1
|
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.
Collapse
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.
| |
Collapse
|
2
|
Modica R, Liccardi A, Minotta R, Benevento E, Cannavale G, Colao A. Parathyroid diseases and metabolic syndrome. J Endocrinol Invest 2023; 46:1065-1077. [PMID: 36773188 DOI: 10.1007/s40618-023-02018-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/17/2023] [Indexed: 02/12/2023]
Abstract
PURPOSE Parathyroid diseases are related to parathyroid hormone (PTH) dysregulation by parathyroid cells or alteration of PTH function. They include hyperparathyroidism (PTH excess), hypoparathyroidism (PTH deficiency) and pseudohypoparathyroidism (PTH resistance). Little is known about correlation between parathyroid diseases and metabolic syndrome (MetS). METHODS An electronic-based search using PubMed was performed until October 2022 and articles were selected based on relevance of title, abstract, English language and publication in peer-reviewed journals. RESULTS Possible association between PTH alterations and the diverse manifestation of MetS have been proposed and it could be supposed that MetS may negatively influence parathyroid diseases. Available data show significant association for hyperparathyroidism and pseudohypoparathyroidism. CONCLUSIONS This review highlights the possible implications between MetS and parathyroid diseases. Given the increasing MetS global prevalence and the higher parathyroid diseases awareness and diagnosis, it may be interesting to further explore the possible role of alterations in parathyroid homeostasis in the development of MetS components with dedicated prospective studies.
Collapse
Affiliation(s)
- R Modica
- Department of Clinical Medicine and Surgery, Endocrinology Unit of Federico II University of Naples, 80131, Naples, Italy.
| | - A Liccardi
- Department of Clinical Medicine and Surgery, Endocrinology Unit of Federico II University of Naples, 80131, Naples, Italy
| | - R Minotta
- Department of Clinical Medicine and Surgery, Endocrinology Unit of Federico II University of Naples, 80131, Naples, Italy
| | - E Benevento
- Department of Clinical Medicine and Surgery, Endocrinology Unit of Federico II University of Naples, 80131, Naples, Italy
| | - G Cannavale
- Department of Clinical Medicine and Surgery, Endocrinology Unit of Federico II University of Naples, 80131, Naples, Italy
| | - A Colao
- Department of Clinical Medicine and Surgery, Endocrinology Unit of Federico II University of Naples, 80131, Naples, Italy
- UNESCO Chair on Health Education and Sustainable Development, Federico II University of Naples, 80131, Naples, Italy
| |
Collapse
|
3
|
Liu F, Liu Y, Peng C, Yu M, Wu S, Qian L, Han Z, Yu J, Chai H, Liang P. Ultrasound-guided microwave and radiofrequency ablation for primary hyperparathyroidism: a prospective, multicenter study. Eur Radiol 2022; 32:7743-7754. [PMID: 35593958 DOI: 10.1007/s00330-022-08851-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/21/2022] [Accepted: 04/28/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To prospectively investigate the efficacy and safety of ultrasound (US)-guided microwave ablation (MWA) and radiofrequency ablation (RFA) for primary hyperparathyroidism (PHPT). METHODS We performed a prospective multicenter study of MWA and RFA for PHPT between August 2017 and October 2020 at five centers. Laboratory testing was performed pre- and post-ablation and followed for at least 6 months. The primary outcome was the cure rate. Secondary outcomes were complications and dynamic changes in serum levels of PTH, calcium, phosphorus, and ALP after ablation. RESULTS A total of 132 participants (mean age, 57.33 ± 13.90 years), with 141 parathyroid nodules (median maximal diameter, 1.55 cm) undergoing either MWA or RFA, were enrolled in the study. The technique success rate was 99.29% (140/141). The follow-up period was 6-36 months (median, 12 months). The cure rate was 80.30% (106/132). Pre-ablation PTH level was the independent factor associated with cure rate (Odds ratio (OR), 0.22; 95% CI, 0.07-0.69; p = 0.0090). There was no difference in cure rate between the MWA group and the RFA group (80.22% vs. 80.49%, p = 0.971). The only main complication was hoarseness (5.30%). CONCLUSIONS US-guided MWA and RFA for PHPT is an effective and safe procedure in the treatment of PHPT. Pre-ablation PTH level is the key factor affecting the cure rate after MWA and RFA. KEY POINTS • To our knowledge, this is the first prospective multicenter clinical trial with ultrasound-guided MWA and RFA for primary hyperparathyroidism. • There was no difference in cure rate between the MWA and RFA groups for primary hyperparathyroidism. The overall cure rate was 80.30%. • Pre-ablation PTH level was the independent factor associated with cure rate (odds ratio (OR), 0.22; 95% CI, 0.07-0.69; p = 0.0090).
Collapse
Affiliation(s)
- Fangyi Liu
- Department of Interventional Ultrasound, The Fifth Medical Center, Chinese PLA General Hospital, NO.28 Fuxing Road, Beijing, 100853, China
| | - Yang Liu
- Department of Interventional Ultrasound, The Fifth Medical Center, Chinese PLA General Hospital, NO.28 Fuxing Road, Beijing, 100853, China
| | - Chengzhong Peng
- Department of Ultrasound, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Mingan Yu
- Department of Interventional Medicine, China-Japan Friendship Hospital, No. 2 Ying-hua-yuan East Street, Chao-yang district, Beijing, 100029, China
| | - Songsong Wu
- Shengli Clinical Medical College of Fujian Medical University, Department of Ultrasonography, Fujian Provincial Hospital, Fuzhou, 350001, China
| | - Linxue Qian
- Department of Ultrasound, Capital Medical University, Beijing Friendship Hospital, Beijing, China
| | - Zhiyu Han
- Department of Interventional Ultrasound, The Fifth Medical Center, Chinese PLA General Hospital, NO.28 Fuxing Road, Beijing, 100853, China
| | - Jie Yu
- Department of Interventional Ultrasound, The Fifth Medical Center, Chinese PLA General Hospital, NO.28 Fuxing Road, Beijing, 100853, China
| | - Huihui Chai
- Graduate Department, Bengbu Medical College, Bengbu, 233000, Anhui, China
| | - Ping Liang
- Department of Interventional Ultrasound, The Fifth Medical Center, Chinese PLA General Hospital, NO.28 Fuxing Road, Beijing, 100853, China.
| |
Collapse
|
4
|
Al-Jehani A, Al-Ahmed F, Nguyen-Thi PL, Bihain F, Nomine-Criqui C, Demarquet L, Guerci B, Ziegler O, Brunaud L. Insulin resistance is more severe in patients with primary hyperparathyroidism. Surgery 2022; 172:552-558. [DOI: 10.1016/j.surg.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 12/05/2021] [Accepted: 02/19/2022] [Indexed: 10/18/2022]
|
5
|
Effect of Parathyroidectomy on Metabolic Homeostasis in Primary Hyperparathyroidism. J Clin Med 2022; 11:jcm11051373. [PMID: 35268464 PMCID: PMC8911089 DOI: 10.3390/jcm11051373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/20/2022] [Accepted: 02/28/2022] [Indexed: 12/10/2022] Open
Abstract
Background: The benefits of parathyroidectomy on cardiovascular risk in primary hyperparathyroidism (PHPT) are controversial. This monocentric, observational, prospective study aimed to assess the effects of parathyroidectomy on glucose and lipid metabolism in classic or mild PHPT. Methods: Patients who underwent parathyroidectomy for classic (calcemia >2.85 mmol/L) or mild PHPT (calcemia ≤2.85 mmol/L) between 2016 and 2019 were included. A metabolic assessment was performed before and 1 year after parathyroidectomy. Patients with a history of diabetes were excluded. Results: Nineteen patients had classic and 120 had mild PHPT. Ninety-five percent were normocalcemic 6 months after surgery. Fasting plasma glucose and insulin levels decreased after parathyroidectomy in patients with mild PHPT (p < 0.001). HOMA-IR decreased after surgery in the overall population (p < 0.001), while plasma adiponectin concentrations increased in patients with both classic (p = 0.005) and mild PHPT (p < 0.001). Plasma triglyceride levels decreased significantly only in patients with classic PHPT (p = 0.021). Plasma PCSK9 levels decreased in patients with mild PHPT (p < 0.001). Conclusions: Parathyroidectomy for PHPT improves insulin resistance and decreases plasma triglyceride levels in classic PHPT and plasma PCSK9 levels in mild PHPT. Further studies are needed to better characterize the consequences of such metabolic risk factors’ improvements on cardiovascular events.
