Primary and Secondary Hyperparathyroidism in Patients with Primary Aldosteronism - Findings From the German Conn's Registry

Asbach E, Bekeran M, König A, Lang K, Hanslik G, Treitl M, Ladurner R, Bidlingmaier M, Beuschlein F, Quinkler M, Reincke M (2019)

Publication Type: Journal article

Publication year: 2019

Journal

Experimental and Clinical Endocrinology and Diabetes Thieme Publishing

DOI: 10.1055/a-1027-6472

Abstract

CONTEXT: Recent studies support a bidirectional interaction between aldosterone and parathyroid hormone (PTH), possibly increasing the individual cardiovascular risk. Primary aldosteronism (PA) and primary hyperparathyroidism can occur simultaneously. OBJECTIVE: Our aim was to investigate the prevalence of hyperparathyroidism in PA. PATIENTS: We performed a case finding of primary hyperparathyroidism in a retrospective series of 503 patients with PA (cohort 1). We analysed primary and secondary hyperparathyroidism in 141 prospective PA patients who underwent PTH, serum calcium and phosphate measurements at time of diagnosis of PA (cohort 2). RESULTS: The prevalence for primary hyperparathyroidism was 1.2% in cohort 1, and 2.1% in cohort 2. Secondary hyperparathyroidism was found in 54.6% of the patients. Patients with secondary hyperparathyroidism had significantly higher aldosterone and lower potassium levels and took more antihypertensive medications compared to those with normal PTH levels. In multivariate analysis, aldosterone and 25-hydroxyvitamin D levels were significantly correlated with serum PTH levels. There was a nonsignificant trend to a higher cardiovascular morbidity in patients with secondary hyperparathyroidism. Patients with aldosterone producing adenoma had significantly higher PTH levels compared to patients with bilateral adrenal hyperplasia. After treatment, there was a significant decrease of PTH levels in both groups. CONCLUSION: Patients with PA frequently have primary or secondary hyperparathyroidism, which is alleviated by correction of PA by surgical or medical means. Patients affected by secondary hyperparathyroidism seem to have a more severe phenotype of PA and have a trend towards more cardiovascular co-morbidities.

Involved external institutions

Charité - Universitätsmedizin Berlin DE Germany (DE) Universitätsklinikum der Ludwig-Maximilians-Universität München DE Germany (DE) Ludwig-Maximilians-Universität (LMU) DE Germany (DE) Endokrinologiepraxis am Stuttgarter Platz, Berlin-Charlottenburg DE Germany (DE) Klinikum der Universität München DE Germany (DE) Klinikum der Universität München (Großhadern und Innenstadt) DE Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School DE Germany (DE) Julius-Maximilians-Universität Würzburg DE Germany (DE)

How to cite

APA:

Asbach, E., Bekeran, M., König, A., Lang, K., Hanslik, G., Treitl, M.,... Reincke, M. (2019). Primary and Secondary Hyperparathyroidism in Patients with Primary Aldosteronism - Findings From the German Conn's Registry. Experimental and Clinical Endocrinology and Diabetes. https://doi.org/10.1055/a-1027-6472

MLA:

Asbach, Evelyn, et al. "Primary and Secondary Hyperparathyroidism in Patients with Primary Aldosteronism - Findings From the German Conn's Registry." Experimental and Clinical Endocrinology and Diabetes (2019).

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