Relationship between bone turnover and left ventricular function in primary hyperparathyroidism: The EPATH trial

Observational studies suggested a link between bone disease and left ventricular (LV) dysfunction that may be pronounced in hyperparathyroid conditions. We therefore aimed to test the hypothesis that circulating markers of bone turnover correlate with LV function in a cohort of patients with primary...

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Main Authors: Verheyen, Nicolas (Author) , März, Winfried (Author)
Format: Article (Journal)
Language:English
Published: April 13, 2017
In: PLOS ONE
Year: 2017, Volume: 12, Issue: 4
ISSN:1932-6203
DOI:10.1371/journal.pone.0173799
Online Access:Verlag, kostenfrei, Volltext: http://dx.doi.org/10.1371/journal.pone.0173799
Verlag, kostenfrei, Volltext: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0173799
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Author Notes:Nicolas Verheyen, Astrid Fahrleitner-Pammer, Evgeny Belyavskiy, Martin R. Gruebler, Hans Peter Dimai, Karin Amrein, Klemens Ablasser, Johann Martensen, Cristiana Catena, Elisabeth Pieske-Kraigher, Caterina Colantonio, Jakob Voelkl, Florian Lang, Ioana Alesutan, Andreas Meinitzer, Winfried März, Helmut Brussee, Burkert Pieske, Stefan Pilz, Andreas Tomaschitz

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520 |a Observational studies suggested a link between bone disease and left ventricular (LV) dysfunction that may be pronounced in hyperparathyroid conditions. We therefore aimed to test the hypothesis that circulating markers of bone turnover correlate with LV function in a cohort of patients with primary hyperparathyroidism (pHPT). Cross-sectional data of 155 subjects with pHPT were analyzed who participated in the “Eplerenone in Primary Hyperparathyroidism” (EPATH) Trial. Multivariate linear regression analyses with LV ejection fraction (LVEF, systolic function) or peak early transmitral filling velocity (e’, diastolic function) as dependent variables and N-terminal propeptide of procollagen type 1 (P1NP), osteocalcin (OC), bone-specific alkaline phosphatase (BALP), or beta-crosslaps (CTX) as the respective independent variable were performed. Analyses were additionally adjusted for plasma parathyroid hormone, plasma calcium, age, sex, HbA1c, body mass index, mean 24-hours systolic blood pressure, smoking status, estimated glomerular filtration rate, antihypertensive treatment, osteoporosis treatment, 25-hydroxy vitamin D and N-terminal pro-brain B-type natriuretic peptide. Independent relationships were observed between P1NP and LVEF (adjusted β-coefficient = 0.201, P = 0.035) and e’ (β = 0.188, P = 0.042), respectively. OC (β = 0.192, P = 0.039) and BALP (β = 0.198, P = 0.030) were each independently related with e’. CTX showed no correlations with LVEF or e’. In conclusion, high bone formation markers were independently and paradoxically related with better LV diastolic and, partly, better systolic function, in the setting of pHPT. Potentially cardio-protective properties of stimulated bone formation in the context of hyperparathyroidism should be explored in future studies. 
650 4 |a Blood pressure 
650 4 |a Bone and mineral metabolism 
650 4 |a Bone development 
650 4 |a Glomerular filtration rate 
650 4 |a Linear regression analysis 
650 4 |a Osteoporosis 
650 4 |a Parathyroid hormone 
650 4 |a Phosphatases 
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