Collapse
|
6
|
Liu F, Zang L, Liu Y, Yu X, Cheng Z, Han Z, Yu J, Liang P. Risk factors influencing cure of ultrasound-guided microwave ablation for primary hyperparathyroidism. Int J Hyperthermia 2022; 39:258-264. [PMID: 35109732 DOI: 10.1080/02656736.2022.2029957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To evaluate the potential risk factors influencing cure rate of ultrasound-guided microwave ablation (MWA) for primary hyperparathyroidism (PHPT). MATERIALS AND METHODS Seventy five patients (25 males and 50 females; mean age, 56.80 ± 12.34; age range, 26-85) with PHPT undergoing MWA under ultrasound guidance were enrolled between May 2017 and December 2020. The cure rate and complications were evaluated after treatment. The potential factors influencing cure rate of ultrasound-guided MWA for PHPT were analyzed by univariate and multivariate binary logistic regression. RESULTS Fifty six of 75 patients had normal PTH and serum calcium levels after at least 6 months after one session MWA, and the cure rate was 74.7% (56/75). 6 uncured patients received the second session MWA during follow-up, and the cure rate achieved 81.3% (61/75) after the second session MWA. Voice changes occurred in 4 patients (5.33%) and recovered within 3 months after ablation without special treatment. Nodule volume was the independent risk factor associated with cure in PHPT patients undergoing MWA, whether after one session (p = 0.0224; odds ratio, 0.67) or the second session MWA (p = 0.0408; odds ratio, 0.74). The cutoff value for nodule volume in predicting the cure was 0.96 cm3 (one session: sensitivity, 76.8%; specificity, 73.7%; the second session: sensitivity, 72.1%; specificity, 71.4%). CONCLUSION In conclusion, parathyroid nodule volume was the independent risk factor associated with cure in PHPT patients undergoing MWA.
Collapse
Affiliation(s)
- Fangyi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Li Zang
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China
| | - Yang Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xiaoling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhigang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhiyu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
7
|
Runova GE, Golounina OO, Glinkina IV, Fadeev VV. Primary hyperparathyroidism and vitamin D deficiency. TERAPEVT ARKH 2021; 93:1221-1226. [DOI: 10.26442/00403660.2021.10.201081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/05/2021] [Indexed: 11/22/2022]
Abstract
Primary hyperparathyroidism (PHPT) is the third most common endocrine disease after diabetes mellitus and thyroid pathology. Recent epidemiological and experimental data have shown that long-term maintenance of low vitamin D levels in the blood can lead to the development of hyperplastic processes in the cells of the parathyroid glands, followed by autonomous production of parathyroid hormone. In PHPT vitamin D insufficiency or deficiency according to various sources occurs with a frequency of 5377% of cases. The literature review indicates more severe disease in patients with concomitant vitamin D deficiency. The expediency of preoperative assessment of vitamin D levels in all patients with PHPT in order to minimize the risk of hypocalcemia after parathyroidectomy is discussed. This article presents the relationship between vitamin D deficiency and PHPT, as well as possible methods for correcting vitamin D deficiency in PHPT. Molecular and cellular mechanisms of the occurrence of pathological processes in the parathyroid glands under conditions of low vitamin D levels are presented.
Collapse
|
8
|
Nikooei Noghani S, Milani N, Afkhamizadeh M, Kabiri M, Bonakdaran S, Vazifeh-Mostaan L, Asadi M, Morovatdar N, Mohebbi M. Assessment of insulin resistance in patients with primary hyperparathyroidism before and after Parathyroidectomy. ENDOCRINOLOGY DIABETES & METABOLISM 2021; 4:e00294. [PMID: 34505755 PMCID: PMC8502214 DOI: 10.1002/edm2.294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/20/2021] [Accepted: 07/03/2021] [Indexed: 12/31/2022]
Abstract
Background Primary hyperparathyroidism (PHPT) can lead to renal and skeletal disorders, as well as insulin resistance and impaired glucose metabolism. The current study aimed to assess the effects of parathyroidectomy on insulin resistance in patients with PHPT. Materials and Methods The present study was conducted on 65 patients with PHPT and indications for parathyroidectomy who were referred to the endocrinology clinics of Mashhad University of Medical Sciences. Thereafter, the demographic characteristics of the patients were recorded. Blood tests, including haemoglobin A1c (HbA1c), fasting blood glucose (FBG) and insulin levels, were assessed one week before and three months after the surgery. The insulin resistance score (HOMA‐IR) was calculated and compared using the relevant formula. Results A total of 65 participants with a mean age of 45.44 ± 9.59 years were included in the current study. In one‐month postoperative tests, mean scores of FBG (p < .05), insulin level (p < .05) and HbA1c (p < .05) were significantly reduced. Moreover, the HOMA‐IR index decreased in 51 patients after the surgery. Conclusion According to our findings, parathyroidectomy can be effective in the reduction of insulin resistance and corresponding complications in patients with PHPT in the present short‐term study. However, it has yet to be confirmed as a treatment method for insulin resistance in these patients. Future long‐term studies are required to be done to investigate the effect of parathyroidectomy on insulin resistance. The present study aimed to assess the effects of parathyroidectomy on insulin resistance in patients with primary hyperparathyroidism (PHPT). The present study was conducted on 65 patients with PHPT and indications for parathyroidectomy. Demographic characteristics of the patients were recorded. Blood tests, including fasting blood sugar (FBS), haemoglobin A1c (HbA1c) and insulin levels, were assessed one week before and three months after the surgery. The Homeostatic Model Assessment for Insulin Resistance (HOMA‐IR index) was calculated. In one‐month postoperative tests, mean scores of FBS (p < .05), insulin level (p < .05) and HbA1c (p < 0.05) were significantly reduced compared to these variables prior to the surgery. Moreover, the HOMA‐IR index decreased in 51 patients after the surgery. As evidenced by the results of the present study, parathyroidectomy can be effective in reducing insulin resistance and its complications in patients with primary hyperparathyroidism (PHPT).
Collapse
Affiliation(s)
- Soudabeh Nikooei Noghani
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nasrin Milani
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mozhgan Afkhamizadeh
- Faculty of Medicine, Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mona Kabiri
- Faculty of Medicine, Clinical Research Development Unit, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shokoufeh Bonakdaran
- Faculty of Medicine, Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Leila Vazifeh-Mostaan
- Department of ORL-Head & Neck Surgery, Faculty of Medicine, Otolaryngologist - Head & Neck Surgeon, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Asadi
- Faculty of Medicine, Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Negar Morovatdar
- Faculty of Medicine, Clinical Research Development Unit, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoud Mohebbi
- Faculty of Medicine, Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
9
|
Šarac I, Jovanović J, Zec M, Pavlović Z, Debeljak-Martačić J, Zeković M, Milešević J, Gurinović M, Glibetić M. Vitamin D Status and Its Correlation With Anthropometric and Biochemical Indicators of Cardiometabolic Risk in Serbian Underground Coal Miners in 2016. Front Nutr 2021; 8:689214. [PMID: 34490320 PMCID: PMC8417231 DOI: 10.3389/fnut.2021.689214] [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: 04/08/2021] [Accepted: 07/19/2021] [Indexed: 12/07/2022] Open
Abstract
The status of vitamin D in underground working coal miners and its association with their cardiometabolic health is rarely studied. This study aimed to examine vitamin D (VitD) status in Serbian underground coal miners and to correlate it with anthropometric and laboratory indicators of cardiometabolic risk. Nutritional data (food frequency questionnaire, FFQ, and two times repeated 24 h recall), anthropometric data (including segmental analysis by bio-impedance analyzer TANITA BC-545N), arterial tension, and biochemical and hematological data of 103 coal miners (aged 22-63 years) were correlated with their late summer (early September) serum 25 (OH)D levels (measured by HPLC). 68.9% of the studied coal miners were overweight/obese, and 48.5% had metabolic syndrome. Their mean VitD nutritional intakes were low: 5.3 ± 3.8 μg/day (FFQ) and 4.9 ± 8 μg/day (24 h recalls), but their mean serum 25 (OH)D levels were surprisingly high (143.7 ± 41.4 nmol/L). Only 2.9% of the coal miners had 25(OH)D levels lower than 75 nmol/L (indicating an insufficient/deficient status), while 63.2% had values above 125 nmol/L (upper optimal limit), and even 10.7% had values above 200 nmol/L. There were no statistical differences in 25 (OH)D levels in the coal miners with or without metabolic syndrome (or overweight/obesity). Interestingly, 25(OH)D levels had significant positive correlations with body mass index (BMI), fat mass (FM), fat mass percentage (FM%), limbs FM%, serum triglycerides, GGT, AST, ALT, and ALT/AST ratio, and had significant negative correlations with serum HDL-cholesterol and age. All these correlations were lost after corrections for age, FM, FM%, and legs FM%. In Serbian coal miners, high levels of early September VitD levels were observed, indicating sufficient non-working-hour sun exposure during the summer period. Furthermore, the unexpected positive correlations of VitD levels with anthropometric and biochemical parameters indicative of obesity, metabolic syndrome, and fatty liver disease were found. More research is needed on the VitD status of coal miners (particularly in the winter period) and its relationship with their cardiometabolic status.
