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中欧非缺血性心力衰竭患者的甲状旁腺激素血清浓度作为疾病严重程度和预后不良的潜在标志物

Parathyroid hormone serum concentration in Central European patients with non-ischaemic heart failure as a potential marker of disease severity and poor prognosis.

作者信息

Kubiak Grzegorz Marcin, Kolaszko Agnieszka, Nowalany-Kozielska Ewa

机构信息

Clinical ward of Cardiology, Medical University of Silesia, Zabrze, Poland.

出版信息

Endokrynol Pol. 2017;68(3):299-305. doi: 10.5603/EP.a2016.0057. Epub 2017 Feb 23.

Abstract

INTRODUCTION

Parathyroid hormone (PTH) might be considered as a potential marker of disease severity and worse prognosis in heart failure (HF) patients. The aim of the study was to assess PTH, vitamin D, phosphorus (P), and total calcium (Ca2+) serum concentrations in Central European patients suffering from HF of non-ischaemic origin compared to non-HF volunteers.To evaluate potential correlations among the enumerated parameters, established markers of worse prognosis and declared sun exposure.

MATERIAL AND METHODS

Serum intact-PTH, 25-OH vitamin D, P, and total Ca2+ concentrations were assessed in a group of HF patients and non-HF volunteers. Patients described their daily profile of sun exposure during the previous eight weeks as "above" or "below" seven hours a week.

RESULTS

The mean PTH concentrations in the non-ischaemic HF group and control group were 79.5 pg/mL and 59.6 pg/mL, respectively (P = 0.009). Non-HF volunteers declaring higher sun exposure time had higher serum concentrations of vitamin D compared to those with lower sun exposure time (30.3 vs. 23.8 ng/mL, P < 0.05), unlike the HF patients (24.1 ng/mL vs. 23.2 ng/mL, P = ns). Multiple regression analysis revealed the relationship between age, NT-proBNP (N-terminal pro-brain natriuretic peptide), P, and PTH as a dependent variable.

CONCLUSIONS

PTH is significantly elevated in non-ischaemic HF patients compared to non-HF volunteers and correlates with established factors of worse prognosis, including age, estimated glomerular filtration rate (eGFR), aspartate aminotransferase (AST), serum concentrations of creatinine, and NT-proBNP. Declared sun exposure did not affect the serum concentration of vitamin D in the HF group, in contrast to the control group.

摘要

引言

甲状旁腺激素(PTH)可能被视为心力衰竭(HF)患者疾病严重程度和预后较差的潜在标志物。本研究的目的是评估中欧非缺血性起源HF患者与非HF志愿者相比的血清PTH、维生素D、磷(P)和总钙(Ca2+)浓度。以评估所列参数、预后较差的既定标志物与自述日照情况之间的潜在相关性。

材料与方法

对一组HF患者和非HF志愿者的血清完整PTH、25-羟基维生素D、P和总Ca2+浓度进行评估。患者将其在前八周的每日日照情况描述为每周“超过”或“低于”七小时。

结果

非缺血性HF组和对照组的平均PTH浓度分别为79.5 pg/mL和59.6 pg/mL(P = 0.009)。与日照时间较短的非HF志愿者相比,自述日照时间较长的非HF志愿者血清维生素D浓度更高(30.3对23.8 ng/mL,P < 0.05),而HF患者则不同(24.1 ng/mL对23.2 ng/mL,P = 无显著性差异)。多元回归分析揭示了年龄、N末端脑钠肽前体(NT-proBNP)、P和作为因变量的PTH之间的关系。

结论

与非HF志愿者相比,非缺血性HF患者的PTH显著升高,且与预后较差的既定因素相关,包括年龄、估计肾小球滤过率(eGFR)、天冬氨酸转氨酶(AST)、血清肌酐浓度和NT-proBNP。与对照组不同,自述日照情况对HF组的血清维生素D浓度没有影响。

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