title: Plasma-parathyroid hormone is associated with subclinical and clinical atherosclerotic disease in 2 community-based cohorts.
abstract: OBJECTIVE
  Cardiovascular risk factors have different impact on different arterial territories. Diseases with elevated circulating parathyroid hormone (PTH) such as primary hyperparathyroidism and chronic renal failure have been shown to be associated with an increased risk of cardiovascular disease, predominantly heart or cerebrovascular diseases. However, data on the associations between circulating PTH and peripheral atherosclerosis are limited.
  
  
  RESULTS
  Two prospective, community-based studies were used. In 306 men and women, who were 70 years old, from the Prospective investigation of the vasculature in Uppsala seniors (PIVUS) study, cross-sectional relations between PTH and atherosclerotic burden assessed by whole-body magnetic resonance angiography were investigated. In 998 men, who were 71 years old, from the Uppsala longitudinal study of adult men (ULSAM) study, the association between PTH concentration and risk of subsequent nonfatal atherosclerotic disease (excluding coronary or cerebrovascular disease) was investigated. Adjusting for established vascular risk factors, PTH was associated with burden of atherosclerosis (increase in total atherosclerotic score per SD PTH increase: 0.04, 0.003-0.08; P=0.03) in the PIVUS study. During follow-up in the ULSAM study (median 16.7 years), 89 men were diagnosed with nonfatal atherosclerotic disease. In Cox-regression analyses adjusting for established vascular risk factors and mineral metabolism, higher PTH was associated with an increased risk of nonfatal atherosclerotic disease (hazard ratio for 1 SD increase of PTH: 1.55, 1.33-1.88; P<0.0001). Results were similar when including fatal atherosclerotic disease in the outcome.
  
  
  CONCLUSIONS
  In 2 independent community-based cohorts, PTH was associated to the degree of atherosclerosis and risk of clinically overt atherosclerotic disease, respectively. Our data confirm and extend previous studies supporting a role for PTH in the development of atherosclerotic disease.
authors.affiliation: From the Uppsala Clinical Research Center (E.H., E.I., J.S., J.Ä.), Departments of Radiology (T.H., H.A., L.J.) and Medical Sciences (E.H., J.Ä., E.I., J.S., L.L.), Uppsala University, Uppsala, Sweden; and the School of Health and Social Studies, Dalarna University, Falun, Sweden (J.Ä.). emil.hagstrom@ucr.uu.se.
authors.forename: Emil
authors.initials: E
authors.lastname: Hagström
authors.affiliation: From the Uppsala Clinical Research Center (E.H., E.I., J.S., J.Ä.), Departments of Radiology (T.H., H.A., L.J.) and Medical Sciences (E.H., J.Ä., E.I., J.S., L.L.), Uppsala University, Uppsala, Sweden; and the School of Health and Social Studies, Dalarna University, Falun, Sweden (J.Ä.).
authors.forename: Karl
authors.initials: K
authors.lastname: Michaëlsson
authors.affiliation: From the Uppsala Clinical Research Center (E.H., E.I., J.S., J.Ä.), Departments of Radiology (T.H., H.A., L.J.) and Medical Sciences (E.H., J.Ä., E.I., J.S., L.L.), Uppsala University, Uppsala, Sweden; and the School of Health and Social Studies, Dalarna University, Falun, Sweden (J.Ä.).
authors.forename: Håkan
authors.initials: H
authors.lastname: Melhus
authors.affiliation: From the Uppsala Clinical Research Center (E.H., E.I., J.S., J.Ä.), Departments of Radiology (T.H., H.A., L.J.) and Medical Sciences (E.H., J.Ä., E.I., J.S., L.L.), Uppsala University, Uppsala, Sweden; and the School of Health and Social Studies, Dalarna University, Falun, Sweden (J.Ä.).
authors.forename: Thomas
authors.initials: T
authors.lastname: Hansen
authors.affiliation: From the Uppsala Clinical Research Center (E.H., E.I., J.S., J.Ä.), Departments of Radiology (T.H., H.A., L.J.) and Medical Sciences (E.H., J.Ä., E.I., J.S., L.L.), Uppsala University, Uppsala, Sweden; and the School of Health and Social Studies, Dalarna University, Falun, Sweden (J.Ä.).
authors.forename: Håkan
authors.initials: H
authors.lastname: Ahlström
authors.affiliation: From the Uppsala Clinical Research Center (E.H., E.I., J.S., J.Ä.), Departments of Radiology (T.H., H.A., L.J.) and Medical Sciences (E.H., J.Ä., E.I., J.S., L.L.), Uppsala University, Uppsala, Sweden; and the School of Health and Social Studies, Dalarna University, Falun, Sweden (J.Ä.).
authors.forename: Lars
authors.initials: L
authors.lastname: Johansson
authors.affiliation: From the Uppsala Clinical Research Center (E.H., E.I., J.S., J.Ä.), Departments of Radiology (T.H., H.A., L.J.) and Medical Sciences (E.H., J.Ä., E.I., J.S., L.L.), Uppsala University, Uppsala, Sweden; and the School of Health and Social Studies, Dalarna University, Falun, Sweden (J.Ä.).
authors.forename: Erik
authors.initials: E
authors.lastname: Ingelsson
authors.affiliation: From the Uppsala Clinical Research Center (E.H., E.I., J.S., J.Ä.), Departments of Radiology (T.H., H.A., L.J.) and Medical Sciences (E.H., J.Ä., E.I., J.S., L.L.), Uppsala University, Uppsala, Sweden; and the School of Health and Social Studies, Dalarna University, Falun, Sweden (J.Ä.).
authors.forename: Johan
authors.initials: J
authors.lastname: Sundström
authors.affiliation: From the Uppsala Clinical Research Center (E.H., E.I., J.S., J.Ä.), Departments of Radiology (T.H., H.A., L.J.) and Medical Sciences (E.H., J.Ä., E.I., J.S., L.L.), Uppsala University, Uppsala, Sweden; and the School of Health and Social Studies, Dalarna University, Falun, Sweden (J.Ä.).
authors.forename: Lars
authors.initials: L
authors.lastname: Lind
authors.affiliation: From the Uppsala Clinical Research Center (E.H., E.I., J.S., J.Ä.), Departments of Radiology (T.H., H.A., L.J.) and Medical Sciences (E.H., J.Ä., E.I., J.S., L.L.), Uppsala University, Uppsala, Sweden; and the School of Health and Social Studies, Dalarna University, Falun, Sweden (J.Ä.).
authors.forename: Johan
authors.initials: J
authors.lastname: Arnlöv
mesh_terms: D000368:Aged; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D018810:Magnetic Resonance Angiography; D008297:Male; D015999:Multivariate Analysis; D010281:Parathyroid Hormone / Q000097:blood*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D051598:Whole Body Imaging
chemical_list: D015415:Biomarkers; C470125:PTH protein, human; D010281:Parathyroid Hormone
keywords: atherosclerosis; magnetic resonance angiography; parathyroid hormone; population