Dahlen Bianca, Müller Felix, Tröbs Sven-Oliver, Heidorn Marc William, Schulz Andreas, Arnold Natalie, Hermanns M Iris, Schwuchow-Thonke Sören, Prochaska Jürgen H, Gori Tommaso, Ten Cate Hugo, Lackner Karl J, Münzel Thomas, Wild Philipp S, Panova-Noeva Marina
Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
DZHK (German Center for Cardiovascular Research), Partner Site Rhine Main, Mainz, Germany.
Front Cardiovasc Med. 2021 Jun 16;8:682521. doi: 10.3389/fcvm.2021.682521. eCollection 2021.
Heart failure (HF) is a multifactorial syndrome with pathophysiological complexities still not fully understood. Higher mean platelet volume (MPV), a potential marker of platelet activation, and high concentrations of parathyroid hormone (PTH) have been implicated in the pathogenesis of HF. This study aims to investigate sex-specifically the association between PTH concentrations and platelet indices in phenotypes of HF. PTH and platelet indices (MPV and platelet count) were available in 1,896 participants from the MyoVasc study in Mainz, Germany. Multivariable linear regression models, adjusted for age, sex, season, vitamin D status, cardiovascular risk factors, comorbidities, estimated glomerular filtration rate, and medication, were used to assess the associations between platelet indices and PTH. The results showed distinct sex-specific associations between PTH and platelet indices. A positive association between PTH and MPV was found in females with symptomatic HF with reduced ejection fraction (HFrEF) only [β = 0.60 (0.19; 1.00)]. Platelet count was inversely associated with PTH in male HFrEF individuals [β = -7.6 (-15; -0.30)] and in both males and females with HF with preserved ejection fraction (HFpEF). This study reports differential, sex-specific relationships between PTH and platelet indices in HF individuals independent of vitamin D status and clinical profile. Particularly in phenotypes of symptomatic HF, distinct associations were observed, suggesting a sex-specific mechanism involved in the interaction between PTH and platelets.
心力衰竭（HF）是一种多因素综合征，其病理生理复杂性仍未完全被理解。较高的平均血小板体积（MPV）是血小板活化的一个潜在标志物，而高浓度的甲状旁腺激素（PTH）与HF的发病机制有关。本研究旨在按性别特异性研究HF表型中PTH浓度与血小板指标之间的关联。德国美因茨的MyoVasc研究中的1896名参与者提供了PTH和血小板指标（MPV和血小板计数）数据。使用经年龄、性别、季节、维生素D状态、心血管危险因素、合并症、估计肾小球滤过率和药物调整的多变量线性回归模型来评估血小板指标与PTH之间的关联。结果显示PTH与血小板指标之间存在明显的性别特异性关联。仅在射血分数降低的有症状HF（HFrEF）女性中发现PTH与MPV呈正相关[β = 0.60（0.19；1.00）]。在男性HFrEF个体[β = -7.6（-15；-0.30）]以及射血分数保留的HF（HFpEF）男性和女性中，血小板计数与PTH呈负相关。本研究报告了HF个体中PTH与血小板指标之间存在差异的、性别特异性的关系，且独立于维生素D状态和临床特征。特别是在有症状HF的表型中，观察到了明显的关联，表明PTH与血小板之间的相互作用涉及性别特异性机制。
