From the Uppsala Clinical Research Center (E.H., E.I., J.S., J.Ä.), Departments of Radiology (T.H., H.A., L.J.) and Medical Sciences (E.H., J.Ä., E.I., J.S., L.L.), Uppsala University, Uppsala, Sweden; and the School of Health and Social Studies, Dalarna University, Falun, Sweden (J.Ä.).
Arterioscler Thromb Vasc Biol. 2014 Jul;34(7):1567-73. doi: 10.1161/ATVBAHA.113.303062. Epub 2014 Mar 13.
Cardiovascular risk factors have different impact on different arterial territories. Diseases with elevated circulating parathyroid hormone (PTH) such as primary hyperparathyroidism and chronic renal failure have been shown to be associated with an increased risk of cardiovascular disease, predominantly heart or cerebrovascular diseases. However, data on the associations between circulating PTH and peripheral atherosclerosis are limited.
Two prospective, community-based studies were used. In 306 men and women, who were 70 years old, from the Prospective investigation of the vasculature in Uppsala seniors (PIVUS) study, cross-sectional relations between PTH and atherosclerotic burden assessed by whole-body magnetic resonance angiography were investigated. In 998 men, who were 71 years old, from the Uppsala longitudinal study of adult men (ULSAM) study, the association between PTH concentration and risk of subsequent nonfatal atherosclerotic disease (excluding coronary or cerebrovascular disease) was investigated. Adjusting for established vascular risk factors, PTH was associated with burden of atherosclerosis (increase in total atherosclerotic score per SD PTH increase: 0.04, 0.003-0.08; P=0.03) in the PIVUS study. During follow-up in the ULSAM study (median 16.7 years), 89 men were diagnosed with nonfatal atherosclerotic disease. In Cox-regression analyses adjusting for established vascular risk factors and mineral metabolism, higher PTH was associated with an increased risk of nonfatal atherosclerotic disease (hazard ratio for 1 SD increase of PTH: 1.55, 1.33-1.88; P<0.0001). Results were similar when including fatal atherosclerotic disease in the outcome.
In 2 independent community-based cohorts, PTH was associated to the degree of atherosclerosis and risk of clinically overt atherosclerotic disease, respectively. Our data confirm and extend previous studies supporting a role for PTH in the development of atherosclerotic disease.
心血管危险因素对不同动脉区域的影响不同。甲状旁腺激素（PTH）水平升高的疾病，如原发性甲状旁腺功能亢进症和慢性肾衰竭，与心血管疾病风险增加相关，主要是心脏或脑血管疾病。然而，关于循环 PTH 与外周动脉粥样硬化之间的关系的数据有限。
我们使用了两项前瞻性、基于社区的研究。在 Prospective investigation of the vasculature in Uppsala seniors（PIVUS）研究的 306 名年龄为 70 岁的男性和女性中，我们研究了 PTH 与全身磁共振血管造影评估的动脉粥样硬化负担之间的横断面关系。在 Uppsala longitudinal study of adult men（ULSAM）研究的 998 名年龄为 71 岁的男性中，我们研究了 PTH 浓度与随后发生非致死性动脉粥样硬化疾病（不包括冠状动脉或脑血管疾病）风险之间的关系。在校正了已确立的血管危险因素后，PTH 与动脉粥样硬化负担相关（每增加一个标准差 PTH 水平，总动脉粥样硬化评分增加：0.04，0.003-0.08；P=0.03）。在 ULSAM 研究的随访期间（中位数为 16.7 年），有 89 名男性被诊断为非致死性动脉粥样硬化疾病。在校正了已确立的血管危险因素和矿物质代谢后，在 Cox 回归分析中，较高的 PTH 与非致死性动脉粥样硬化疾病风险增加相关（PTH 增加一个标准差的危险比：1.55，1.33-1.88；P<0.0001）。当将致死性动脉粥样硬化疾病纳入结局时，结果相似。
在 2 项独立的基于社区的队列中，PTH 分别与动脉粥样硬化程度和临床明显动脉粥样硬化疾病的风险相关。我们的数据证实并扩展了先前支持 PTH 在动脉粥样硬化疾病发展中的作用的研究。
