Zaheer Sarah, Brown Jenifer M, Connors Molly, Williams Jonathan S, Adler Gail K, Vaidya Anand
Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Int J Endocrinol. 2017;2017:4138783. doi: 10.1155/2017/4138783. Epub 2017 Jul 20.
Prior studies suggest that renin-angiotensin-aldosterone system (RAAS) inhibitors decrease parathyroid hormone (PTH) secretion.
To evaluate the effect of angiotensin-converting enzyme inhibitors (ACEi) on serum PTH in participants with and without primary hyperparathyroidism (P-HPT).
An open-label, single-arm, pilot study whereby participants with and without P-HPT had PTH were evaluated before and after 1 week of maximally tolerated lisinopril therapy.
A total of 12 participants with, and 15 participants without, P-HPT successfully completed the protocol. Following 1 week of lisinopril, participants with P-HPT had a decrease in systolic blood pressure (SBP) (-6.4 mmHg, < 0.01), an increase in plasma renin activity (PRA) (+1.50 ng/mL/h, = 0.06), and a decrease in PTH (79.5 (21.6) to 70.9 (19.6) pg/mL, ∆ = -8.6 pg/mL, = 0.049); however, serum and urine calcium did not change. In contrast, although 1 week of lisinopril significantly decreased SBP and increased PRA among participants without P-HPT, there were no changes in PTH or calcium.
In this short pilot investigation, 1 week of maximally titrated ACEi did not impact PTH in participants without P-HPT, but resulted in a modest and marginally significant reduction of PTH but not calcium, among participants with P-HPT. This trial is registered with ClinicalTrials.gov NCT01691781.
先前的研究表明，肾素-血管紧张素-醛固酮系统（RAAS）抑制剂可降低甲状旁腺激素（PTH）分泌。
评估血管紧张素转换酶抑制剂（ACEi）对有或无原发性甲状旁腺功能亢进症（P-HPT）参与者血清PTH的影响。
一项开放标签、单臂的试点研究，有或无P-HPT的参与者在接受最大耐受剂量赖诺普利治疗1周前后接受PTH评估。
共有12名患有P-HPT的参与者和15名未患有P-HPT的参与者成功完成了该方案。服用赖诺普利1周后，患有P-HPT的参与者收缩压（SBP）下降（-6.4 mmHg，P<0.01），血浆肾素活性（PRA）升高（+1.50 ng/mL/h，P = 0.06），PTH下降（从79.5（21.6）降至70.9（19.6）pg/mL，∆=-8.6 pg/mL，P = 0.049）；然而，血清和尿钙没有变化。相比之下，虽然服用赖诺普利1周后未患有P-HPT的参与者SBP显著下降且PRA升高，但PTH或钙没有变化。
在这项短期试点研究中，最大剂量滴定的ACEi治疗1周对未患有P-HPT的参与者的PTH没有影响，但在患有P-HPT的参与者中导致PTH适度且边缘性显著降低，但对钙没有影响。该试验已在ClinicalTrials.gov注册，注册号为NCT01691781。