Collapse
Affiliation(s)
- Ivana Šarac
- Laboratory for Public Health Nutrition, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Jovica Jovanović
- Faculty of Medicine, Department of Occupational Health, University of Niš, Niš, Serbia
| | - Manja Zec
- Laboratory for Public Health Nutrition, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Zoran Pavlović
- Department of Sanitary Chemistry and Ecotoxicology, Institute for Public Health Požarevac, Požarevac, Serbia
| | - Jasmina Debeljak-Martačić
- Laboratory for Public Health Nutrition, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Milica Zeković
- Laboratory for Public Health Nutrition, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Jelena Milešević
- Laboratory for Public Health Nutrition, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Mirjana Gurinović
- Laboratory for Public Health Nutrition, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Maria Glibetić
- Laboratory for Public Health Nutrition, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, Belgrade, Serbia
| |
Collapse
|
10
|
Мокрышева НГ, Еремкина АК, Мирная СС, Крупинова ЮА, Воронкова ИА, Ким ИВ, Бельцевич ДГ, Кузнецов НС, Пигарова ЕА, Рожинская ЛЯ, Дегтярев МВ, Егшатян ЛВ, Румянцев ПО, Андреева ЕН, Анциферов МБ, Маркина НВ, Крюкова ИВ, Каронова ТЛ, Лукьянов СВ, Слепцов ИВ, Чагай НБ, Мельниченко ГА, Дедов ИИ. [The clinical practice guidelines for primary hyperparathyroidism, short version]. PROBLEMY ENDOKRINOLOGII 2021; 67:94-124. [PMID: 34533017 PMCID: PMC9753843 DOI: 10.14341/probl12801] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 12/14/2022]
Abstract
Primary hyperparathyroidism (PHPT) is an endocrine disorder of parathyroid glands characterized by excessive secretion of parathyroid hormone (PTH) with an upper normal or elevated blood calcium level. Classical PHPT refers to a symptomatic, multi-system disorder, wich can lead to a significant decrease in the quality of life, disability of patients, and even an increased risk of premature death. Hypercalcemia and the catabolic effect of PTH on various cells are considered as the main pathogenetic mechanisms of the PHPT associated complications. In the last two decades, there has been an increase in the incidence of PHPT, mainly due to the mild forms of the disease, primarily due to the routine calcium screening in North America, Western Europe and, Asia. High prevalence of the disease, as well as the variety of clinical manifestations, cause the attention of different specialists - physicians, rheumatologists, urologists, nephrologists, cardiologists and other doctors. This review cover the main issues of Russian guidelines for the management of PHPT, approved in 2020, including laboratory and instrumental methods, differential diagnosis, surgical and conservative approach, short-term and long-term follow-up. This guidelines also include the recommendations for special groups of patients with hereditary forms of PHPT, parathyroid carcinoma, PHPT during pregnancy.
Collapse
Affiliation(s)
- Н. Г. Мокрышева
- Национальный медицинский исследовательский центр эндокринологии
| | - А. К. Еремкина
- Национальный медицинский исследовательский центр эндокринологии
| | | | - Ю. А. Крупинова
- Национальный медицинский исследовательский центр эндокринологии
| | - И. А. Воронкова
- Национальный медицинский исследовательский центр эндокринологии
| | - И. В. Ким
- Национальный медицинский исследовательский центр эндокринологии
| | - Д. Г. Бельцевич
- Национальный медицинский исследовательский центр эндокринологии
| | - Н. С. Кузнецов
- Национальный медицинский исследовательский центр эндокринологии
| | - Е. А. Пигарова
- Национальный медицинский исследовательский центр эндокринологии
| | - Л. Я. Рожинская
- Национальный медицинский исследовательский центр эндокринологии
| | - М. В. Дегтярев
- Национальный медицинский исследовательский центр эндокринологии
| | - Л. В. Егшатян
- Национальный медицинский исследовательский центр эндокринологии
| | | | - Е. Н. Андреева
- Национальный медицинский исследовательский центр эндокринологии
| | - М. Б. Анциферов
- Эндокринологический диспансер Департамента здравоохранения города Москвы
| | - Н. В. Маркина
- Эндокринологический диспансер Департамента здравоохранения города Москвы
| | - И. В. Крюкова
- Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского
| | - Т. Л. Каронова
- Национальный медицинский исследовательский центр им. В.А. Алмазова
| | | | | | - Н. Б. Чагай
- Ставропольский государственный медицинский университет
| | | | - И. И. Дедов
- Национальный медицинский исследовательский центр эндокринологии
| |
Collapse
|
11
|
Tournis S, Makris K, Cavalier E, Trovas G. Cardiovascular Risk in Patients with Primary Hyperparathyroidism. Curr Pharm Des 2021; 26:5628-5636. [PMID: 33155899 DOI: 10.2174/1381612824999201105165642] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/01/2020] [Indexed: 12/20/2022]
Abstract
Primary hyperparathyroidism (PHPT) is one of the most common endocrine disorders characterized by parathyroid hormone (PTH)-dependent hypercalcemia. Cardinal features include low trauma fractures, nephrolithiasis, and chronic kidney disease. Several experimental studies established that parathyroid hormone exerts actions on the cardiovascular (CV) system, including vasodilatation and positive inotropic and chronotropic effects. Observational studies, especially in severe cases, report a higher prevalence of hypertension, diabetes mellitus, lipid abnormalities, endothelial dysfunction, arrhythmias, and left ventricular hypertrophy in patients with PHPT, while the risk of CV events seems to be increased in severe cases. However, the effect of surgery is inconsistent on CV abnormalities and, more importantly, on CV disease (CVD) events, especially in mild cases. In the current review, we describe the available evidence linking PHPT and CVD, as well as the effect of surgical management and pharmacological treatment on CVD manifestations in patients with PHPT. Based on the current evidence, CVD is not considered an indication for surgery.
Collapse
Affiliation(s)
- Symeon Tournis
- Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", National and Kapodistrian University of Athens, KAT Hospital, Athens, Greece
| | | | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liege, CHU Sart-Tilman, Domaine du Sart-Tilman, B-4000, Liege, Belgium
| | - George Trovas
- Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", National and Kapodistrian University of Athens, KAT Hospital, Athens, Greece
| |
Collapse
|
12
|
Frey S, Mirallié É, Cariou B, Blanchard C. Impact of parathyroidectomy on cardiovascular risk in primary hyperparathyroidism: A narrative review. Nutr Metab Cardiovasc Dis 2021; 31:981-996. [PMID: 33612382 DOI: 10.1016/j.numecd.2020.12.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/23/2020] [Accepted: 12/27/2020] [Indexed: 12/22/2022]
Abstract
AIMS Primary hyperparathyroidism (PHPT), one of the most frequent endocrine disorders, is not only associated with bone and kidney disorders but also with increased cardiovascular risk. This cardiovascular risk is not part of the indication for surgery owing to discordant evidence of the effects of parathyroidectomy (PTX), especially in mild PHPT which is the most common presentation of PHPT. This literature review focuses on the effects of PTX on the cardiovascular risk in PHPT. The MEDLINE database was searched via the PubMed interface, selecting relevant articles published after 1990 in English. DATA SYNTHESIS In the most recent series, PTX appeared to have a positive impact on cardiovascular morbidity and mortality. Surgery improves arterial hypertension, markers of glucose homeostasis, vascular and cardiac remodeling and electrocardiographic impairments due to classical PHPT. However, the results of surgery on mild PHPT are conflicting. CONCLUSIONS PTX seems to improve cardiovascular risk in patients presenting the classical form of PHPT. This improvement is correlated with preoperative serum calcium and/or PTH level, depending on the cardiovascular risk factor. However, many aspects of this improvement are not fully understood. Future studies should assess the effects of PTX on nocturnal hypertension, cardiac morphology and functions. The results for mild PHPT are conflicting owing to the limited size of the cohorts included in studies and the lack of randomized trials. Surgery is not currently recommended for patients presenting mild PHPT based on the cardiovascular risk and more studies are needed to better understand the interest of PTX on cardiovascular outcomes.
Collapse
Affiliation(s)
- Samuel Frey
- Chirurgie Cancérologique, Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, CHU de Nantes, Nantes, France; Université de Nantes, Quai de Tourville, 44000, Nantes, France
| | - Éric Mirallié
- Chirurgie Cancérologique, Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, CHU de Nantes, Nantes, France; Université de Nantes, Quai de Tourville, 44000, Nantes, France
| | - Bertrand Cariou
- Université de Nantes, Quai de Tourville, 44000, Nantes, France; L'institut du Thorax, UNIV NANTES, CNRS, INSERM, CHU de Nantes, Nantes, France; Service d'Endocrinologie et Maladies Métaboliques, l'Institut du Thorax, CHU de Nantes, Nantes, France.
| | - Claire Blanchard
- Chirurgie Cancérologique, Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, CHU de Nantes, Nantes, France; Université de Nantes, Quai de Tourville, 44000, Nantes, France; L'institut du Thorax, UNIV NANTES, CNRS, INSERM, CHU de Nantes, Nantes, France.
| |
Collapse
|
13
|
Kord-Varkaneh H, Rinaldi G, Hekmatdoost A, Fatahi S, Tan SC, Shadnoush M, Khni V, Mousavi SM, Zarezadeh M, Salamat S, Bawadi H, Rahmani J. Reply to "Double-counting of effect sizes and inappropriate exclusion of studies in "The influence of vitamin D supplementation on IGF-1 levels in humans: A systematic review and meta_analysis". Ageing Res Rev 2021; 66:101239. [PMID: 33346153 DOI: 10.1016/j.arr.2020.101239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
14
|
Amiri M, Raeisi-Dehkordi H, Vorland CJ, Chen X, Brown AW, Allison DB. Double-counting of effect sizes and inappropriate exclusion of studies in "The influence of vitamin D supplementation on IGF-1 levels in humans: A systematic review and meta-analysis". Ageing Res Rev 2021; 66:101236. [PMID: 33338606 DOI: 10.1016/j.arr.2020.101236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 12/10/2020] [Indexed: 11/28/2022]
Abstract
We read with interest the review by Kord-Varkaneh et al. which examined the effects of vitamin D supplementation on IGF-1 levels in humans. We believe that the article suffers from severe methodological faults and subsequently the conclusions are likely to be biased. Thus, the authors should address the mentioned limitations and update the analyses to provide robust and trustful estimates. We are concerned that without correction, the analyses may lead to erroneous findings and conclusions.
