Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, Cuneo, Italy.
Department of Endocrinology, Diabetes and Metabolism, Santa Croce and Carle Hospital, Cuneo, Italy.
Endocr Pract. 2021 Nov;27(11):1072-1076. doi: 10.1016/j.eprac.2021.04.886. Epub 2021 Jun 21.
There is a direct bidirectional link between parathyroid hormone (PTH) and the renin-angiotensin-aldosterone system (RAAS), but few studies evaluated the RAAS in patients with primary hyperparathyroidism (PHPT), mainly biased from concomitant antihypertensive treatment.
We retrospectively evaluated a consecutive series of 130 normotensive patients with PHPT comparing aldosterone (ALD) levels and plasma renin activity (PRA) with the demographic, biochemical, or clinical features of PHPT.
No correlation was found between ALD and PRA, and the demographic, biochemical, and bone densitometry parameters in patients with PHPT without hypertension, with the exception of a negative correlation between age and serum PRA. Moreover, there was no significant correlation between PTH and ALD levels even in patients whose PTH level was >100 ng/L (P = .088).
In our normotensive patients with PHPT, the ALD, PRA, and aldosterone/renin ratio were not correlated to PTH and calcium levels. In addition, they were neither related to PHPT clinical presentation nor renal function, vitamin D status, bone mass loss, or the presence of comorbidities such as diabetes and obesity. Further studies are needed to clarify the complex interplay between PTH and the RAAS in the modern PHPT presentation.
甲状旁腺激素 (PTH) 与肾素-血管紧张素-醛固酮系统 (RAAS) 之间存在直接的双向联系，但很少有研究评估原发性甲状旁腺功能亢进症 (PHPT) 患者的 RAAS，主要是因为同时存在抗高血压治疗的偏倚。
我们回顾性评估了 130 例血压正常的 PHPT 连续患者系列，比较了醛固酮 (ALD) 水平和血浆肾素活性 (PRA) 与 PHPT 的人口统计学、生化或临床特征。
在无高血压的 PHPT 患者中，ALD 和 PRA 与人口统计学、生化和骨密度计参数之间没有相关性，除了年龄与血清 PRA 之间存在负相关外。此外，即使在 PTH 水平>100ng/L 的患者中，PTH 和 ALD 水平之间也没有显著相关性（P=0.088）。
在我们的血压正常的 PHPT 患者中，ALD、PRA 和醛固酮/肾素比值与 PTH 和钙水平无关。此外，它们与 PHPT 的临床表现、肾功能、维生素 D 状态、骨量丢失或合并症如糖尿病和肥胖无关。需要进一步研究以阐明现代 PHPT 表现中 PTH 和 RAAS 之间的复杂相互作用。
