PTH: a new target in arteriosclerosis?
BACKGROUND
Growing evidence demonstrates that hyperparathyroidism is associated with an increased risk of cardiovascular morbidity and mortality. However, little is known about the relation between serum PTH levels within the normal range and cardiovascular diseases (CVD).


OBJECTIVE
In this study the relationship of serum PTH levels within the normal range with CVD and abdominal aortic calcifications was investigated.


METHODS
A cross-sectional, population-based study was performed using data of the Longitudinal Aging Study Amsterdam, including 558 men and 537 women, aged 65-88 years. Models were controlled for sex, age, body mass index, hypertension, diabetes mellitus, high-density lipoprotein cholesterol, total cholesterol, smoking, physical activity, alcohol consumption, glomerular filtration rate, season of blood collection, calcium or diuretic use, and serum 25-hydroxyvitamin D and osteocalcin levels when these variables were found to be relevant confounders.


RESULTS
Multivariate models showed that subjects in the highest quintile of serum PTH had a significantly higher risk of CVD as compared with subjects in the lowest quintile (odds ratio 2.22, confidence interval 1.39-3.56). The relationship between PTH and abdominal aortic calcifications was observed only in men, which remained significant after adjusting for confounders (odds ratio 4.03, confidence interval 1.50-10.83).


CONCLUSIONS
This study demonstrated that in older persons the presence of serum PTH levels within the upper normal range is highly related to CVD. In men, this association may partly be explained by calcifications of the abdominal aorta. Because CVD poses an important health risk, further elucidation of the role of serum PTH in CVD and arteriosclerosis is relevant.
PhD, Internist-Endocrinologist, Department of Endocrinology, VU University Medical Center, Box 7057, 1007 MB Amsterdam, The Netherlands. emw.eekhoff@vumc.nl.
Petra J
PJ
Buizert
Natasja M
NM
van Schoor
Suat
S
Simsek
Paul
P
Lips
A C
AC
Heijboer
M
M
den Heijer
Dorly J H
DJ
Deeg
Elisabeth M W
EM
Eekhoff
D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000097:blood; D001161:Arteriosclerosis / Q000097:blood*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood*; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood*; D012307:Risk Factors; D012907:Smoking / Q000097:blood
D010281:Parathyroid Hormone; D002784:Cholesterol