Collapse
Affiliation(s)
- Mojgan Amiri
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hamidreza Raeisi-Dehkordi
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Colby J Vorland
- Department of Applied Health Sciences, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
| | - Xiwei Chen
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
| | - Andrew W Brown
- Department of Applied Health Sciences, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
| | - David B Allison
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
| |
Collapse
|
15
|
Juhlin CC, Falhammar H, Zedenius J, Nilsson IL, Höög A. Lipoadenoma of the Parathyroid Gland: Characterization of an Institutional Series Spanning 28 Years. Endocr Pathol 2020; 31:156-165. [PMID: 32193823 PMCID: PMC7250804 DOI: 10.1007/s12022-020-09616-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Parathyroid lipoadenomas (PLAs) are rare tumors, and case descriptions are limited, < 80 to date. As a consequence, scarce information regarding the etiology of these enigmatic lesions is available. We searched our departmental pathology database for PLAs diagnosed between 1992 and 2020, reexamined the histology of each case, and recorded clinical parameters from the patients' medical charts. As the diagnostic criteria of this lesion vary over this time period, we defined PLA as an enlarged parathyroid gland with > 50% fat on histologic examination with preoperative evidence of primary hyperparathyroidism (PHPT). A total of 8 bona fide PLA cases and 2 equivocal PLAs (close to 50% fat) were included. As approximately 4000 conventional parathyroid adenomas were diagnosed at our department during the same time interval, the prevalence of PLA was 0.20%. PLA patients were predominately female (63%) and presented with classical PHPT-related symptoms. Majority of cases were successfully located preoperatively and had an average tumor weight of 445 mg. Histologically, all PLAs consisted of > 50% mature adipose tissue, except a single case with brown fat. Of note, PLA patients exhibited a body mass index in line with PHPT patients in general, but a relatively high, near-significant prevalence of arterial hypertension was observed when compared to tumors with less fat (P = 0.0584). Future studies on this finding might be warranted. To summarize, we present one of the largest institutional PLA case series to date, and conclude that PLAs are rare, sporadic tumors mirroring many clinical aspects of conventional adenomas-with a potential coupling to hypertension worthy of follow-up studies.
Collapse
Affiliation(s)
- C Christofer Juhlin
- Department of Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden.
- Department of Oncology-Pathology, Karolinska Institutet, BioClinicum J6:20, 171 64, Solna, Stockholm, Sweden.
| | - Henrik Falhammar
- Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Jan Zedenius
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Breast, Endocrine Tumors and Sarcoma, Karolinska University Hospital, Stockholm, Sweden
| | - Inga-Lena Nilsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Breast, Endocrine Tumors and Sarcoma, Karolinska University Hospital, Stockholm, Sweden
| | - Anders Höög
- Department of Pathology and Cytology, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, BioClinicum J6:20, 171 64, Solna, Stockholm, Sweden
| |
Collapse
|
16
|
Meshkini F, Abdollahi S, Clark CCT, Soltani S. The effect of vitamin D supplementation on insulin-like growth factor-1: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2020; 50:102300. [PMID: 32444034 DOI: 10.1016/j.ctim.2020.102300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 10/14/2019] [Accepted: 01/03/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE There is equivocality regarding the interaction between vitamin D and insulin-like growth factor-1 (IGF-1). Thus, the aim of this study was to elucidate the effect of vitamin D supplementation on serum levels of IGF-1 by conducting a systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS PubMed, Scopus, and ISI Web of Science databases were searched up to May 2019 for RCTs that evaluated the effect of vitamin D supplementation on IGF-1 levels. Mean and standard deviation changes of IGF-1 in each treatment group were considered for analysis and pooled using random-effect model. Risk of bias for included studies was assessed by the Cochrane scale and the NutriGrade approach was applied to evaluate the quality of evidence. RESULTS Six trials (n = 773 participants) were included in the meta-analysis. Compared with control group, vitamin D supplementation yielded no significant effect on serum level of IGF-1 (weighted mean difference [WMD] =4.66 ng/ml, 95 % CIs: -6.72 to 16.03, P = 0.42, I2 = 74.8, P-heterogeneity = 0.001). Additionally, no meaningful changes were observed in subgroup analyses. CONCLUSION The evidence from the limited number of published trials does not convincingly show that vitamin D supplementation elicits any clinically relevant effects on IGF-1 levels. More high-quality studies are needed to reach a consensual conclusion in this area.
Collapse
Affiliation(s)
- Fatemeh Meshkini
- Department of Biochemistry, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Shima Abdollahi
- Department of Nutrition and Public Health, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Cain C T Clark
- Faculty Research Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, CV1 5FB, UK
| | - Sepideh Soltani
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, 74877-94149, Iran.
| |
Collapse
|
17
|
Antonopoulou V, Karras SN, Koufakis T, Yavropoulou M, Katsiki N, Gerou S, Papavramidis T, Kotsa K. Rising Glucagon-Like Peptide 1 Concentrations After Parathyroidectomy in Patients With Primary Hyperparathyroidism. J Surg Res 2020; 245:22-30. [DOI: 10.1016/j.jss.2019.07.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 05/26/2019] [Accepted: 07/11/2019] [Indexed: 01/16/2023]
|
18
|
|
19
|
Nilsson IL. Primary hyperparathyroidism: should surgery be performed on all patients? Current evidence and residual uncertainties. J Intern Med 2019; 285:149-164. [PMID: 30289185 DOI: 10.1111/joim.12840] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Primary hyperparathyroidism (pHPT) is the third most common endocrine disease and is characterized by hypercalcaemia and elevated or inappropriately 'normal' levels of the parathyroid hormone (PTH). The main target organs of PTH are the skeletal system and the kidneys. Before the 1970s, pHPT was a rarely detected disease associated with notable morbidity and premature mortality. Introduction of biochemical screening, allowing for a wide range of indications, has contributed to the detection of the full spectrum of the disease. A new entity with an isolated elevation of PTH, normocalcaemic HP, has emerged and is currently being explored. The highest incidence of pHPT, 3-5%, is observed amongst women, and the prevalence increases with age. The female-to-male ratio is 3-4 : 1 except in younger patients where distribution is equal and known hereditary causes account for approximately 10% of the cases. In the last few decades, it has become evident that fewer patients than previously believed are truly asymptomatic. The cause of pHPT is often a benign tumour, a parathyroid adenoma, and the only definite treatment is parathyroidectomy (PTX). No medical treatment, single or combined, can achieve a curing of pHPT. Recent data indicate that PTX, despite being proven to be cost-effective compared to conservative treatment, is underutilized, especially in elderly pHPT patients. The decision of PTX should always be based on a safe diagnosis, and the potential benefits of curative treatment should not be outweighed by the risks of surgery or anaesthesia.
Collapse
Affiliation(s)
- I-L Nilsson
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department ofBreast, Endocrine Tumors and Sarcoma, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
20
|
Godang K, Lundstam K, Mollerup C, Fougner SL, Pernow Y, Nordenström J, Rosén T, Jansson S, Hellström M, Bollerslev J, Heck A. The effect of surgery on fat mass, lipid and glucose metabolism in mild primary hyperparathyroidism. Endocr Connect 2018; 7:941-948. [PMID: 30300532 PMCID: PMC6144936 DOI: 10.1530/ec-18-0259] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
CONTEXT Mild primary hyperparathyroidism has been associated with increased body fat mass and unfavorable cardiovascular risk factors. OBJECTIVE To assess the effect of parathyroidectomy on fat mass, glucose and lipid metabolism. DESIGN, PATIENTS, INTERVENTIONS, MAIN OUTCOME MEASURES 119 patients previously randomized to observation (OBS; n = 58) or parathyroidectomy (PTX; n = 61) within the Scandinavian Investigation of Primary Hyperparathyroidism (SIPH) trial, an open randomized multicenter study, were included. Main outcome measures for this study were the differences in fat mass, markers for lipid and glucose metabolism between OBS and PTX 5 years after randomization. RESULTS In the OBS group, total cholesterol (Total-C) decreased from mean 5.9 (±1.1) to 5.6 (±1.0) mmol/L (P = 0.037) and LDL cholesterol (LDL-C) decreased from 3.7 (±1.0) to 3.3 (±0.9) mmol/L (P = 0.010). In the PTX group, the Total-C and LDL-C remained unchanged resulting in a significant between-group difference over time (P = 0.013 and P = 0.026, respectively). This difference was driven by patients who started with lipid-lowering medication during the study period (OBS: 5; PTX: 1). There was an increase in trunk fat mass in the OBS group, but no between-group differences over time. Mean 25(OH) vitamin D increased in the PTX group (P < 0.001), but did not change in the OBS group. No difference in parameters of glucose metabolism was detected. CONCLUSION In mild PHPT, the measured metabolic and cardiovascular risk factors were not modified by PTX. Observation seems safe and cardiovascular risk reduction should not be regarded as a separate indication for parathyroidectomy based on the results from this study.
