Longitudinal Assessment of PTH in Community-Dwelling Older Women—Elevations Are Not Associated With Mortality

Buchebner, David; Malmgren, Linnea; Christensson, Anders; McGuigan, Fiona; Gerdhem, Paul; Ridderstråle, Martin; Åkesson, Kristina

doi:10.1210/js.2017-00104

Cited by 7 publications

(3 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At the 5- and 10-year follow-up, PTH was analyzed using Cobas auto-analyzer by Roche (intra-assay CV, 7–5%). To ensure inter-assay comparability between methods, consistency of PTH values was assessed by duplicate measurements [ 13 ]. Plasma phosphate from all visits was analyzed in batch according to routine methods.…”

Section: Methodsmentioning

confidence: 99%

Reduced kidney function is associated with BMD, bone loss and markers of mineral homeostasis in older women: a 10-year longitudinal study

et al. 2017

View full text Add to dashboard Cite

SummaryKidney function decreases with age; however, the long-term influence on bone density (BMD) in older women already at risk of osteoporosis is unknown. We followed kidney function and bone loss for 10 years. Declining kidney function was adversely associated with bone loss and mineral homeostasis in old women, though it attenuated with advanced aging.IntroductionExisting studies do not fully address the relationship between kidney function and bone metabolism with advanced aging in Caucasian women. This study describes the association between kidney function, BMD, bone loss and bone metabolism in older women and provides a review of the available literature for context.MethodsWe studied participants from the OPRA cohort with follow-up after 5 and 10 years. Using plasma cystatin C (cysC), estimated glomerular function rate (eGFR) was evaluated at age 75 (n = 981), 80 (n = 685) and 85 (n = 365). Women were stratified into “normal” function (CKD stages 1–2), “intermediate” (stage 3a) and “poor” (stages 3b–5), and outcome measures—BMD, bone loss and markers of mineral homeostasis—were compared.ResultsFemoral neck (FN) BMD positively associated with kidney function at 75 years old ( = 0.001, p = 0.028) and 80 years old ( = 0.001, p = 0.001), although with small effect size. Prevalence of osteoporosis (FN T-score ≤ − 2.5) did not differ with kidney function. Measured at age 75, women with poor kidney function had higher annual percentage bone loss over 5 years compared to those with normal function (2.3%, 95% CI 1.8–2.8 versus 1.3%, 95% CI 1.1–1.5, p = 0.007), although not when measured from age 80 or 85. Additionally, markers of mineral homeostasis (PTH, phosphate, vitamin D, calcium), CRP and osteocalcin differed by kidney function.ConclusionsIn old women, kidney function is associated with BMD, bone loss and altered mineral homeostasis; probably, a relationship attenuated in the very elderly.Electronic supplementary materialThe online version of this article (10.1007/s00198-017-4221-y) contains supplementary material, which is available to authorized users.

show abstract

Section: Methodsmentioning

confidence: 99%

Reduced kidney function is associated with BMD, bone loss and markers of mineral homeostasis in older women: a 10-year longitudinal study

et al. 2017

View full text Add to dashboard Cite

show abstract

“…The Helsinki Ageing Study reported a significant impact of elevated serum PTH on all-cause mortality in three age cohorts (75, 80, and 85 years) during a follow-up of 17 years [ 31 ]. However, the Malmo Osteoporosis Prospective Risk Assessment cohort, which included 1044 community-dwelling women who were aged >85 years and followed for 10 years, found that PTH was not independently associated with all-cause mortality [ 32 ]. However, until now, the association between PTH and all-cause mortality has not been investigated in centenarians.…”

Section: Discussionmentioning

confidence: 99%

Associations of Serum 25(OH)D, PTH, and β-CTX Levels with All-Cause Mortality in Chinese Community-Dwelling Centenarians

