Parathyroid

Japanese study findings suggest that a serum 25D level of 28 ng/ml is the threshold necessary to maintain normal calcium availability, without adversely elevating parathyroid hormone levels. (Source: MedWire News - Bone Health)

Conclusions  Endogenous estrogen may prevent bone loss in postmenopausal hemodialysis patients throughout life. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00198-010-1350-yAuthors N. Sugiya, Hiroshima University Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences Minami-ku Hiroshima JapanA. Nakashima, Department of Advanced Nephrology, Graduate School of Biomedical Sciences, Hiroshima University 1-2-3 Kasumi Minami-Ku Hiroshima City 734-8551 JapanN. Takasugi, Hakuai Clinic Department of Internal Medicine Kure Hiroshima JapanA. Kawai, Chuonaika Clinic Department of Internal Medicine Kure Hiroshima JapanK. Kiribayashi, Clear Yakeyama Clinic Department of Internal Medicine Kure Hiroshima JapanJ. Tanaka, Hiroshima Unive...

Authors: Nakai K, Komaba H, Fukagawa M Fibroblast growth factor 23 (FGF23) is a recently identified bone-derived hormone that regulates phosphate and 1,25-dihydroxyvitamin D metabolism. FGF23 principally acts in the kidney to induce urinary phosphate excretion and suppress 1,25-dihydroxyvitamin D synthesis in the presence of FGF receptor 1 (FGFR1) and its coreceptor Klotho. FGF23 also acts in the parathyroid to decrease parathyroid hormone synthesis and secretion. In patients with chronic kidney disease (CKD), circulating FGF23 levels are progressively increased to compensate for persistent phosphate retention, but this results in reduced renal production of 1,25-dihydroxyvitamin D and leads to hypersecretion of parathyroid hormone. In patients undergoing dialysis, FGF23 levels are mar...

We investigated the effect of heat stress on Ca, P and Mg balance and bone turnover in lactating cows. In a 2 × 2 crossover design, four multiparous lactating Holstein cows were kept in a chamber and subjected to a constant moderate (18°C) ambient temperature (MT) or high (28°C) ambient temperature (HT). The cows were fed total mixed ration (Ca, 0.7%; P, 0.4%; Mg, 0.2%) ad libitum. The milk yield under HT (35.4 kg/day) tended to be lower (P < 0.10) than that under MT (43.2 kg/day). The concentrations of milk P (P < 0.05) and Mg (P < 0.01) were significantly lower under HT than MT. The Ca, P and Mg intake (P < 0.10); Ca (P < 0.10), P, and Mg (P < 0.05) secretion into milk; and Ca (P < 0.05), P (P < 0.01), and Mg (P < 0.05) absorption in the intestine were lower under HT than MT. The plas...

The inverse relationship between vitamin D level and parathyroid hormone is altered by age, but not gender, reveal study findings published in the journal Bone. (Source: MedWire News - Bone Health)

Authors: Zhao G, Ford ES, Li C, Balluz LS Although there is evidence that vitamin D deficiency may play a role in depression, studies done on the associations have yielded mixed results. The present study aimed to examine the associations between serum concentrations of 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone (PTH) and the presence of depression among US adults. A cross-sectional, population-based sample (including 3916 participants aged >/= 20 years) from the 2005-6 National Health and Nutrition Examination Survey was used. Participants' depressive symptoms were assessed using the Patient Health Questionnaire-9 diagnostic algorithm. The associations of 25(OH)D and PTH with depression were explored using multivariate logistic regression models. For all the participants...

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Conclusions  Malignant central nodal metastases occur with high frequency in PTC but not in FVPTC. The risk of metastases correlated with the size and multifocality of the primary tumor. Additional studies are warranted to determine the extent of CND in patients with and without known multifocal disease and to determine the role of CND in patients with FVPTC. (Source: Archives of Otolaryngology)

Conclusion  Inability of the surgeon to find the abnormal parathyroid gland—not missed multiglandular disease—is the main cause of operative failure in focused parathyroidectomy guided by IPM. (Source: Archives of Surgery)

Authors: Castellanos M, Jung E, Park SY, Schuller-Levis G, Odaimi M, Elsayegh S, Kleiner M, Elsoueidi R, Shtaynberg N, Park E Clinical data indicate that patients with hyperparathyroidism due to chronic kidney disease have abnormal immune function. We evaluated the direct effect of parathyroid hormone (PTH) and two 1-34 peptide fragments of PTH on immune function in activated leukocytes from healthy donors. IL-6 and IL-8 were measured from supernatants from phytohemagglutinin-activated non-adherent and lipopolysaccharide-activated adherent leukocytes in the presence of PTH and the two peptides using ELISA. Data showed no significant change in IL-6 and IL-8 production using PTH (0.1 - 0.8 microM) or two peptides (0.2 - 1.6 microM). Lymphocyte proliferation using 3H-thymidine was not inh...