Collapse
Affiliation(s)
- Kristin Godang
- Section of Specialized EndocrinologyOslo University Hospital, Oslo, Norway
| | - Karolina Lundstam
- Department of RadiologyInstitute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Charlotte Mollerup
- Clinic of Breast and Endocrine SurgeryCenter HOC, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | | | - Ylva Pernow
- Departments of Molecular MedicineSurgery and Endocrinology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Jörgen Nordenström
- Department of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, Sweden
| | - Thord Rosén
- Department of MedicineSahlgrenska University Hospital, Gothenburg, Sweden
| | - Svante Jansson
- Department of Endocrine SurgerySahlgrenska University Hospital, Gothenburg, Sweden
| | - Mikael Hellström
- Department of RadiologyInstitute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jens Bollerslev
- Section of Specialized EndocrinologyOslo University Hospital, Oslo, Norway
- Faculty of MedicineUniversity of Oslo, Oslo, Norway
| | - Ansgar Heck
- Section of Specialized EndocrinologyOslo University Hospital, Oslo, Norway
- Faculty of MedicineUniversity of Oslo, Oslo, Norway
- Correspondence should be addressed to A Heck:
| | | |
Collapse
|
21
|
Relationship of vitamin D and parathyroid hormone with the nocturnal blood pressure decline in hypertension. Blood Press Monit 2018; 22:322-327. [PMID: 28926360 DOI: 10.1097/mbp.0000000000000286] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Vitamin D deficiency and high parathyroid hormone (PTH) levels have been linked with hypertension. Nondipper hypertension is associated with increased morbidity and mortality. We aimed to investigate the relationship of vitamin D and PTH levels with nondipper hypertension and nocturnal decline in untreated hypertensive patients. PATIENTS AND METHODS This cross-sectional study included a total of 73 hypertensive and 34 normotensive participants. Each patient underwent 24-hour ambulatory blood pressure monitoring, routine biochemical tests, vitamin D, and PTH analysis. RESULTS The study population was divided into three groups according to ambulatory blood pressure monitoring records: 40 nondippers (mean age; 59.8±10.8 years, 24 women and 16 men), 33 dipper hypertensives (mean age; 58±11.8 years, 13 women and 20 men), and 34 normotensives (mean age; 56.9±11.7 years, 19 women and 15 men). Nondipper hypertensives showed lower levels of vitamin D than dippers and normotensives (9.7±6.1 vs. 14.9±10.1 vs. 16.4±9.5 ng/ml, P=0.001, for both) and higher levels of PTH than dippers (74.8±34.7 vs. 53.3±19.9 ng/ml, P=0.001). A significant positive correlation was observed between vitamin D and nocturnal decline (r=0.34, P=0.001), whereas a significant negative correlation was present between PTH and nocturnal decline(r=-0.26, P=0.006). In multivariate analysis, PTH level was correlated independently with nocturnal decline (β=-0.07, 95% confidence interval: -0.114-0.025, P=0.003). CONCLUSION In this study, vitamin D levels were significantly lower and PTH levels were significantly higher in nondippers. The vitamin D level was correlated positively and the PTH level was correlated negatively with nocturnal decline. In addition, PTH level was associated independently with nocturnal decline in hypertension.
Collapse
|
22
|
Malihi Z, Wu Z, MM Lawes C, Scragg R. Noncalcemic adverse effects and withdrawals in randomized controlled trials of long-term vitamin D2 or D3 supplementation: a systematic review and meta-analysis. Nutr Rev 2017; 75:1007-1034. [DOI: 10.1093/nutrit/nux059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
|
23
|
Primary hyperparathyroidism, hypercalciuria, and bone recovery after parathyroidectomy. Surgery 2017; 162:429-436. [DOI: 10.1016/j.surg.2017.02.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 01/29/2017] [Accepted: 02/15/2017] [Indexed: 11/20/2022]
|
24
|
Abstract
OBJECTIVE The aim of this article is to compare clinical characteristics and lab values for metabolic syndrome between primary hyperparathyroidism (PHPT) patients with different levels of serum intact parathyroid hormone (iPTH) and to determine correlation between different clinical characteristics among PHPT patients Methods: We reviewed charts of 212 PHPT patients in this retrospective study. Patients were divided into two groups according to their initial serum iPTH levels. Student's t-tests were used to compare the two groups for differences in clinical characteristics and laboratory values. Pearson's correlation coefficients were used to assess associations. RESULTS Of the 212 PHPT patients, 100 were classified as m-iPTH group (serum iPTH < 140 pg/mL), whereas 112 patients were defined as h-iPTH group (serum iPTH ≥ 140 pg/mL). The h-iPTH patients were younger, had higher serum calcium and alkaline phosphatase levels, but exhibited lower 25(OH)-vitamin D and HDL levels, when compared with those of m-iPTH patients. Adenoma weights in the h-iPTH group tended to be higher than that in the m-iPTH group. Furthermore, association studies revealed that the iPTH level was positively correlated with adenoma weight and serum calcium and triglyceride (TG) levels but negatively correlated with HDL level. CONCLUSION Our study supports the hypothesis that iPTH level is associated with TG and HDL levels and should be a factor to consider in the management of PHPT patients.
Collapse
Affiliation(s)
- Haidar Al-Hraishawi
- a Division of Endocrinology, Metabolism & Nutrition , Department of Medicine, Rutgers University-Robert Wood Johnson Medical School , New Brunswick , NJ , USA
| | - Peter J Dellatore
- a Division of Endocrinology, Metabolism & Nutrition , Department of Medicine, Rutgers University-Robert Wood Johnson Medical School , New Brunswick , NJ , USA
| | - Xinjiang Cai
- a Division of Endocrinology, Metabolism & Nutrition , Department of Medicine, Rutgers University-Robert Wood Johnson Medical School , New Brunswick , NJ , USA
- b Department of Medicine , Icahn School of Medicine at Mount Sinai (James J. Peters VA Bronx) , New York , NY , USA
| | - Xiangbing Wang
- a Division of Endocrinology, Metabolism & Nutrition , Department of Medicine, Rutgers University-Robert Wood Johnson Medical School , New Brunswick , NJ , USA
| |
Collapse
|
25
|
SPECT/CT’s Advantage for Preoperative Localization of Small Parathyroid Adenomas in Primary Hyperparathyroidism. Clin Nucl Med 2017; 42:e109-e114. [DOI: 10.1097/rlu.0000000000001447] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
26
|
Leere JS, Karmisholt J, Robaczyk M, Vestergaard P. Contemporary Medical Management of Primary Hyperparathyroidism: A Systematic Review. Front Endocrinol (Lausanne) 2017; 8:79. [PMID: 28473803 PMCID: PMC5397399 DOI: 10.3389/fendo.2017.00079] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Accepted: 03/30/2017] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Primary hyperparathyroidism is increasingly an asymptomatic disease at diagnosis, but the recognized guidelines for management are based on evidence obtained from studies on patients with symptomatic disease, and surgery is not always indicated. Other patients are unable to undergo surgery, and thus a medical treatment is warranted. This systematic review provides an overview of the existing literature on contemporary pharmaceutical options available for the medical management of primary hyperparathyroidism. METHODS Databases of medical literature were searched for articles including terms for primary hyperparathyroidism and each of the included drugs. Data on s-calcium, s-parathyroid hormone, bone turnover markers, bone mineral density (BMD) and hard endpoints were extracted and tabulated, and level of evidence was determined. Changes in s-calcium were estimated and a meta-regression analysis was performed. RESULTS The 1,999 articles were screened for eligibility and 54 were included in the review. Weighted mean changes calculated for each drug in s-total calcium (mean change from baseline ± SEM) were pamidronate (0.31 ± 0.034 mmol/l); alendronate (0.07 ± 0.05 mmol/l); clodronate (0.20 ± 0.040 mmol/l); mixed bisphosphonates (0.16 ± 0.049 mmol/l); and cinacalcet (0.37 ± 0.013 mmol/l). The meta-analysis revealed a significant decrease of effect on s-calcium with time for the bisphosphonates (Coef. -0.049 ± 0.023, p = 0.035), while cinacalcet proved to maintain its effect on s-calcium over time. Bisphosphonates improved BMD while cinacalcet had no effect. DISCUSSION The included studies demonstrate advantages and drawbacks of the available pharmaceutical options that can prove helpful in the clinical setting. The great variation in how primary hyperparathyroidism is manifested requires that management should rely on an individual evaluation when counseling patients. Combining resorptive agents with calcimimetics could prove rewarding, but more studies are warranted.
