636, rs10190, and rs1802757; GCC (OR: 0.355, P=0.015); and ATT (OR: 2.769, P=0.014) with cinacalcet response was also significant. Conclusion We obtained supporting information of the associations between cinacalcet response and CASR polymorphisms. CASR single nucleotide polymorphisms (SNPs) rs1802757, rs1042636, and haplotypes of rs1042636, rs10190, and rs1802757 were significantly associated with cinacalcet response variance.
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Affiliation(s)
- Sohyun Jeong
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Seoul National University
| | - In-Wha Kim
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Seoul National University
| | - Kook-Hwan Oh
- Department of Internal Medicine, Division of Nephrology, Seoul National University Hospital, Seoul, Korea
| | - Nayoung Han
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Seoul National University
| | - Kwon Wook Joo
- Department of Internal Medicine, Division of Nephrology, Seoul National University Hospital, Seoul, Korea
| | - Hyo Jin Kim
- Department of Internal Medicine, Division of Nephrology, Seoul National University Hospital, Seoul, Korea
| | - Jung Mi Oh
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Seoul National University
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Wang XM, Wu YW, Li ZJ, Zhao XH, Lv SM, Wang XH. Polymorphisms of CASR gene increase the risk of primary hyperparathyroidism. J Endocrinol Invest 2016; 39:617-25. [PMID: 26710757 DOI: 10.1007/s40618-015-0405-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/27/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To evaluate correlations between polymorphisms of calcium-sensing receptor (CASR) gene [A986S (rs1081725), R990G (rs1042636) and Q1011E (rs1801726)] and the risk of primary hyperparathyroidism (PHPT) among human population. METHODS Relevant studies were retrieved from online databases using computer-based search strategies, which were then supplemented by manual search strategies. Case-control studies related to our topic were identified based on strict inclusion and exclusion criteria. Statistical analyses were conducted using the Comprehensive Meta-analysis 2.0 (Biostat Inc., Englewood, NJ, USA). RESULTS We retrieved 202 studies from online databases and other sources initially and eventually enrolled six studies into our meta-analysis. These six studies contained a sum of 693 PHPT patients and 1252 healthy controls. Our meta-analysis results showed that single nucleotide polymorphisms (SNPs) of CASR gene A986S (rs1081725) and R990G (rs1042636), but not Q1011E (rs1801726), may increase the risk of PHPT [A986S (rs1081725): allele model: P = 0.013; dominant model: P = 0.044; R990G (rs1042636): allele model: P = 0.023; dominant model: P = 0.026)]. Subgroup analyses based on ethnicity showed that among Asians, A986S (rs1081725) increased the PHPT risk (P = 0.04) under the allele model, but not under the dominant model. Among Caucasians, there was no association between gene frequencies and PHPT under both the allele and dominant model. In Asians, no significant association was observed between R990G (rs1042636) and PHPT risk, but in Caucasians, R990G (rs1042636) significantly increased the incidence of PHPT [R990G (rs1042636): allele model: P = 0.015; dominant model: P = 0.009)]. CONCLUSION Our results indicate that SNPs of CASR gene A986S (rs1081725) and R990G (rs1042636) may increase the risk of PHPT, and the polymorphisms can potentially be used as important biological markers for early diagnosis of PHPT.
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Affiliation(s)
- X-M Wang
- Department of Nephrology, Shaanxi Provincial People's Hospital, Xi'an, 710068, Shaanxi, China
| | - Y-W Wu
- Second Department of Gastroenterology, Shaanxi Provincial People's Hospital, No. 256 West Youyi Road, Xi'an, 710068, Shaanxi, China
| | - Z-J Li
- Department of Nephrology, Shaanxi Provincial People's Hospital, Xi'an, 710068, Shaanxi, China
| | - X-H Zhao
- Department of Nephrology, Shaanxi Provincial People's Hospital, Xi'an, 710068, Shaanxi, China
| | - S-M Lv
- Second Department of Gastroenterology, Shaanxi Provincial People's Hospital, No. 256 West Youyi Road, Xi'an, 710068, Shaanxi, China.
| | - X-H Wang
- Department of Nephrology, Shaanxi Provincial People's Hospital, Xi'an, 710068, Shaanxi, China
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The role of the calcium-sensing receptor in disorders of abnormal calcium handling and cardiovascular disease. Curr Opin Nephrol Hypertens 2015; 23:494-501. [PMID: 24992569 DOI: 10.1097/mnh.0000000000000042] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW The calcium-sensing receptor (CaSR) has a central role in parathyroid gland function. Genetic alterations in CaSR are well known to cause inherited forms of abnormal calcium homeostasis. This review focuses on studies investigating the role of CaSR in common disorders of abnormal calcium handling and in cardiovascular calcification. RECENT FINDINGS Genetic population studies tested the association of common allelic CASR variants with serum and urine calcium levels, kidney stone disease, primary hyperparathyroidism and bone mineral density. The results of these association studies suggested either minor or no effects of CASR variants in these phenotypes. Decreased expression of CaSR was associated with the etiology of cardiovascular calcification in individuals with advanced chronic kidney disease. SUMMARY Ionized calcium plays a central role in the physiology of many organ systems and disease states, but the roles of CaSR other than as illustrated by Mendelian forms of CaSR dysfunction remain unclear. The contributions of CaSR to bone mineral homeostasis, vascular calcification and other forms of cardiovascular disease need further investigation.
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The G allele of CaSR R990G polymorphism increases susceptibility to urolithiasis and hypercalciuria: evidences from a comprehensive meta-analysis. BIOMED RESEARCH INTERNATIONAL 2015; 2015:958207. [PMID: 25705702 PMCID: PMC4331470 DOI: 10.1155/2015/958207] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 10/04/2014] [Accepted: 10/06/2014] [Indexed: 12/31/2022]
Abstract
Background. The calcium-sensing receptor gene (CaSR) is a candidate to explain urolithiasis. A number of case-control studies were conducted to investigate associations between CaSR polymorphisms with risks of hypercalciuria and urolithiasis in humans. But the results were still inconsistent. Methods. A meta-analysis was performed to address this issue. Crude odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to estimate the strength of associations between CaSR polymorphisms and the risk of urolithiasis. The pooled standardized mean difference (SMD) with 95% CI was used for the meta-analysis of CaSR polymorphisms and urine calcium concentration. Results. For urolithiasis association, the SS genotype of A986S polymorphism was a risk factor for urolithiasis in Asians and PHPT patients, but a protective factor in Caucasians. The GG genotype of R990 polymorphism was associated with an increased risk of urolithiasis, especially in Caucasians and healthy population. Regarding urine calcium concentration association, individuals with the G allele had a higher level of urine calcium than the noncarriers. Conclusions. This meta-analysis revealed that the G allele of CaSR R990G polymorphism increases susceptibility to urolithiasis and hypercalciuria. The A986S and Q1011E polymorphisms were associated with urolithiasis and hypercalciuria in specific populations.
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