Inga-Lena Nilsson1, Sophie Norenstedt2, Fredrik Granath3, Jan Zedenius2, Ylva Pernow4, Tobias E Larsson5. 1. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Section of Endocrine Surgery, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden. Electronic address: inga-lena.nilsson@ki.se. 2. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. 3. Department of Medicine, Karolinska Institutet, Stockholm, Sweden. 4. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Endocrinology, Metabolism and Diabetes, Karolinska Institutet, Stockholm, Sweden; Karolinska University Hospital, Stockholm, Sweden. 5. Department of Clinical Science, Intervention and Technology, Renal Unit, Karolinska Institutet, Stockholm, Sweden.
Abstract
BACKGROUND: Fibroblast growth factor-23 (FGF23), a regulator of secretion of parathyroid hormone (PTH), is implicated in the development of cardiovascular disease. The role of FGF23 in primary hyperparathyroidism (pHPT) is unclear. METHODS: A total of 150 consecutive patients with pHPT were examined with ambulatory blood pressure monitoring ((24h)ABP) before parathyroid adenomectomy (PTX). Blood samples were collected 6 ± 2 weeks before and 6 ± 2 weeks after PTX. RESULTS: Plasma FGF23 levels decreased after PTX from a median of 45.2 pg/mL (interquartile range 37.6-54.8) to 36.8 pg/mL (26.7-48.7); P < .001. This postoperative decrease correlated with the decrease in ionized calcium (r = 0.24; P < .01). Greater FGF23 concentrations at baseline were associated with a greater weight of the adenoma and PTH levels, as well as with body mass index, triglycerides, and insulin levels and greater postoperative decreases in FGF23, ionized calcium, insulin growth-like factor 1, and insulin. FGF23 and PTH both correlated with greater blood pressures on (24h)ABP, especially at nighttime (r = 0.31 and r = 0.28; P ≤ .01), whereas after multivariate adjustment, only PTH remained independently associated with (24)ABP. CONCLUSION: Circulating FGF23 is increased in pHPT and is associated independently with the metabolic risk profile. The long-term benefit of decreasing FGF23 in pHPT after PTX remains to be established.
BACKGROUND:Fibroblast growth factor-23 (FGF23), a regulator of secretion of parathyroid hormone (PTH), is implicated in the development of cardiovascular disease. The role of FGF23 in primary hyperparathyroidism (pHPT) is unclear. METHODS: A total of 150 consecutive patients with pHPT were examined with ambulatory blood pressure monitoring ((24h)ABP) before parathyroid adenomectomy (PTX). Blood samples were collected 6 ± 2 weeks before and 6 ± 2 weeks after PTX. RESULTS: Plasma FGF23 levels decreased after PTX from a median of 45.2 pg/mL (interquartile range 37.6-54.8) to 36.8 pg/mL (26.7-48.7); P < .001. This postoperative decrease correlated with the decrease in ionizedcalcium (r = 0.24; P < .01). Greater FGF23 concentrations at baseline were associated with a greater weight of the adenoma and PTH levels, as well as with body mass index, triglycerides, and insulin levels and greater postoperative decreases in FGF23, ionizedcalcium, insulin growth-like factor 1, and insulin. FGF23 and PTH both correlated with greater blood pressures on (24h)ABP, especially at nighttime (r = 0.31 and r = 0.28; P ≤ .01), whereas after multivariate adjustment, only PTH remained independently associated with (24)ABP. CONCLUSION: Circulating FGF23 is increased in pHPT and is associated independently with the metabolic risk profile. The long-term benefit of decreasing FGF23 in pHPT after PTX remains to be established.
Authors: A Gatu; C Velicescu; A Grigorovici; R Danila; V Muntean; S J Mogoş; V Mogoş; C Vulpoi; C Preda; D Branisteanu Journal: Acta Endocrinol (Buchar) Date: 2017 Oct-Dec Impact factor: 0.877
Authors: Michaël R Laurent; Jean De Schepper; Dominique Trouet; Nathalie Godefroid; Emese Boros; Claudine Heinrichs; Bert Bravenboer; Brigitte Velkeniers; Johan Lammens; Pol Harvengt; Etienne Cavalier; Jean-François Kaux; Jacques Lombet; Kathleen De Waele; Charlotte Verroken; Koenraad van Hoeck; Geert R Mortier; Elena Levtchenko; Johan Vande Walle Journal: Front Endocrinol (Lausanne) Date: 2021-03-19 Impact factor: 5.555