Collapse
Affiliation(s)
- Julius Simoni Leere
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- *Correspondence: Julius Simoni Leere,
| | | | - Maciej Robaczyk
- Department of Endocrinology, Aalborg University, Aalborg, Denmark
| | | |
Collapse
|
27
|
Karakose M, Caliskan M, Arslan MS, Demirci T, Karakose S, Cakal E. The impact of parathyroidectomy on serum ADAMTS1, ADAMTS4 levels, insulin resistance, and subclinical cardiovascular disease in primary hyperparathyroidism. Endocrine 2017; 55:283-288. [PMID: 27844209 DOI: 10.1007/s12020-016-1175-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 11/06/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Primary hyperparathyroidism has been associated with increased incidence of morbidity and mortality of the cardiovascular system. The etiopathogenetic mechanisms underlying this association are still not completely clear. Accumulating evidence suggested that a disintegrin and metalloproteinase with thrombospondin-like motifs (ADAMTS) has a role in the development of inflammation and atherosclerosis. In this study, we aimed to determine whether there is a change in serum levels of ADAMTS1, ADAMTS4, carotid intima-media thickness, and cardiovascular risk score after the surgery and also whether there is a relationship between ADAMTS levels and cardiovascular risk score in hypercalcemic primary hyperparathyroidism patients. METHODS The study included the 48 consecutive newly diagnosed patients with primary hyperparathyroidism. The patients were evaluated before and six months after parathyroidectomy. The Framingham score is used to calculate cardiovascular risk. Serum ADAMTS levels were determined by a human enzyme-linked immunoassay in all subjects. RESULTS The fasting glucose, fasting insulin levels and HOMA values were decreased significantly in all patients after surgery compared to the pretreatment values (p < 0.05). ADAMTS1, ADAMTS4, and carotid intima-media thickness levels were significantly lower after surgical correction of primary hyperparathyroidism compared to the preoperative values (p < 0.05). cardiovascular risk score was decreased after parathyroidectomy however, the difference were not statistical significant (p > 0.05). There were statistically significant relationship between cardiovascular risk score and waist/hip ratio, calcium, LDL-cholesterol, carotid intima-media thickness, ADAMTS4 values. CONCLUSION Based on the results of the present study, fasting glucose, fasting insulin levels, ADAMTS1, ADAMTS4, and carotid intima-media thickness might be an additional parameters during the management of patients with primary hyperparathyroidism, since these factors might improve after surgery.
Collapse
Affiliation(s)
- Melia Karakose
- Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
| | - Mustafa Caliskan
- Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Muyesser Sayki Arslan
- Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Taner Demirci
- Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Suleyman Karakose
- Department of Nephrology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Erman Cakal
- Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
28
|
Haglund F, Juhlin CC, Kiss NB, Larsson C, Nilsson IL, Höög A. Diffuse parathyroid hormone expression in parathyroid tumors argues against important functional tumor subclones. Eur J Endocrinol 2016; 174:583-90. [PMID: 26865585 PMCID: PMC5081673 DOI: 10.1530/eje-15-1062] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 02/09/2016] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Primary hyperparathyroidism is usually characterized by a monoclonal parathyroid tumor secreting excess parathyroid hormone (PTH). The main regulator of PTH secretion is calcium and the calcium-PTH set point is shifted in parathyroid tumor cells. We sought to investigate the relationship between tumor PTH and PTH mRNA expression and clinical presentation as well as the regulatory factors including phosphate, vitamin D, and fibroblast growth factor 23. DESIGN A total of 154 parathyroid tumors were analyzed by PTH immunohistochemistry and chromogenic in situ hybridization of PTH mRNA. A subset of samples (n = 34) was analyzed using quantitative real-time PCR. RESULTS Low tumor PTH mRNA level was significantly associated with low tumor PTH immunoreactivity (P = 0.026), but the two did not correlate with regard to histological distribution within individual tumors. Tumors displaying reduced PTH mRNA levels as compared with normal rim were significantly larger (P = 0.013) and showed higher expression of the calcium-sensing receptor (CASR) (P = 0.046). Weaker tumor PTH mRNA level was significantly associated with higher concentration of circulating 25-hydroxyvitamin D (P = 0.005). No significant correlation was seen between PTH immunoreactivity and patient biochemistry. Tumor weight was strongly associated with circulatory concentrations of calcium and PTH. CONCLUSIONS No areas with apparently higher PTH expression were identified, perhaps suggesting that hyper functioning parathyroid tumor subclones should be rare. Circulating 25-hydroxyvitamin D levels may influence tumor PTH expression in vivo. If PTH immunoreactivity reflects the tumor calcium-PTH set point, our data imply that the main determinant of disease severity should be tumor weight.
Collapse
Affiliation(s)
- Felix Haglund
- Department of Oncology-PathologyKarolinska Institutet, Karolinska University Hospital CCK, SE-171 76 Stockholm, Sweden
| | - C Christofer Juhlin
- Department of Oncology-PathologyKarolinska Institutet, Karolinska University Hospital CCK, SE-171 76 Stockholm, Sweden
| | - Nimrod B Kiss
- Department of Oncology-PathologyKarolinska Institutet, Karolinska University Hospital CCK, SE-171 76 Stockholm, Sweden
| | - Catharina Larsson
- Department of Oncology-PathologyKarolinska Institutet, Karolinska University Hospital CCK, SE-171 76 Stockholm, Sweden
| | - Inga-Lena Nilsson
- Department of Molecular Medicine and SurgeryKarolinska Institutet, Karolinska University Hospital CCK, SE-171 76 Stockholm, Sweden
| | - Anders Höög
- Department of Oncology-PathologyKarolinska Institutet, Karolinska University Hospital CCK, SE-171 76 Stockholm, Sweden
| |
Collapse
|
29
|
George JA, Norris SA, Toman M, Snyman T, Crowther NJ. Visceral adiposity is a predictor of parathyroid hormone levels in healthy adults. J Endocrinol Invest 2016; 39:447-53. [PMID: 26501363 DOI: 10.1007/s40618-015-0400-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 10/10/2015] [Indexed: 02/07/2023]
Abstract
PURPOSE Parathyroid hormone (PTH) has been shown to correlate positively with fat mass, however there are no studies that have investigated whether this association is a result of, or is modified by, body fat distribution. The aim of this study was to investigate the association of PTH with several body composition indices, namely visceral (VAT) and subcutaneous adiposity (SCAT) as well as with lean mass and with serum leptin, which has been reported to increase PTH. METHODS This was a cross-sectional study in which PTH was measured by chemiluminescent assay; body fat and lean mass by dual-energy X-ray absorptiometry (DXA) and abdominal fat by ultrasonography in 714 healthy adults aged 18-65 years. Serum leptin was measured by ELISA. RESULTS In a multivariate linear regression model that included height, age, gender, ethnicity, serum 25 hydroxyvitamin D, leptin levels, calcium, magnesium and phosphate concentrations, glomerular filtration rate, smoking status, and calcium and vitamin D supplementation as independent variables and PTH as the dependent variable, VAT (β = 0.094, p = 0.035) correlated significantly with PTH levels but SCAT (β = -0.045, p = 0.386) and body fat mass (β = 0.098, p = 0.126) did not. Leptin did not correlate with PTH (β = 0.013, p = 0.832) in this regression model. CONCLUSIONS Plasma PTH is significantly associated with VAT in healthy adults. In view of the association of PTH with increased cardiovascular mortality, it is important to investigate this association further.
Collapse
Affiliation(s)
- J A George
- Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand, Room 3B 41, Third Floor, Medical School, Parktown, Johannesburg, 2193, South Africa.
