title: A high aldosterone to renin ratio is associated with high serum parathyroid hormone concentrations in the general population.
abstract: BACKGROUND
  Activation of the renin-angiotensin-aldosterone system (RAAS) is associated with high serum PTH concentrations and vice versa.
  
  
  OBJECTIVE
  The aim of this study was to analyze the associations of the plasma aldosterone concentration (PAC), the plasma renin concentration (PRC), or the aldosterone to renin ratio (ARR) with serum PTH concentrations in a sample from the general population of northeast Germany.
  
  
  METHODS
  We selected 3105 subjects (25-88 y) from the first 5-year follow-up examination of the Study of Health in Pomerania. The associations of PAC, PRC, or ARR with serum PTH concentrations were examined with multivariable linear regression analyses. We further calculated adjusted mean serum PTH concentrations according to PAC, PRC, and ARR categories (≥90th and < 90th sex specific percentiles and sex specific quartiles). The models were adjusted for age, sex, estimated glomerular filtration rate, serum 25-hydroxy vitamin D concentration, waist circumference, body mass index, hypertension, diabetes mellitus, liver disease, and intake of drugs that affect the RAAS or bone metabolism.
  
  
  RESULTS
  We found no associations between PAC or PRC and serum PTH concentrations in fully adjusted linear regression models. However, fully adjusted linear regression and ANOVA models revealed higher serum PTH concentrations in subjects with an ARR 90th percentile or greater than in subjects with a lower ARR.
  
  
  CONCLUSIONS
  Our data show that a high ARR is associated with high serum PTH concentrations in the general population and thus add to the increasing evidence of a relation between the RAAS and PTH.
authors.affiliation: Medizinische Klinik und Poliklinik IV (E.F., A.P., M.B., F.B., M.R.), Klinikum der Ludwig-Maximilians-Universität München, D-80336 München, Deutschland; Institut für Klinische Chemie und Laboratoriumsmedizin (A.H., M.N., H.W.), Universitätsmedizin Greifswald, D-17475 Greifswald, Deutschland; Institut für Physiologie (R.R.) and Institut für Community Medicine (W.L.), Universitätsmedizin Greifswald, D-17475 Greifswald, Deutschland; and Institut für Epidemiologie (W.L.), Christian-Albrechts-Universität Kiel, D-24105 Kiel, Deutschland.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Fischer
authors.forename: Anke
authors.initials: A
authors.lastname: Hannemann
authors.forename: Rainer
authors.initials: R
authors.lastname: Rettig
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Lieb
authors.forename: Matthias
authors.initials: M
authors.lastname: Nauck
authors.forename: Anna
authors.initials: A
authors.lastname: Pallauf
authors.forename: Martin
authors.initials: M
authors.lastname: Bidlingmaier
authors.forename: Martin
authors.initials: M
authors.lastname: Bildingmaier
authors.forename: Felix
authors.initials: F
authors.lastname: Beuschlein
authors.forename: Henri
authors.initials: H
authors.lastname: Wallaschofski
authors.forename: Martin
authors.initials: M
authors.lastname: Reincke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000097:blood*; D005260:Female; D005858:Germany / Q000453:epidemiology; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D012083:Renin / Q000097:blood*; D012084:Renin-Angiotensin System / Q000502:physiology; D055815:Young Adult
chemical_list: D010281:Parathyroid Hormone; D000450:Aldosterone; D012083:Renin