Limits...
Bone and mineral metabolism in patients with primary aldosteronism.

Petramala L, Zinnamosca L, Settevendemmie A, Marinelli C, Nardi M, Concistrè A, Corpaci F, Tonnarini G, De Toma G, Letizia C - Int J Endocrinol (2014)

Bottom Line: Recently, in a cohort of PA patients a significant increase of primary hyperparathyroidism was found, suggesting a bidirectional functional link between the adrenal and parathyroid glands.Compared to HS and EH, PA subjects had significantly lower serum calcium levels and higher urinary calcium excretion.This study supports the hypothesis that bone loss and fracture risk in PA patients are potentially the result of aldosterone mediated hypercalciuria and the consecutive secondary hyperparathyroidism.

View Article: PubMed Central - PubMed

Affiliation: Internal Medicine and Secondary Hypertension Unit, Department of Internal Medicine and Medical Specialties, University of Rome La Sapienza, Viale del Policlinico 155, 00165 Rome, Italy.

ABSTRACT
Primary aldosteronism represents major cause of secondary hypertension, strongly associated with high cardiovascular morbidity and mortality. Aldosterone excess may influence mineral homeostasis, through higher urinary calcium excretion inducing secondary increase of parathyroid hormone. Recently, in a cohort of PA patients a significant increase of primary hyperparathyroidism was found, suggesting a bidirectional functional link between the adrenal and parathyroid glands. The aim of this study was to evaluate the impact of aldosterone excess on mineral metabolism and bone mass density. In 73 PA patients we evaluated anthropometric and biochemical parameters, renin-angiotensin-aldosterone system, calcium-phosphorus metabolism, and bone mineral density; control groups were 73 essential hypertension (EH) subjects and 40 healthy subjects. Compared to HS and EH, PA subjects had significantly lower serum calcium levels and higher urinary calcium excretion. Moreover, PA patients showed higher plasma PTH, lower serum 25(OH)-vitamin D levels, higher prevalence of vitamin D deficiency (65% versus 25% and 25%; P < 0.001), and higher prevalence of osteopenia/osteoporosis (38.5 and 10.5%) than EH (28% and 4%) and NS (25% and 5%), respectively. This study supports the hypothesis that bone loss and fracture risk in PA patients are potentially the result of aldosterone mediated hypercalciuria and the consecutive secondary hyperparathyroidism.

No MeSH data available.


Related in: MedlinePlus

Plasma levels of 25(OH)-vitamin D in all subjects enrolled. HS: healthy subjects; EH: essential arterial hypertension; PA: primary aldosteronism; APA: aldosterone-producing adrenal adenoma; IHA: idiopathic bilateral hyperplasia.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4016829&req=5

fig1: Plasma levels of 25(OH)-vitamin D in all subjects enrolled. HS: healthy subjects; EH: essential arterial hypertension; PA: primary aldosteronism; APA: aldosterone-producing adrenal adenoma; IHA: idiopathic bilateral hyperplasia.

Mentions: Several studies have shown that vitamin D scoreis easily assessed by serum 25(OH)-vitamin D. Concentration less than 20 ng/mL is generally considered vitamin D deficiency whereas between 20 and 30 ng/mL vitamin insufficiency. In Figure 1, we reported the behavior of serum 25(OH)-vitamin. D levels in all study groups. In particular the prevalence of vitamin D deficiency was significantly higher in patients with PA than in EH and HS subjects (65% versus 25% and 25%, resp.; P < 0.001). Among PA subjects the prevalence of vitamin D deficiency was higher in subjects with IHA when compared with those with APA (72.5% versus 56%; P < 0.01, resp.).


Bone and mineral metabolism in patients with primary aldosteronism.

Petramala L, Zinnamosca L, Settevendemmie A, Marinelli C, Nardi M, Concistrè A, Corpaci F, Tonnarini G, De Toma G, Letizia C - Int J Endocrinol (2014)

Plasma levels of 25(OH)-vitamin D in all subjects enrolled. HS: healthy subjects; EH: essential arterial hypertension; PA: primary aldosteronism; APA: aldosterone-producing adrenal adenoma; IHA: idiopathic bilateral hyperplasia.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4016829&req=5

fig1: Plasma levels of 25(OH)-vitamin D in all subjects enrolled. HS: healthy subjects; EH: essential arterial hypertension; PA: primary aldosteronism; APA: aldosterone-producing adrenal adenoma; IHA: idiopathic bilateral hyperplasia.
Mentions: Several studies have shown that vitamin D scoreis easily assessed by serum 25(OH)-vitamin D. Concentration less than 20 ng/mL is generally considered vitamin D deficiency whereas between 20 and 30 ng/mL vitamin insufficiency. In Figure 1, we reported the behavior of serum 25(OH)-vitamin. D levels in all study groups. In particular the prevalence of vitamin D deficiency was significantly higher in patients with PA than in EH and HS subjects (65% versus 25% and 25%, resp.; P < 0.001). Among PA subjects the prevalence of vitamin D deficiency was higher in subjects with IHA when compared with those with APA (72.5% versus 56%; P < 0.01, resp.).

Bottom Line: Recently, in a cohort of PA patients a significant increase of primary hyperparathyroidism was found, suggesting a bidirectional functional link between the adrenal and parathyroid glands.Compared to HS and EH, PA subjects had significantly lower serum calcium levels and higher urinary calcium excretion.This study supports the hypothesis that bone loss and fracture risk in PA patients are potentially the result of aldosterone mediated hypercalciuria and the consecutive secondary hyperparathyroidism.

View Article: PubMed Central - PubMed

Affiliation: Internal Medicine and Secondary Hypertension Unit, Department of Internal Medicine and Medical Specialties, University of Rome La Sapienza, Viale del Policlinico 155, 00165 Rome, Italy.

ABSTRACT
Primary aldosteronism represents major cause of secondary hypertension, strongly associated with high cardiovascular morbidity and mortality. Aldosterone excess may influence mineral homeostasis, through higher urinary calcium excretion inducing secondary increase of parathyroid hormone. Recently, in a cohort of PA patients a significant increase of primary hyperparathyroidism was found, suggesting a bidirectional functional link between the adrenal and parathyroid glands. The aim of this study was to evaluate the impact of aldosterone excess on mineral metabolism and bone mass density. In 73 PA patients we evaluated anthropometric and biochemical parameters, renin-angiotensin-aldosterone system, calcium-phosphorus metabolism, and bone mineral density; control groups were 73 essential hypertension (EH) subjects and 40 healthy subjects. Compared to HS and EH, PA subjects had significantly lower serum calcium levels and higher urinary calcium excretion. Moreover, PA patients showed higher plasma PTH, lower serum 25(OH)-vitamin D levels, higher prevalence of vitamin D deficiency (65% versus 25% and 25%; P < 0.001), and higher prevalence of osteopenia/osteoporosis (38.5 and 10.5%) than EH (28% and 4%) and NS (25% and 5%), respectively. This study supports the hypothesis that bone loss and fracture risk in PA patients are potentially the result of aldosterone mediated hypercalciuria and the consecutive secondary hyperparathyroidism.

No MeSH data available.


Related in: MedlinePlus