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Serum parathyroid hormone levels predict coronary heart disease: the Tromsø Study
Elena Kamycheva1, Johan Sundsfjord, Rolf Jorde
1Department of Internal Medicine, University Hospital of North, Norway. elena.kamycheva@unn.no
Insights
Elevated serum parathyroid hormone (PTH) levels predict coronary heart disease (CHD) in individuals with normal calcium levels. This finding suggests PTH may play a role in cardiovascular disease development.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Epidemiology
Background:
- Primary hyperparathyroidism (PHPT) is linked to cardiovascular issues like hypertension and atherosclerosis.
- The role of parathyroid hormone (PTH) in coronary heart disease (CHD) among individuals with normal serum calcium is not fully understood.
Purpose of the Study:
- To investigate serum PTH levels as an independent risk factor for CHD.
- To assess the association between PTH and CHD in a population with serum calcium within the reference range.
Main Methods:
- A population-based cross-sectional study (Tromsø Study) involving 3570 subjects.
- Serum PTH, calcium, and other relevant biochemical markers were measured.
- Logistic regression analysis was used to identify independent predictors of CHD, considering factors like age, BMI, and smoking status.
Main Results:
- Higher serum PTH levels correlated with an increased rate of CHD in both men and women.
- The highest PTH quartile significantly predicted CHD, with odds ratios of 1.70 for men and 1.73 for women compared to the lowest quartile.
- These associations remained significant even when serum calcium levels were within the normal reference range.
Conclusions:
- Serum PTH levels are a significant predictor of CHD in individuals with normal serum calcium.
- The findings suggest a potential role for PTH in the pathogenesis of coronary heart disease.
Background:
Primary hyperparathyroidism (PHPT) is associated with hypertension, coronary atherosclerosis and other cardiovascular diseases. We aimed to evaluate serum parathyroid hormone (PTH) levels as an independent risk factor for coronary heart disease (CHD) in subjects with serum calcium within the reference range.
Design:
Population-based cross-sectional study.
Methods:
The Tromsø Study was attended by 27159 subjects aged 25-79 years. Serum PTH was measured in 3570 subjects. They all completed a questionnaire on medical history, including questions on angina pectoris and myocardial infarction along with a food-frequency questionnaire. A total of 1459 men and 1753 women with serum calcium 2.20-2.60 mmol/l, serum creatinine<121 micromol/l and who did not use diuretics were included in the present study. Linear regression was used to reveal associations between PTH, age, body mass index, serum calcium, calcium intake, cholesterol, blood pressure, glycosylated haemoglobin (HbA1c) and smoking status. A logistic regression model was used to find the independent predictors of CHD.
Results:
When stratified for age the rate of CHD was higher in the subjects with serum PTH > 6.8 pmol/l than in those with normal or low serum PTH levels [relative risk 1.67, 95% confidence interval (CI) 1.26-2.23 in men and 1.78, 95% CI 1.22-2.57 in women]. The highest PTH quartile (> 3.50 pmol/l in men and > 3.30 pmol/l in women) predicted CHD, with odds ratios of 1.70 (95% CI 1.08-2.70) for men and 1.73 (95% CI 1.04-2.88) for women, versus the lowest PTH quartile (< 1.90 pmol/l for men and <1.80 pmol/l for women).
Conclusions:
Serum PTH predicts CHD in subjects with calcium levels within the reference range. This may indicate a role for PTH in the development of CHD.
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