Wang

Cheng

et al. 2022

Nutrients

View full text Add to dashboard Cite

This longitudinal cohort study explored the associations of 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), and β-C-terminal telopeptide of type 1 collagen (β-CTX) levels with all-cause mortality in centenarians. The study included 952 centenarians (81.4% female). During a median follow-up of 32 months, 752 (78.9%) centenarians died. The estimated 1-year, 3-year, and 5-year survival rates were 80.0%, 45.7%, and 23.6%, respectively. The association of mortality with 25(OH)D was linear, whereas the associations with PTH and β-CTX were J-shaped, with a lower risk below the median levels. Compared with 25(OH)D of ≥30 ng/mL, 25(OH)D < 30 ng/mL was associated with increased mortality (HR 1.52, 95% CI 1.24–1.86, p < 0.001). Compared with PTH of ≤65 pg/mL, PTH > 65 pg/mL was associated with increased mortality (HR 1.30, 95% CI 1.08–1.56, p = 0.005). Compared with β-CTX of <0.55 ng/mL, β-CTX ≥ 0.55 ng/mL was associated with increased mortality (HR 1.30, 95% CI 1.10–1.54, p = 0.002). A higher β-CTX level (even in the clinical reference range of 0.55–1.01 ng/mL) was associated with increased mortality (HR 1.23, 95% CI 1.04–1.47, p = 0.018). Centenarians with 25(OH)D < 30 ng/mL, PTH > 65 pg/mL, and β-CTX ≥ 0.55 ng/mL had a 2.77-fold (95% CI 1.99–3.85, p < 0.001) increased risk of mortality when compared with those with 25(OH)D of >30 ng/mL, PTH < 65 pg/mL, and β-CTX < 0.55 ng/mL. Lower serum 25(OH)D and higher PTH and β-CTX were independently correlated with increased all-cause mortality in Chinese community-dwelling centenarians.

show abstract

“…There are several physiologic considerations in the measurement of PTH. Specifically, whereas serum calcium is relatively stable throughout adult life, PTH secretion increases with age, and an estimated 20% of women ≥80 years will have an elevated PTH level, primarily related to age-related decreases in renal function [ 5 ]. Furthermore, PTH secretion is dynamic, with intermittent pulses superimposed on a background of basal secretion [ 6 ], and has a circadian rhythm [ 7 , 8 ].…”

mentioning

confidence: 99%

The Eucalcemic Patient With Elevated Parathyroid Hormone Levels

Shaker

Wermers

2023

Journal of the Endocrine Society

View full text Add to dashboard Cite

Primary hyperparathyroidism (PHPT) is classically characterized by hypercalcemia with elevated or inappropriately normal parathyroid hormone (PTH) levels. Elevated PTH levels in the presence of normal calcium levels are not infrequently found during the evaluation of metabolic bone disorders or kidney stone disease. This can be caused by secondary hyperparathyroidism (SHPT) or normocalcemic primary hyperparathyroidism (NPHPT). NPHPT is due to autonomous parathyroid function whereas SHPT is caused by a physiologic stimulation to PTH secretion. Many medical conditions and medications can contribute to SHPT, and differentiation between SHPT and NPHPT may be difficult. Cases are presented to illustrate examples. In this paper, we review the distinction between SHPT and NPHPT as well as end organ effects of NPHPT and outcomes of surgery in NPHPT. We suggest that the diagnosis of NPHPT be made only after careful exclusion of causes of SHPT and consideration of medications that can increase PTH secretion. Further, we advise a conservative approach to surgery in NPHPT.

show abstract

Longitudinal Assessment of PTH in Community-Dwelling Older Women—Elevations Are Not Associated With Mortality

Cited by 7 publications

References 27 publications

Reduced kidney function is associated with BMD, bone loss and markers of mineral homeostasis in older women: a 10-year longitudinal study

Reduced kidney function is associated with BMD, bone loss and markers of mineral homeostasis in older women: a 10-year longitudinal study

Associations of Serum 25(OH)D, PTH, and β-CTX Levels with All-Cause Mortality in Chinese Community-Dwelling Centenarians

The Eucalcemic Patient With Elevated Parathyroid Hormone Levels

Contact Info

Product

Resources

About