Loh Huai H, Yee Anne, Loh Huai S
Faculty of Medicine and Health Sciences, University of Malaysia, Sarawak, Malaysia -
Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Minerva Endocrinol. 2019 Dec;44(4):387-396. doi: 10.23736/S0391-1977.18.02867-5. Epub 2018 Nov 26.
Recent studies showed a possible association between hyperaldosteronism and secondary hyperparathyroidism leading to reduced bone health, however results are conflicting.
We conducted a meta-analysis to evaluate the relationship between primary aldosteronism (PA) with bone biochemical markers and to assess bone mineral density in patients with primary aldosteronism.
A total of 939 subjects were examined (37.5% with PA). Patients with PA had significantly higher serum parathyroid hormone, lower serum calcium, higher urine calcium excretion and higher serum alkaline phosphatase compared to patients without PA, with no significant difference in serum vitamin D between both groups. Bone mineral density of lumbar spine, femoral neck and total neck of femur were similar between two groups. With PA treatment, there was a significant increment in serum calcium and reduction in serum parathyroid hormone.
PA is associated with hypercalciuria with subsequent secondary hyperparathyroidism. This potentially affects bone health. We recommend this to be part of complication screening among patients with PA.
近期研究表明，醛固酮增多症与继发性甲状旁腺功能亢进之间可能存在关联，进而导致骨骼健康状况下降，然而研究结果相互矛盾。
我们进行了一项荟萃分析，以评估原发性醛固酮增多症（PA）与骨生化标志物之间的关系，并评估原发性醛固酮增多症患者的骨密度。
共检查了939名受试者（37.5%患有PA）。与未患PA的患者相比，PA患者的血清甲状旁腺激素显著更高，血清钙更低，尿钙排泄更高，血清碱性磷酸酶更高，两组之间血清维生素D无显著差异。两组之间腰椎、股骨颈和股骨总颈的骨密度相似。随着PA治疗，血清钙显著增加，血清甲状旁腺激素降低。
PA与高钙尿症及随后的继发性甲状旁腺功能亢进有关。这可能会影响骨骼健康。我们建议将此作为PA患者并发症筛查的一部分。
