Parathyroid hormone, cardiovascular and all-cause mortality: A meta-analysis

Area of Science:

• Endocrinology
• Cardiovascular Medicine
• Epidemiology

Background:

• Inconsistent findings exist regarding the association between parathyroid hormone (PTH) concentration and mortality.
• The relationship between PTH levels and cardiovascular or all-cause mortality requires clarification.

Purpose of the Study:

• To determine if elevated PTH concentration is an independent predictor of cardiovascular or all-cause mortality.
• To conduct a meta-analysis of prospective studies to assess this association in the general population.

Main Methods:

• A systematic literature search was performed in Cochrane Library, PubMed, and Embase up to June 2015.
• Included were prospective studies examining serum PTH concentration and mortality outcomes.
• Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated for highest versus lowest PTH concentrations.

Main Results:

• Ten studies comprising 31,616 subjects were analyzed.
• Elevated PTH concentration was associated with an increased risk of all-cause mortality (RR 1.19; 95% CI 1.08-1.30).
• No significant association was found for cardiovascular mortality (RR 1.26; 95% CI 0.96-1.66), though risk appeared higher in men (RR 1.68; 95% CI 1.05-2.67).

Conclusions:

• Elevated PTH concentration is an independent predictor of all-cause mortality.
• Elevated serum PTH concentration may increase cardiovascular mortality risk specifically in men.