Division of Endocrinology and Metabolism, Department of Internal Medicine, Kanazawa University Graduate School of Medicine, Japan.
Department of Health Promotion and Medicine of the Future, Kanazawa University, Japan.
Intern Med. 2021;60(7):993-998. doi: 10.2169/internalmedicine.5282-20. Epub 2021 Apr 1.
Objective Primary aldosteronism (PA) is a major cause of secondary hypertension. The association between PA and other hormone disorders is unclear. The present study aimed to evaluate whether the parathyroid hormone (PTH) value is associated with PA subtypes or specific treatments. Methods We enrolled 135 patients with PA who had their PTH value measured before undergoing a specific treatment. We evaluated whether PTH value is associated with PA subtypes or with specific treatments. The present study is a single-center retrospective study (2011-2018). Results Our study showed that, among the patients with PA, the proportion of those with PTH elevation was >30%. The PTH value was significantly correlated with both the basal plasma aldosterone concentration (PAC) and PAC after a captopril challenge test. However, the PTH value was not significantly different between the patients with unilateral and bilateral PA. We observed that the serum PTH value decreased after treatment of PA with unilateral adrenalectomy or mineralocorticoid receptor antagonists. Conclusion Our findings suggest that the PTH value in PA patients might be associated with the autonomous production of aldosterone. However, there was no correlation between the PTH value and PA subtypes in our study. Additionally, our study showed that targeted treatment for PA may lead to a decrease in the serum PTH levels. Hence, the PTH value could potentially be used as an index for measuring the suitability for PA treatment.
目的 原发性醛固酮增多症（PA）是继发性高血压的主要病因。PA 与其他激素紊乱之间的关系尚不清楚。本研究旨在评估甲状旁腺激素（PTH）值是否与 PA 亚型或特定治疗方法相关。
方法 我们纳入了 135 例 PA 患者，这些患者在接受特定治疗前测量了其 PTH 值。我们评估了 PTH 值是否与 PA 亚型或特定治疗方法相关。本研究为单中心回顾性研究（2011-2018 年）。
结果 我们的研究表明，在 PA 患者中，PTH 升高的比例>30%。PTH 值与基础血浆醛固酮浓度（PAC）和卡托普利激发试验后的 PAC 均显著相关。然而，单侧和双侧 PA 患者的 PTH 值无显著差异。我们观察到单侧肾上腺切除术或盐皮质激素受体拮抗剂治疗 PA 后，血清 PTH 值下降。
结论 我们的研究结果提示，PA 患者的 PTH 值可能与醛固酮的自主产生有关。然而，在本研究中，PTH 值与 PA 亚型之间没有相关性。此外，我们的研究表明，针对 PA 的靶向治疗可能会导致血清 PTH 水平降低。因此，PTH 值可能可作为衡量 PA 治疗适宜性的指标。
