title: Serum fetuin-A levels increased following parathyroidectomy in uremic hyperparathyroidism.
abstract: BACKGROUND
  Both fetuin-A and hyperparathyroidism play crucial roles in vascular calcification (VC) and bone metabolism. However, the correlation between secondary hyperparathyroidism (SHPT), parathyroidectomy (PTX) and fetuin-A levels in dialysis patients has not yet been studied.
  
  
  METHODS
  For this study, we included 27 consecutive dialysis patients with severe SHPT who underwent total PTX with autotransplantation over a period of 2 years (from Oct 2006 to Sep 2008). Serum ionized calcium (iCa), phosphorus (Pi), bone-specific alkaline phosphatase (bAP), intact parathyroid hormone (iPTH), and fetuin-A were checked basally and 2, 7, 14, 30, and 60 days after PTX.
  
  
  RESULTS
  Two days after PTX, the iPTH, serum iCa, and Pi concentrations significantly decreased. Serum bAP levels gradually increased after PTX, peaked after 14 days (p < 0.05), and then gradually decreased. Serum fetuin-A levels significantly increased during the first 7 days after PTX, peaked 14 days after PTX (0.21 ± 0.05 vs. 0.35 ± 0.07 mg/ml, p < 0.05), and then remained at a stable level 60 days after PTX. There were significant correlations between percentage increase in serum fetuin-A levels and percentage decrease in serum iPTH levels 2 days and 7 days after PTX (r = 0.526, p < 0.01; r = 0.403, p < 0.05, respectively) and correlations between percentage increase in serum fetuin-A levels and percentage decrease in serum iCa levels 30 and 60 days after PTX (r = 0.449, p < 0.05; r = 0.474, p < 0.05, respectively).
  
  
  CONCLUSIONS
  Serum fetuin-A significantly increased after PTX in uremic patients with SHPT. The percentage increase in serum fetuin-A after PTX was closely correlated with the percentage decrease in serum iPTH levels immediately after PTX, and with the percentage decrease in serum iCa levels in the later stage after PTX. Further investigations are necessary to further understand the regulation of fetuin-A in dialysis patients with sSHPT.
authors.affiliation: Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chih-Chiang
authors.initials: CC
authors.lastname: Wang
authors.forename: Yu-Juei
authors.initials: YJ
authors.lastname: Hsu
authors.forename: Chia-Chao
authors.initials: CC
authors.lastname: Wu
authors.forename: Sung-Sen
authors.initials: SS
authors.lastname: Yang
authors.forename: Giien-Shuen
authors.initials: GS
authors.lastname: Chen
authors.forename: Shih-Hua
authors.initials: SH
authors.lastname: Lin
authors.forename: Pauling
authors.initials: P
authors.lastname: Chu
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy; D014511:Uremia / Q000150:complications*; D060749:alpha-2-HS-Glycoprotein / Q000032:analysis*
chemical_list: C556354:AHSG protein, human; D010281:Parathyroid Hormone; D060749:alpha-2-HS-Glycoprotein; D000469:Alkaline Phosphatase