دورية أكاديمية
Secondary hyperparathyroidism: Predictors and relationship with vitamin D status, bone turnover markers and bone mineral density.
| العنوان: | Secondary hyperparathyroidism: Predictors and relationship with vitamin D status, bone turnover markers and bone mineral density. |
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| المؤلفون: | Fitzpatrick D; Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland; School of Medicine, Trinity College, Dublin, Ireland. Electronic address: dofitzpatrick@stjames.ie., Laird E; Department of Health & Nutritional Sciences, Atlantic Technological University Sligo, Ireland., Ward M; Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland., Hoey L; Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland., Hughes CF; Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland., Strain JJ; Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland., Cunningham C; Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland., Healy M; Department of Biochemistry, St James's Hospital, Dublin, Ireland., Molloy AM; School of Medicine, Trinity College, Dublin, Ireland., McNulty H; Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine BT52 1SA, Northern Ireland, United Kingdom of Great Britain and Northern Ireland., Lannon R; Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland; School of Medicine, Trinity College, Dublin, Ireland., McCarroll K; Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Ireland; School of Medicine, Trinity College, Dublin, Ireland. |
| المصدر: | Bone [Bone] 2024 Jul; Vol. 184, pp. 117108. Date of Electronic Publication: 2024 Apr 18. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Science Country of Publication: United States NLM ID: 8504048 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-2763 (Electronic) Linking ISSN: 18732763 NLM ISO Abbreviation: Bone Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York : Elsevier Science Original Publication: Elmsford, NY : Pergamon Press, c1985- |
| مواضيع طبية MeSH: | Vitamin D*/blood , Vitamin D*/analogs & derivatives , Bone Density*/physiology , Hyperparathyroidism, Secondary*/blood , Biomarkers*/blood , Bone Remodeling*/physiology, Humans ; Female ; Male ; Aged ; Middle Aged ; Prevalence ; Vitamin D Deficiency/blood ; Vitamin D Deficiency/complications ; Vitamin D Deficiency/epidemiology ; Aged, 80 and over |
| مستخلص: | Introduction: Secondary hyperparathyroidism (SHPT) has adverse implications for bone health but is relatively understudied. In this study we examine the prevalence and determinants of SHPT and describe the relationship of SHPT with bone turnover markers and bone mineral density (BMD) in older Irish adults. Method: Eligible participants (n = 4139) were identified from the Trinity-Ulster-Department of Agriculture (TUDA) study, a cohort of Irish adults aged ≥60 years. Exclusion criteria included an estimated glomerular filtration rate (eGFR) <30 ml/min and serum calcium >2.5 mmol/l to remove hyperparathyroidism due to advanced chronic kidney disease (CKD) and primary hyperparathyroidism respectively. The relationship between SHPT and bone turnover markers and BMD (measured by densitometry) was examined in a subsample (n = 1488). Vitamin D deficiency was defined as 25-hydroxyvitamin D [25 (OH)D] <30 nmol/l. Results: Participants had a mean age of 73.6 ± 7.9 years, 65.1 % were female and 19.4 % were found to be vitamin D deficient. The prevalence of SHPT decreased as vitamin D increased, from 30.6 % in those deficient to 9.8 % in those with 25(OH)D ≥ 50 nmol/l and increased with declining kidney function. In non‑calcium supplement users, principal determinants of SHPT were vitamin D deficiency (OR 4.18, CI 3.05-5.73, p < 0.001), eGFR 30-44 ml/min (OR 3.69, CI 2.44-5.57, p < 0.001), loop diuretic use (OR 3.52, CI 2.59-4.79, p < 0.001) and to a lesser extent body mass index (p = 0.001), eGFR 45-59 ml/min (p < 0.001) and 25(OH)D level 30-49 nmol/l (p = 0.002). Similar findings were observed in calcium supplement users, though proton pump inhibitors were also associated with SHPT (OR 1.55, CI 1.08-2.22, p = 0.018) while vitamin D 30-49 nmol/l was not. In participants with SHPT versus those without, bone turnover markers were higher: bone alkaline phosphatase (p = 0.017) and tartrate-resistant acid phosphatase (p = 0.033), whilst there was lower BMD at the neck of femur (0.880 vs. 0.903 g/cm 2 , p = 0.033) and total hip (0.968 vs. 0.995 g/cm 2 , P = 0.017). Discussion: The results show that up to one in six older Irish adults had SHPT and this was associated with lower BMD and higher concentrations of bone turnover markers. Both vitamin D deficiency and 25(OH)D level 30-49 nmol/l were important predictors of SHPT. Loop diuretics and PPIs may also increase the risk of SHPT, and their use may need to be carefully considered in this population. Further studies examining the potential impact of these factors on bone health in similar populations to our study sample are warranted. Competing Interests: Declaration of competing interest The authors have no conflicts of interest associated with the material presented in this paper. (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Bone mineral density; Bone turnover; Calcium supplementation; Markers; Parathyroid hormone; Secondary hyperparathyroidism; Vitamin D |
| المشرفين على المادة: | 0 (25-hydroxyvitamin D) |
| تواريخ الأحداث: | Date Created: 20240420 Date Completed: 20240518 Latest Revision: 20240518 |
| رمز التحديث: | 20240519 |
| DOI: | 10.1016/j.bone.2024.117108 |
| PMID: | 38642819 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1873-2763 |
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| DOI: | 10.1016/j.bone.2024.117108 |