| | - S A Norris
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - M Toman
- Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand, Room 3B 41, Third Floor, Medical School, Parktown, Johannesburg, 2193, South Africa
| | - T Snyman
- Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand, Room 3B 41, Third Floor, Medical School, Parktown, Johannesburg, 2193, South Africa
| | - N J Crowther
- Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand, Room 3B 41, Third Floor, Medical School, Parktown, Johannesburg, 2193, South Africa
| |
Collapse
|
30
|
Larsson S, Jones HA, Göransson O, Degerman E, Holm C. Parathyroid hormone induces adipocyte lipolysis via PKA-mediated phosphorylation of hormone-sensitive lipase. Cell Signal 2016; 28:204-213. [DOI: 10.1016/j.cellsig.2015.12.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 12/18/2015] [Accepted: 12/20/2015] [Indexed: 12/19/2022]
|
31
|
Nilsson IL, Norenstedt S, Granath F, Zedenius J, Pernow Y, Larsson TE. FGF23, metabolic risk factors, and blood pressure in patients with primary hyperparathyroidism undergoing parathyroid adenomectomy. Surgery 2016; 159:211-7. [DOI: 10.1016/j.surg.2015.06.057] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 04/26/2015] [Accepted: 06/03/2015] [Indexed: 01/01/2023]
|
32
|
Verheyen ND, Kienreich K, Gaksch M, van Ballegooijen AJ, Grübler MR, Hartaigh BÓ, Schmid J, Fahrleitner-Pammer A, Kraigher-Krainer E, Colantonio C, Belyavskiy E, Treiber G, Catena C, Brussee H, Pieske B, März W, Tomaschitz A, Pilz S. Plasma Parathyroid Hormone Is Independently Related to Nocturnal Blood Pressure in Hypertensive Patients: The Styrian Hypertension Study. J Clin Hypertens (Greenwich) 2015; 18:543-50. [DOI: 10.1111/jch.12710] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Revised: 08/12/2015] [Accepted: 08/16/2015] [Indexed: 12/21/2022]
Affiliation(s)
| | - Katharina Kienreich
- Department of Internal Medicine; Division of Endocrinology and Metabolism; Medical University of Graz; Graz Austria
| | - Martin Gaksch
- Department of Internal Medicine; Division of Endocrinology and Metabolism; Medical University of Graz; Graz Austria
| | | | - Martin R. Grübler
- Department of Internal Medicine; Division of Endocrinology and Metabolism; Medical University of Graz; Graz Austria
| | - Briain Ó. Hartaigh
- Department of Radiology; Dalio Institute of Cardiovascular Imaging; NewYork-Presbyterian Hospital and the Weill Cornell Medical College; New York NY
- Department of Internal Medicine; Section of Geriatrics; Yale School of Medicine; Adler Geriatric Center; New Haven CT
| | - Johannes Schmid
- Department of Cardiology; Medical University of Graz; Graz Austria
| | - Astrid Fahrleitner-Pammer
- Department of Internal Medicine; Division of Endocrinology and Metabolism; Medical University of Graz; Graz Austria
| | - Elisabeth Kraigher-Krainer
- Medizinische Klinik mit Schwerpunkt Kardiologie; Campus Virchow-Klinikum; Charité-Universitaetsmedizin Berlin; Berlin Germany
| | | | - Evgeny Belyavskiy
- Medizinische Klinik mit Schwerpunkt Kardiologie; Campus Virchow-Klinikum; Charité-Universitaetsmedizin Berlin; Berlin Germany
| | - Gerlies Treiber
- Department of Internal Medicine; Division of Endocrinology and Metabolism; Medical University of Graz; Graz Austria
| | - Cristiana Catena
- Clinical Institute of Medical and Chemical Laboratory Diagnostics; Medical University of Graz; Graz Austria
| | - Helmut Brussee
- Department of Cardiology; Medical University of Graz; Graz Austria
| | - Burkert Pieske
- Department of Cardiology; Medical University of Graz; Graz Austria
- Medizinische Klinik mit Schwerpunkt Kardiologie; Campus Virchow-Klinikum; Charité-Universitaetsmedizin Berlin; Berlin Germany
| | - Winfried März
- Hypertension Unit; Internal Medicine; Department of Experimental and Clinical Medical Sciences; University of Udine; Udine Italy
- Synlab Academy; Synlab Services LLC; Mannheim Germany
- Medical Clinic V (Nephrology, Hypertensiology, Endocrinology); Medical Faculty Mannheim; Ruperto Carola University Heidelberg; Mannheim Germany
| | - Andreas Tomaschitz
- Department of Cardiology; Medical University of Graz; Graz Austria
- Medizinische Klinik mit Schwerpunkt Kardiologie; Campus Virchow-Klinikum; Charité-Universitaetsmedizin Berlin; Berlin Germany
- Specialist Clinic for Rehabilitation; PV Bad Aussee; Bad Aussee Austria
| | - Stefan Pilz
- Department of Internal Medicine; Division of Endocrinology and Metabolism; Medical University of Graz; Graz Austria
- Department of Epidemiology and Biostatistics; EMGO Institute for Health and Care Research; VU University Medical Centre; Amsterdam the Netherlands
| |
Collapse
|
33
|
Mendoza-Zubieta V, Gonzalez-Villaseñor GA, Vargas-Ortega G, Gonzalez B, Ramirez-Renteria C, Mercado M, Molina-Ayala MA, Ferreira-Hermosillo A. High prevalence of metabolic syndrome in a mestizo group of adult patients with primary hyperparathyroidism (PHPT). BMC Endocr Disord 2015; 15:16. [PMID: 25886602 PMCID: PMC4415358 DOI: 10.1186/s12902-015-0014-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 03/27/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Primary hyperparathyroidism (PHPT) and metabolic syndrome (MS) have been independently related to cardiovascular morbidities, however this association is still controversial. Mexican population has a high prevalence of metabolic syndrome, however its frequency seems to be even higher than expected in patients with PHPT. METHODS We retrospectively reviewed the charts of patients that underwent parathyroidectomy for PHPT in a referral center and used the criteria from the National Cholesterol Educational Program (NCEP)/Adult Treatment Panel III (ATP III) to define MS before surgery. We compared the characteristics between the patients with and without MS. RESULTS 60 patients were analyzed, 77% were female and 72% had a single parathyroid adenoma. MS was present in 59% of the patients, this group was significantly older (57 vs. 48 years, p = 0.01) and they had lower iPTH (115 vs. 161 ng/ml, p = 0.017). Other parameters did not show differences. CONCLUSIONS MS is frequent in our population diagnosed with primary hyperparathyroidism, adverse cardiovascular parameters are common and significant differences in calcium metabolism compared to the non-MS group are present.
Collapse
Affiliation(s)
- Victoria Mendoza-Zubieta
- Endocrinology Departament Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Cuauhtemoc N° 330, Colonia Doctores, México City, DF, Mexico.
| | - Gloria A Gonzalez-Villaseñor
- Endocrinology Departament Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Cuauhtemoc N° 330, Colonia Doctores, México City, DF, Mexico.
| | - Guadalupe Vargas-Ortega
- Endocrinology Departament Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Cuauhtemoc N° 330, Colonia Doctores, México City, DF, Mexico.
| | - Baldomero Gonzalez
- Endocrinology Departament Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Cuauhtemoc N° 330, Colonia Doctores, México City, DF, Mexico.
| | - Claudia Ramirez-Renteria
- Endocrinology Experimental Investigation Unit Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Cuauhtemoc N° 330, Colonia Doctores, México City, DF, Mexico.
| | - Moises Mercado
- Endocrinology Experimental Investigation Unit Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Cuauhtemoc N° 330, Colonia Doctores, México City, DF, Mexico.
| | - Mario A Molina-Ayala
- Endocrinology Departament Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Cuauhtemoc N° 330, Colonia Doctores, México City, DF, Mexico.
| | - Aldo Ferreira-Hermosillo
- Endocrinology Departament Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social (IMSS), Cuauhtemoc N° 330, Colonia Doctores, México City, DF, Mexico.
| |
Collapse
|
34
|
Haglund F, Rosin G, Nilsson IL, Juhlin CC, Pernow Y, Norenstedt S, Dinets A, Larsson C, Hartman J, Höög A. Tumour nuclear oestrogen receptor beta 1 correlates inversely with parathyroid tumour weight. Endocr Connect 2015; 4:76-85. [PMID: 25648860 PMCID: PMC4351559 DOI: 10.1530/ec-14-0109] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Primary hyperparathyroidism (PHPT) is a common endocrinopathy, frequently caused by a parathyroid adenoma, rarely by a parathyroid carcinoma that lacks effective oncological treatment. As the majority of cases are present in postmenopausal women, oestrogen signalling has been implicated in the tumourigenesis. Oestrogen receptor beta 1 (ERB1) and ERB2 have been recently identified in parathyroid adenomas, the former inducing genes coupled to tumour apoptosis. We applied immunohistochemistry and slide digitalisation to quantify nuclear ERB1 and ERB2 in 172 parathyroid adenomas, atypical adenomas and carcinomas, and ten normal parathyroid glands. All the normal parathyroid glands expressed ERB1 and ERB2. The majority of tumours expressed ERB1 (70.6%) at varying intensities, and ERB2 (96.5%) at strong intensities. Parathyroid carcinomas expressed ERB1 in three out of six cases and ERB2 in five out of six cases. The intensity of tumour nuclear ERB1 staining significantly correlated inversely with tumour weight (P=0.011), and patients whose tumours were classified as ERB1-negative had significantly greater tumour weight as well as higher serum calcium (P=0.002) and parathyroid hormone levels (P=0.003). Additionally, tumour nuclear ERB1 was not expressed differentially with respect to sex or age of the patient. Levels of tumour nuclear ERB2 did not correlate with clinical characteristics. In conclusion, decreased ERB1 immunoreactivity is associated with increased tumour weight in parathyroid adenomas. Given the previously reported correlation with tumour-suppressive signalling, selective oestrogen receptor modulation (SERMs) may play a role in the treatment of parathyroid carcinomas. Future studies of SERMs and oestrogen treatment in PHPT should consider tumour weight as a potential factor in pharmacological responsiveness.
