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Patients with primary aldosteronism prone to secondary hyperparathyroidism
Pilz S. J Clin Endocrinol Metab. 2011;doi:10.1210/jc.2011-2183.
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Patients with primary aldosteronism appeared to have elevated parathyroid hormone levels compared with those with essential hypertension, according to recent data.
Previous studies have linked aldosterone excess to increased risk for cardiovascular morbidity and mortality, as well as hypercalciuria, which may contribute to the development of hyperparathyroidism, researchers in Austria wrote. Data in humans, however, are limited. Therefore, the researchers examined participants with hypertension from the Graz Endocrine Causes of Hypertension (GECOH) study to assess the relationship between primary aldosteronism and parathyroid hormone (PTH) levels, calcium homeostasis and vitamin D status.
Of 192 patients included in the analysis, 10 had primary aldosteronism and 182 had essential hypertension, according to the researchers. Results revealed significantly increased PTH levels among patients with primary aldosteronism vs. those with essential hypertension (67.8 pg/mL vs. 46.5 pg/mL; P=.002). PTH concentrations, however, decreased to 43.9 pg/mL in patients with primary aldosteronism after specific treatment with adrenal surgery or mineralocorticoid receptor antagonists (P=.023).
Additionally, the researchers noted significantly lower serum calcium and albumin-corrected calcium in patients with primary aldosteronism vs. those with essential hypertension (2.26 mmol/L vs. 2.35 mmol/L; P=.013). Data also highlighted a nonsignificant trend toward increased spot urine calcium to creatinine ratio in patients with primary aldosteronism. No differences in serum 25-hydroxyvitamin D levels, however, were observed between groups.
"Our results show that primary aldosteronism patients are prone to secondary hyperparathyroidism that can be successfully treated with mineralocorticoid receptor antagonists or adrenal surgery," the researchers wrote. "Further studies are warranted to evaluate whether PTH has implications for diagnostic procedures for primary aldosteronism and whether mineralocorticoid receptor antagonists have, beyond primary aldosteronism, a general impact on PTH and calcium metabolism."
Disclosure: The researchers report no relevant financial disclosures.
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