Conclusions: Serum alkaline phosphatase is associated with increased mortality in hemodialysis patients, independent of bone metabolism parameters and liver enzymes. Alkaline phosphatase might be a potential therapeutic target in hemodialysis patients. PMID: 20630128 [PubMed - in process] (Source: Clinical Nephrology)

Conclusions. PTX accomplishes long-term control of HPT and calcium-phosphate metabolism in children with CKD and following PTX and may thus mitigate uraemic bone and cardiovascular disease. This has to be taken into account if alternative long-term therapy with calcimimetics (with as yet unknown effects on longitudinal growth and pubertal development) is considered. (Source: Nephrology Dialysis Transplantation)

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Conclusions. In haemodialysis patients, treatment with sevelamer over 8 weeks was associated with a delayed yet long-lasting increase in serum fetuin-A levels. Increasing the serum level of fetuin-A, a negative acute-phase protein and systemic calcification inhibitor, might be one of the potential anti-calcification mechanisms of sevelamer. Since we failed to detect a decrease in systemic inflammation and uraemic toxins, the exact mechanisms by which sevelamer treatment affects serum fetuin-A remain to be determined. (Source: Nephrology Dialysis Transplantation)

Conclusions. PTHrP seems to participate in the hypertrophic signalling triggered by HG. In this condition, AngII induces the upregulation of PTHrP, which might induce the expression of TGF-β1 and p27Kip1. These findings provide new insights into the protective effects of AngII antagonists in DN, opening new paths for intervention. (Source: Nephrology Dialysis Transplantation)

Conclusion  Oncological en bloc clearance of the central compartment with meticulous removal of all possibly involved soft tissues, including a systematic central lymph node resection, may improve outcomes and should be included in the routine approach to the suspicious parathyroid lesion. There is no need for a prophylactic lateral neck dissection. Content Type Journal ArticleDOI 10.1007/s00268-010-0722-yAuthors Klaus-Martin Schulte, King’s College Hospital, King’s Health Partners Department of Endocrine Surgery Denmark Hill London SE5 9RS UKNadia Talat, King’s College Hospital, King’s Health Partners Department of Endocrine Surgery Denmark Hill London SE5 9RS UKJohn Miell, University Hospital Lewisham Department of Endocrinology Lewisham London SE13 6HL UKC...

Conclusions  Even though hypoparathyroid patients require more calcium carbonate and vitamin D3 than nonhypoparathyroid patients do, they do not have any side effects. Content Type Journal ArticleDOI 10.1007/s00268-010-0711-1Authors Fong-Fu Chou, Chang Gung University College of Medicine Department of Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center 123, Ta-Pei Road, Niao-Sung Hsiang Kaohsiung Hsien 833 Taiwan, ROCShun-Yu Chi, Chang Gung University College of Medicine Department of Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center 123, Ta-Pei Road, Niao-Sung Hsiang Kaohsiung Hsien 833 Taiwan, ROCKun-Chou Hsieh, Chang Gung University College of Medicine Department of Surgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center 123, Ta-Pei R...

Abstract  While the effects of calcium, phosphorus intake, and vitamin D on parathyroid hormone (PTH) have been well studied, less is known about other factors that impact PTH. Our goal was to delineate associations between demographic, dietary, and plasma factors and PTH. We conducted a cross-sectional study of intact PTH among 1,288 nonblack women in the Nurses Health Study II aged 33–53 with BMI <30 kg/m2 and eGFR ≥60 ml/min/1.73 m2. Median PTH was 30.7 pg/ml. After adjusting for 25-hydroxyvitamin D and other factors, PTH was 4.1 pg/ml lower (95% CI −7.7 to −0.5) in women who smoked 1–14 cigarettes/day and 6.4 pg/ml lower (95% CI −11.2 to −1.7) in women who smoked >15 cigarettes/day compared to nonsmokers. After multivaria...

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CONCLUSION:: Total parathyroidectomy alone has minimal associated morbidity or mortality, and a good medium- to long-term clinical outcome with a low recurrence rate. Copyright (c) 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. PMID: 20641052 [PubMed - as supplied by publisher] (Source: The British Journal of Surgery)

This study reviewed the medium- to long-term results of this procedure.A retrospective review was undertaken of patients undergoing total parathyroidectomy between August 2000 and March 2009. The procedure was performed by a single surgeon and median follow-up was 31 (range 1-120) months.Data were obtained on 115 patients with no re-explorations for bleeding or clinical recurrent laryngeal nerve injuries. The rate of postoperative hypocalcaemia on the day after surgery was 15·7 per cent. Thirty-three patients (28·7 per cent) had an undetectable parathyroid hormone level at the end of follow-up. Fourteen patients (12·2 per cent) developed recurrent hyperparathyroidism with a median parathyroid hormone level of 35·4 (range 5·4-200·0) pmol/l. The reoperation rate was 3·5 per cent. Thym...

CONCLUSIONS: Although no single biochemical marker is able to provide a complete assessment of renal osteodystrophy, a combination of serum calcium, alkaline phosphatase, and PTH levels may lead to a more precise noninvasive assessment of turnover and mineralization abnormalities in this population. PMID: 20634327 [PubMed - as supplied by publisher] (Source: Clinical Journal of the American Society of Nephrology : CJASN)

CONCLUSION: Our data indicate that patients with a high serum FGF-23 level and/or a low PTH level at the time of transplantation are at risk for increased BMD loss during the first post-transplant year. PMID: 20634326 [PubMed - as supplied by publisher] (Source: Clinical Journal of the American Society of Nephrology : CJASN)

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