Collapse
Affiliation(s)
- Felix Haglund
- Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine
| | - Gustaf Rosin
- Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine
| | - Inga-Lena Nilsson
- Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine
| | - C Christofer Juhlin
- Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine
| | - Ylva Pernow
- Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine
| | - Sophie Norenstedt
- Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine
| | - Andrii Dinets
- Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine
| | - Catharina Larsson
- Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine
| | - Johan Hartman
- Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine
| | - Anders Höög
- Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine Department of Oncology-PathologyKarolinska Institutet, Stockholm, SwedenCancer Centre KarolinskaR8:04, Karolinska Institutet, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Biosciences and NutritionKarolinska Institutet, Novum, Huddinge, Stockholm, SwedenDepartment of Molecular Medicine and SurgeryKarolinska Institutet, Stockholm, SwedenDepartment of Surgery #4Bogomolets National Medical University, Kiev, Ukraine
| |
Collapse
|
35
|
Åberg V, Norenstedt S, Zedenius J, Sääf M, Nordenström J, Pernow Y, Nilsson IL. Health-related quality of life after successful surgery for primary hyperparathyroidism: no additive effect from vitamin D supplementation: results of a double-blind randomized study. Eur J Endocrinol 2015; 172:181-7. [PMID: 25414430 DOI: 10.1530/eje-14-0757] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Vitamin D insufficiency is common in primary hyperparathyroidism (pHPT). Patients with pHPT frequently have a reduced health-related quality of life (HRQoL). Our objectives were to evaluate whether HRQoL in pHPT is associated with vitamin D insufficiency and whether vitamin D supplementation after parathyroidectomy (PTX) could improve HRQoL. DESIGN A randomized, double-blind study (ClinicalTrials.gov identifier: NCT00982722). METHODS The study included 150 pHPT patients randomized, 6 weeks after PTX, to daily treatment with either cholecalciferol 1600 IU and calcium carbonate 1000 mg (D+) or calcium carbonate alone (D-). HRQoL was estimated with SF-36 before and after PTX and after 12 months of study medication. RESULTS Three-quarters (77%) of the pHPT patients had vitamin D insufficiency, defined as 25OHD <50 nmol/l. The pHPT patients scored lower than a reference population in all domains of SF-36. A total of 135 patients completed the entire study period. Improvements in nearly all domains were registered at the follow-up 6 weeks after PTX. At the end of the study medication period, the D+ group had a significantly higher median serum (s-) 25OHD concentration (76 (65; 93) (lower; upper interquartile ranges) vs 48 (40; 62) nmol/l, P<0.001) and a lower plasma (p-) parathyroid hormone concentration (40 (34; 52) vs 49 (38; 66) ng/l, P=0.01) than the D- group. The improvements in HRQoL remained unchanged at the follow-up 1 year after PTX. Postoperative vitamin D supplementation had no obvious effect on HRQoL. CONCLUSION PTX resulted in significant improvements in HRQoL. Despite a high prevalence of vitamin D insufficiency, 1 year of postoperative vitamin D supplementation had no obvious beneficial effect on HRQoL.
Collapse
Affiliation(s)
- Viveca Åberg
- Department of Breast and Endocrine SurgeryKarolinska University Hospital, P9:03, SE-171 76 Stockholm, Sweden
| | - Sophie Norenstedt
- Department of Breast and Endocrine SurgeryKarolinska University Hospital, P9:03, SE-171 76 Stockholm, Sweden
| | - Jan Zedenius
- Department of Breast and Endocrine SurgeryKarolinska University Hospital, P9:03, SE-171 76 Stockholm, Sweden
| | - Maria Sääf
- Department of Breast and Endocrine SurgeryKarolinska University Hospital, P9:03, SE-171 76 Stockholm, Sweden
| | - Jörgen Nordenström
- Department of Breast and Endocrine SurgeryKarolinska University Hospital, P9:03, SE-171 76 Stockholm, Sweden
| | - Ylva Pernow
- Department of Breast and Endocrine SurgeryKarolinska University Hospital, P9:03, SE-171 76 Stockholm, Sweden
| | - Inga-Lena Nilsson
- Department of Breast and Endocrine SurgeryKarolinska University Hospital, P9:03, SE-171 76 Stockholm, Sweden
| |
Collapse
|
36
|
Gianotti L, Tassone F, Baffoni C, Pellegrino M, Cassibba S, Castellano E, Magro G, Cesario F, Visconti G, Borretta G. Relationship between insulin sensitivity and bone mineral density in primary hyperparathyroidism. Clin Endocrinol (Oxf) 2014; 81:350-5. [PMID: 24750210 DOI: 10.1111/cen.12472] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 01/20/2014] [Accepted: 04/14/2014] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Evidence of crosstalk between bone and insulin metabolism has been identified. In primary hyperparathyroidism (PHPT), scant data exist on this relationship. AIM To evaluate the relationship between insulin levels or sensitivity and bone mineral density (BMD) in PHPT. SUBJECT AND METHODS Two hundred and sixty-seven patients with PHPT without known diabetes mellitus were studied. Fasting blood glucose and insulin levels as well as BMD at lumbar spine, femoral neck and forearm were measured. Insulin sensitivity was assessed using Quantitative Insulin Sensitivity Check Index (QUICKI). The same parameters were measured 2 years (interquartile range 2·8 years) after surgery (PTX) in a subgroup of patients (n = 51). RESULTS In univariate analysis, a positive relationship between insulin levels and BMD (R = 0·17, P < 0·03) or T-score (R = 0·20, P < 0·005) was found at femoral neck level. Consequently, a negative relationship between QUICKI and femoral BMD (R = -0·20, P < 0·01) or T-score (R = -0·21, P < 0·004) was found. In multivariate analysis, when femoral BMD was the dependent variable, age (beta = -0·35, P < 0·000004), BMI (beta = 0·39, P < 0·00001), PTH (beta = -0·18, P < 0·05) and QUICKI (R = -0·15, P < 0·05) had an independent effect (R(2) = 0·29). Insulin levels and QUICKI did not change after PTX. No relationship was found between QUICKI or insulin levels at the time of diagnosis and change in BMD at any site at follow-up. CONCLUSIONS Our data show a weak relationship between insulin levels and/or insulin sensitivity and BMD in PHPT. However, the insulin state does not influence change in bone density after PTX in PHPT.
Collapse
Affiliation(s)
- Laura Gianotti
- Division of Endocrinology, Department of Internal Medicine, S.Croce & Carle Hospital, Cuneo, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Laflamme MH, Mahjoub H, Mahmut A, Boulanger MC, Larose E, Pibarot P, Mathieu P. Parathyroid hormone is associated with the LV mass after aortic valve replacement. Heart 2014; 100:1859-64. [PMID: 25095827 DOI: 10.1136/heartjnl-2014-305837] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIMS LV hypertrophy (LVH) is frequent after aortic valve replacement (AVR) and is often associated with comorbidities, including hypertension, obesity, renal failure and prosthesis-patient mismatch (PPM). However, whether other biological mechanism(s) may participate to LVH after AVR is still unknown. Parathyroid hormone (PTH) may play a role in LVH. However, it is presently unknown whether PTH is associated with LVH in patients that have undergone an AVR. METHODS In this cross-sectional study, 195 patients have been investigated at a mean of 8 ± 3.5 years following AVR. LV function and mass were evaluated by Doppler echocardiography. The plasma levels of PTH, 25-hydroxyvitamin D (25-OHD), calcium and phosphate were measured. RESULTS There were 102 (52%) patients with LVH after AVR. In univariate analyses, PTH blood level was associated with LV mass (LVMi) and LVH. After adjustment for other risk factors, elevated PTH remained associated with LVMi (p=0.003) and LVH (p=0.02). In turn, the blood levels of 25-OHD and the renal function (GFR) were independently and inversely related to the blood level of PTH. CONCLUSIONS After AVR, the level of PTH is independently associated with LVH. In turn, the level of PTH is related with the renal function and the level of 25-OHD.
Collapse
Affiliation(s)
- Marie-Hélène Laflamme
- Laboratoire d'Études Moléculaires des Valvulopathies (LEMV), Department of Surgery, Groupe de Recherche en Valvulopathies (GRV), Quebec Heart and Lung Institute/Research Center, Laval University, Quebec, Canada
| | - Haifa Mahjoub
- Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
| | - Ablajan Mahmut
- Laboratoire d'Études Moléculaires des Valvulopathies (LEMV), Department of Surgery, Groupe de Recherche en Valvulopathies (GRV), Quebec Heart and Lung Institute/Research Center, Laval University, Quebec, Canada
| | - Marie-Chloé Boulanger
- Laboratoire d'Études Moléculaires des Valvulopathies (LEMV), Department of Surgery, Groupe de Recherche en Valvulopathies (GRV), Quebec Heart and Lung Institute/Research Center, Laval University, Quebec, Canada
| | - Eric Larose
- Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
| | - Philippe Pibarot
- Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
| | - Patrick Mathieu
- Laboratoire d'Études Moléculaires des Valvulopathies (LEMV), Department of Surgery, Groupe de Recherche en Valvulopathies (GRV), Quebec Heart and Lung Institute/Research Center, Laval University, Quebec, Canada
| |
Collapse
|
38
|
Ellam T. Confounded complexity: vitamin d, parathyroid hormone, and metabolic syndrome in peritoneal dialysis. Perit Dial Int 2014; 34:333-7. [PMID: 24991048 DOI: 10.3747/pdi.2014.00005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Timothy Ellam
- Sheffield Kidney Institute Department of Cardiovascular Science University of Sheffield Sheffield, UK
| |
Collapse
|