Yagi Shusuke, Aihara Ken-ichi, Kondo Takeshi, Endo Itsuro, Hotchi Junko, Ise Takayuki, Iwase Takashi, Akaike Masashi, Matsumoto Toshio, Sata Masataka
Department of Cardiovascular Medicine, The University of Tokushima Graduate School of Health Biosciences, Tokushima 770-8503, Japan.
Endocr J. 2014;61(7):727-33. doi: 10.1507/endocrj.ej14-0004. Epub 2014 May 22.
Excess parathyroid hormone (PTH), known as primary hyperparathyroidism (pHPT), results in hypercalcemia and bone loss. Recent studies have shown that PTH is associated with the occurrence of hypertension in Western countries; however, controversy remains regarding high serum levels of PTH and calcium as risk factors for hypertension in Japanese patients. We retrospectively enrolled 114 consecutive Japanese patients who visited our hospital for examination and treatment of hypercalcemia and/or hypertension with serum calcium levels ≥ 9.8 mg/dL. To estimate the prevalence of hypertension, the patients were categorized according to calcium levels into hypercalcemic (10.2-13.4 mg/dL) and normocalcemic (9.8-10.1 mg/dL) groups, which were further categorized into high PTH (50-440 pg/mL) and low PTH (8-49 pg/mL) groups. The prevalence of hypertension was higher in patients with hypercalcemia than in patients with normocalcemia in both the high and low PTH groups. The prevalence of hypertension was higher in patients with high serum PTH levels than in patients with low serum PTH levels in both the hypercalcemic and normocalcemic groups. Logistic multiple regression analysis determined that serum calcium (P < 0.05) and PTH (P < 0.01) levels were positive contributors to hypertension. In conclusion, high serum levels of PTH and calcium are risk factors for hypertension in Japanese patients.
甲状旁腺激素（PTH）分泌过多，即原发性甲状旁腺功能亢进症（pHPT），会导致高钙血症和骨质流失。最近的研究表明，在西方国家，PTH与高血压的发生有关；然而，对于日本患者而言，血清PTH和钙水平升高作为高血压的危险因素仍存在争议。我们回顾性纳入了114例连续就诊于我院检查和治疗高钙血症和/或高血压且血清钙水平≥9.8mg/dL的日本患者。为了评估高血压的患病率，根据钙水平将患者分为高钙血症组（10.2 - 13.4mg/dL）和正常钙血症组（9.8 - 10.1mg/dL），并进一步将每组分为高PTH组（50 - 440pg/mL）和低PTH组（8 - 49pg/mL）。在高PTH组和低PTH组中，高钙血症患者的高血压患病率均高于正常钙血症患者。在高钙血症组和正常钙血症组中，血清PTH水平高的患者高血压患病率均高于血清PTH水平低的患者。多因素logistic回归分析确定血清钙水平（P < 0.05）和PTH水平（P < 0.01）是高血压的正向影响因素。总之，血清PTH和钙水平升高是日本患者高血压的危险因素。
