Elevated parathyroid hormone 44-68 and osteoarticular changes in patients with genetic hemochromatosis.
OBJECTIVE
To determine whether the osteoarticular changes associated with genetic hemochromatosis could be explained by metabolic parathyroid hormone (PTH) disorders.


METHODS
The study involved 210 patients with liver iron overload syndromes. Osteoarticular changes were numerically scored as the number of damaged joints. PTH 1-84 and 44-68 were assayed.


RESULTS
An increase in serum PTH 44-68 levels was found in one-third of untreated patients who had no calcium or PTH 1-84 abnormalities. Serum PTH 44-68 levels correlated positively with serum ferritin levels. In multivariate analyses, the number of affected joints correlated positively with age, serum PTH 44-68 levels, and serum ferritin levels.


CONCLUSIONS
Liver iron overload syndromes, especially genetic hemochromatosis, are associated with elevated circulating levels of PTH fragments containing the 44-68 region, which appears to play a role in osteoarticular changes. This increase seems to be a consequence of iron overload.
Pawlotsky
Y
Y
Centre Hospitalier et Universitaire, Rennes, France.
Le Dantec
P
P
Moirand
R
R
Guggenbuhl
P
P
Jouanolle
A M
AM
Catheline
M
M
Meadeb
J
J
Brissot
P
P
Deugnier
Y
Y
Chalès
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002805:Chondrocalcinosis / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D005260:Female; D005293:Ferritins / Q000097:blood; D006432:Hemochromatosis / Q000150:complications / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D007501:Iron / Q000378:metabolism; D007596:Joints / Q000378:metabolism / Q000473:pathology; D008099:Liver / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010281:Parathyroid Hormone / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D014168:Transferrin / Q000378:metabolism
D010281:Parathyroid Hormone; D010446:Peptide Fragments; D014168:Transferrin; C046111:parathyroid hormone (44-68); D005293:Ferritins; D007501:Iron