Parathyroidectomy reduces inflammatory cytokines and increases vitamin D metabolites in patients with primary hyperparathyroidism.

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Endocrine Practice Pub Date : 2024-10-17 DOI:10.1016/j.eprac.2024.10.005

Lingqiong Meng, Sue A Shapses, Xiangbing Wang

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引用次数: 0

Abstract

Context: Primary hyperparathyroidism (PHPT) is accompanied by a decreased 25-hydroxyvitamin D (25OHD) and vitamin D binding protein (DBP). High parathyroid hormone (PTH) is associated with elevated interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1), yet the role of parathyroidectomy (PTX) on DBP and cytokines is not clear.

Objective: To prospectively evaluate the effect of PTX on inflammatory profiles, total and free 25OHD, and DBP in patients with PHPT.

Methods: Newly diagnosed patients with PHPT were recruited in the study (n=70). Twenty-eight patients returned after PTX, 3 months later. Biochemical markers were measured before and after PTX. A group of age and BMI-matched healthy subjects were included as controls (n=70).

Results: Prior to PTX, patients had lower serum DBP (37.5±6.0 vs 41.5±6.1mg/dL, p<0.001) and total 25OHD (30.1±9.5 vs 33.3±7.9ng/mL, P<0.05), but similar free 25OHD when compared to controls. Serum IL-6, C-reactive protein (CRP), and MCP-1 were higher in PHPT patients (p<0.05), whereas interleukin-10 (IL-10) was similar to controls. PTX increased total and free 25OHD and DBP (p<0.001), and decreased serum IL-6 and MCP-1 (p<0.05), but not CRP and IL-10. Multiple regression analysis indicated that the preoperative PTH explained a significant portion of the variance of IL-6 and MCP-1 (p<0.05).

Conclusions: These findings suggest that PTH may upregulate the production of MCP-1 and IL-6 and downregulate circulating DBP in patients with PHPT, that are normalized by PTX. The exact effect of IL-6 and MCP-1 on DBP, vitamin D metabolites and the role on clinical outcomes in patients with PHPT is an area requiring further study.

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甲状旁腺切除术可减少原发性甲状旁腺功能亢进症患者的炎性细胞因子，并增加维生素 D 代谢物。

背景：原发性甲状旁腺功能亢进症（PHPT）伴有 25- 羟维生素 D（25OHD）和维生素 D 结合蛋白（DBP）的降低。高甲状旁腺激素（PTH）与白细胞介素-6（IL-6）和单核细胞趋化蛋白-1（MCP-1）升高有关，但甲状旁腺切除术（PTX）对DBP和细胞因子的作用尚不明确：目的：前瞻性评估 PTX 对 PHPT 患者的炎症特征、总 25OHD 和游离 25OHD 以及 DBP 的影响：研究招募了新诊断的 PHPT 患者（70 人）。28名患者在PTX治疗3个月后复诊。在 PTX 之前和之后测量了生化指标。一组年龄和体重指数相匹配的健康人作为对照组（70 人）：结果：在 PTX 之前，患者的血清 DBP 较低（37.5±6.0 vs 41.5±6.1mg/dL，p）：这些研究结果表明，PTH 可上调 MCP-1 和 IL-6 的产生，并下调 PHPT 患者的循环 DBP，而 PTX 可使其恢复正常。IL-6和MCP-1对DBP、维生素D代谢物的确切影响以及对PHPT患者临床预后的作用还需要进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.