Calcium-regulating hormones and parathyroid hormone-related peptide in normal human pregnancy and postpartum: a longitudinal study

Ardawi, M. S. M.; Nasrat, Hassan A.; Ba'Aqueel, Hassan S.M.

doi:10.1530/eje.0.1370402

Cited by 179 publications

(144 citation statements)

References 36 publications

(41 reference statements)

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“…Owing to the difficulties in the performance of the assays used to measure PTHrp in pregnancy, there has been debate on whether the circulating levels of PTHrp increase (20,21) or remain unchanged (22). The complications with the accurate measurement of PTHrp start by the expression of three different isoforms by the human gene (23).…”

Section: Pth and Pthrpmentioning

confidence: 99%

ENDOCRINOLOGY IN PREGNANCY: Bone metabolic changes during pregnancy: a period of vulnerability to osteoporosis and fracture

Sanz-Salvador

Garcı́a-Pérez

Tarı́n

et al. 2015

European Journal of Endocrinology

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Changes in bone density and bone markers suggest that pregnancy is associated with deterioration of bone mass in the mother. The metabolism of calcium resets to allow for the needs imposed by the building of the fetal skeleton. The fetus contributes to the process through the output of regulators from the placenta. Understanding of the whole process is limited, but some changes are unambiguous. There is an increase in the circulating levels of vitamin D, but its functional impact is unclear. Fetal parathyroid hormone (PTH) and PTH-related peptide (PTHrp) play an indirect role through support of a calcium gradient that creates hypercalcemia in the fetus. Placental GH, which increases up to the end of pregnancy, may exert some anabolic effects, either directly or through the regulation of the IGF1 production. Other key regulators of bone metabolism, such as estrogens or prolactin, are elevated during pregnancy, but their role is uncertain. An increase in the ratio of receptor activator of nuclear factor kappa B ligand (RANKL) to osteoprotegerin (OPG) acts as an additional pro-resorbing factor in bone. The increase in bone resorption may lead to osteoporosis and fragility fracture, which have been diagnosed, although rarely. However, the condition is transitory as long-term studies do not link the number of pregnancies with osteoporosis. Prevention is limited by the lack of identifiable risk factors. When fractures are diagnosed, rest, analgesics, or, when indicated, orthopedic intervention have demonstrated efficacy. Systemic treatment with anti-osteoporotic drugs is effective, but the potential harm to the fetus imposes caution in their use.

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Section: Pth and Pthrpmentioning

confidence: 99%

ENDOCRINOLOGY IN PREGNANCY: Bone metabolic changes during pregnancy: a period of vulnerability to osteoporosis and fracture

Sanz-Salvador

Garcı́a-Pérez

Tarı́n

et al. 2015

European Journal of Endocrinology

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“…8 Calcitriol, frequently increased during pregnancy, also contributes to increased uptake of calcium. 13 An additional problem encountered in pregnancy and a prominent feature of pregnancy-related milk-alkali syndrome is dehydration related to vomiting. 14 In our patient, the amount of elemental calcium ingested was approximately 2,500-4,400 mg, three to five times the normal daily intake.…”

Section: Discussionmentioning

confidence: 99%

Hypercalcemia in Pregnancy: A Case of Milk-Alkali Syndrome

et al. 2011

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Milk-alkali syndrome is a rare cause of hypercalcemia characterized by the triad of hypercalcemia, renal insufficiency, and metabolic alkalosis that results from the overconsumption of calcium containing products. In the setting of pregnancy where there is a physiologic increase in calcium absorption, milkalkali syndrome can be potentially life threatening. We report a case of a 26-year-old woman in her second trimester of pregnancy who presented with 2 weeks of flank pain, nausea, vomiting, anorexia, headache, and lightheadedness. The history revealed consumption of a large quantity of milk, calcium carbonate antacid, and calcium-containing prenatal vitamins. Her symptoms and hypercalcemia resolved with intravenous fluids and a loop diuretic. With the increased use of calcium carbonate for peptic ulcer disease, gastroesophageal reflux disease, and osteoporosis, milk-alkali syndrome has experienced a resurgence and must be considered in the differential diagnosis of hypercalcemia. In this clinical vignette we review the literature on milk-alkali syndrome in pregnancy and discuss important diagnostic and therapeutic considerations when managing the pregnant patient with hypercalcemia.KEY WORDS: hypercalcemia; milk-alkali syndrome; pregnancy. J Gen Intern Med 26(8):

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“…In present study, most of patients were villager and naturally had high level of physical activity. In addition pregnancy to be associated with changes of several hormones, including, estrogen, progesterone, cortisol and 1, 25 dihydroxyvitamin D3 (Henricks et al, 1972;Smith et al, 1973;Ardawi et al, 1997). Some of these hormones such as cortisol and catecholamines and 1, 25 dihydroxy D3 are potent inhibitor of TNF-α production by monocyte/macrophage (DeRijk et al, 1997;Guirao et al, 1997;Anand et al, 2009;Ito et al, 2002).…”

Section: Discussionmentioning

confidence: 99%

Do Resistin and Tumor Necrosis Factor-Î± Relate to Changes in Insulin Resistance in Normal Pregnancy?

Zareian¹,

Jahromi²,

Rad³

et al. 2010

American Journal of Biochemistry and Biotechnology

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Problem statement:The purpose of this study was to evaluate the role of resistin and Tumor Necrosis Factor-α (TNF-α) in insulin resistance during pregnancy. Approach: Serum resistin and TNF-α concentrations were measured by ELISA in 86 healthy pregnant women (26, 23 and 37 of them in the 1st, 2nd and 3rd trimesters, respectively) and in 21 healthy non pregnant women in a cross sectional study. Results: Resistin concentration was significantly higher in the third trimester (9.5±3.3 ng mL −1 ) as compared with non pregnant women (7±3.3 ng mL −1 ). Serum TNF-α level were also significantly increase in pregnant women (2.6±1.9 pg mL −1 ) as compared with maternal healthy controls (0.8 ±0.7 pg mL −1 ). There were significant correlation between gestational age and BMI (r = 0.28, p = 0.01), resistin (r = 0.36, p = 0.002) and TNF-α (r = -0.44, p<0.0001). There was not significant correlation between gestational age and Insulin Resistance (IR). We also did not found correlation between IR and resistin as well as between IR and TNF-α in pregnant women. Conclusion: TNF-α and resistin do not appear to contribute greatly to pregnancy induced insulin resistance in healthy pregnancy.

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Calcium-regulating hormones and parathyroid hormone-related peptide in normal human pregnancy and postpartum: a longitudinal study

Cited by 179 publications

References 36 publications

ENDOCRINOLOGY IN PREGNANCY: Bone metabolic changes during pregnancy: a period of vulnerability to osteoporosis and fracture

ENDOCRINOLOGY IN PREGNANCY: Bone metabolic changes during pregnancy: a period of vulnerability to osteoporosis and fracture

Hypercalcemia in Pregnancy: A Case of Milk-Alkali Syndrome

Do Resistin and Tumor Necrosis Factor-Î± Relate to Changes in Insulin Resistance in Normal Pregnancy?

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