副甲状腺激素-PTH1R在心血管疾病和平衡中发出信号
1Department of Internal Medicine - Endocrine Division, Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, UT Southwestern Medical Center, Dallas, TX 75390, USA.
Trends in endocrinology and metabolism: TEM
|March 1, 2024
概括
原发性偏甲状腺症 (pHPT) 增加了心血管疾病的风险. 目前的pHPT管理指南没有系统地考虑心血管健康,需要重新评估治疗策略.
科学领域:
- 内分泌学 在内分泌学.
- 心血管医学 心血管医学
- 老年病的医生 老年病的医生
背景情况:
- 初级甲状腺功能障碍症 (pHPT) 在老年人群中普遍存在,女性的发病率更高.
- 目前的pHPT手术管理决策主要关注骨,脏和水平,往往忽视心血管方面的影响.
- 患有pHPT的个人面临心血管死亡风险显著增加,特别是如果不符合手术干预的标准.
研究的目的:
- 为了突出低估心血管疾病 (CVD) 风险在初级甲状腺功能障碍症 (pHPT) 管理中的低估.
- 强调甲状腺前激素 (PTH) 1受体 (PTH1R) 在血管生物学中的作用及其对心血管疾病的影响.
- 倡导将心脏病风险评估纳入pHPT的临床管理.
主要方法:
- 审查关于pHPT发病率和人口统计的流行病学数据.
- 分析PTH1R在心血管系统中的生理作用.
- 对pHPT手术管理的现有临床指南的审查.
- 讨论PTH1R配体的药理动力学-药理动力学 (PK-PD) 关系.
主要成果:
- 在不符合手术治疗建议的pHPT患者中,调整后心血管死亡风险几乎是pHPT患者的三倍.
- 副甲状腺激素 (PTH) 1受体 (PTH1R) 在血管系统中具有生物活性,将pHPT与心血管风险联系起来.
- 目前对pHPT的管理策略没有系统地纳入心血管风险评估.
结论:
- 对于评估心血管PTH1R信号传递,有必要确定生物标志物.
- 需要对PTH1R配体的PK-PD进行进一步的研究,以了解心血管平衡.
- 将心血管疾病风险评估整合到pHPT管理中,对于改善患者的治疗结果和降低死亡率至关重要.
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