Document Detail


Hyperparathyroidism in Patients with Primary Aldosteronism: Cross-Sectional and Interventional Data from the GECOH Study.
MedLine Citation:
PMID:  22013107     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Context:Experimental studies suggest that aldosterone induces hypercalciuria and might contribute to hyperparathyroidism.Objective:We aimed to test for differences in PTH levels and parameters of calcium and vitamin D metabolism in patients with primary aldosteronism (PA) compared with patients with essential hypertension (EH) and to evaluate the impact of PA treatment on these laboratory values.Design, Setting, and Participants:The Graz Endocrine Causes of Hypertension study includes hypertensive patients referred for screening for endocrine hypertension at a tertiary care center in Graz, Austria.Main Outcome Measures:Differences in PTH levels between patients with PA and EH.Results:Among 192 patients, we identified 10 patients with PA and 182 with EH. PTH levels (mean ± sd in picograms per milliliter) were significantly higher in PA patients compared with EH (67.8 ± 26.9 vs. 46.5 ± 20.9; P = 0.002). After treatment of PA with either adrenal surgery (n = 5) or mineralocorticoid receptor antagonists (n = 5), PTH concentrations decreased to 43.9 ± 14.9 (P = 0.023). Serum 25-hydroxyvitamin D concentrations were similar in both groups. Compared with EH, serum calcium concentrations were significantly lower (2.35 ± 0.10 vs. 2.26 ± 0.10 mmol/liter; P = 0.013), and there was a nonsignificant trend toward an increased spot urine calcium to creatinine ratio in PA [median (interquartile range) 0.19 (0.11-0.31) vs. 0.33 (0.12-0.53); P = 0.094].Conclusions:Our results suggest that PA contributes to secondary hyperparathyroidism. Further studies are warranted to evaluate whether PTH has implications for PA diagnostics and whether mineralocorticoid receptor antagonists have a general impact on PTH and calcium metabolism.
Authors:
Stefan Pilz; Katharina Kienreich; Christiane Drechsler; Eberhard Ritz; Astrid Fahrleitner-Pammer; Martin Gaksch; Andreas Meinitzer; Winfried März; Thomas R Pieber; Andreas Tomaschitz
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-19
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  -     ISSN:  1945-7197     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Internal Medicine (S.P., K.K., A.F.-P., M.G., T.R.P., A.T.), Division of Endocrinology and Metabolism, and Clinical Institute of Medical and Chemical Laboratory Diagnostics (A.M., W.M.), Medical University of Graz, 8036 Graz, Austria; Department of Epidemiology and Biostatistics and EMGO Institute for Health and Care Research (S.P.), VU University Medical Center, 1081 BT Amsterdam, The Netherlands; Department of Medicine (C.D.), Division of Nephrology, University of Würzburg, 97070 Würzburg, Germany; Department of Medicine (E.R.), Division of Nephrology, University Hospital Heidelberg, 69115 Heidelberg, Germany; Synlab-Academy (W.M.), Synlab Services LLC, 69214 Eppelheim, Germany; and Mannheim Institute of Public Health (W.M.), Medical Faculty Mannheim, Ruperto Carola University Heidelberg, 68167 Mannheim, Germany.
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