Bone and Mineral Metabolism in Patients with Primary Aldosteronism
Primary aldosteronism represents major cause of secondary hypertension, strongly associated with high cardiovascular morbidity and mortality. Aldosterone excess may influence mineral homeostasis, through higher urinary calcium excretion inducing secondary increase of parathyroid hormone. Recently, i...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2014/836529 |
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| author | Luigi Petramala Laura Zinnamosca Amina Settevendemmie Cristiano Marinelli Matteo Nardi Antonio Concistrè Francesco Corpaci Gianfranco Tonnarini Giorgio De Toma Claudio Letizia |
| author_facet | Luigi Petramala Laura Zinnamosca Amina Settevendemmie Cristiano Marinelli Matteo Nardi Antonio Concistrè Francesco Corpaci Gianfranco Tonnarini Giorgio De Toma Claudio Letizia |
| author_sort | Luigi Petramala |
| collection | DOAJ |
| description | Primary aldosteronism represents major cause of secondary hypertension, strongly associated with high cardiovascular morbidity and mortality. Aldosterone excess may influence mineral homeostasis, through higher urinary calcium excretion inducing secondary increase of parathyroid hormone. Recently, in a cohort of PA patients a significant increase of primary
hyperparathyroidism was found, suggesting a bidirectional functional link between the adrenal and parathyroid glands. The aim of this study was to evaluate the impact of aldosterone excess on mineral metabolism and bone mass density. In 73 PA patients we evaluated anthropometric and biochemical parameters, renin-angiotensin-aldosterone system, calcium-phosphorus metabolism, and bone mineral density; control groups were 73 essential hypertension (EH) subjects and 40 healthy subjects. Compared to HS and EH, PA subjects had significantly lower serum calcium levels and higher urinary calcium excretion. Moreover, PA patients showed higher plasma PTH, lower serum 25(OH)-vitamin D levels, higher prevalence of vitamin D deficiency (65% versus 25% and 25%; P<0.001), and higher prevalence of osteopenia/osteoporosis (38.5 and 10.5%) than EH (28% and 4%) and NS (25% and 5%), respectively. This study supports the hypothesis that bone loss and fracture risk in PA patients are potentially the result of aldosterone mediated hypercalciuria and the consecutive secondary hyperparathyroidism. |
| format | Article |
| id | doaj-art-43bbb1725d8a486bb0dcba1932b8e458 |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-43bbb1725d8a486bb0dcba1932b8e4582025-02-03T05:51:03ZengWileyInternational Journal of Endocrinology1687-83371687-83452014-01-01201410.1155/2014/836529836529Bone and Mineral Metabolism in Patients with Primary AldosteronismLuigi Petramala0Laura Zinnamosca1Amina Settevendemmie2Cristiano Marinelli3Matteo Nardi4Antonio Concistrè5Francesco Corpaci6Gianfranco Tonnarini7Giorgio De Toma8Claudio Letizia9Internal Medicine and Secondary Hypertension Unit, Department of Internal Medicine and Medical Specialties, University of Rome La Sapienza, Viale del Policlinico 155, 00165 Rome, ItalyInternal Medicine and Secondary Hypertension Unit, Department of Internal Medicine and Medical Specialties, University of Rome La Sapienza, Viale del Policlinico 155, 00165 Rome, ItalyInternal Medicine and Secondary Hypertension Unit, Department of Internal Medicine and Medical Specialties, University of Rome La Sapienza, Viale del Policlinico 155, 00165 Rome, ItalyInternal Medicine and Secondary Hypertension Unit, Department of Internal Medicine and Medical Specialties, University of Rome La Sapienza, Viale del Policlinico 155, 00165 Rome, ItalyInternal Medicine and Secondary Hypertension Unit, Department of Internal Medicine and Medical Specialties, University of Rome La Sapienza, Viale del Policlinico 155, 00165 Rome, ItalyInternal Medicine and Secondary Hypertension Unit, Department of Internal Medicine and Medical Specialties, University of Rome La Sapienza, Viale del Policlinico 155, 00165 Rome, ItalyInternal Medicine and Secondary Hypertension Unit, Department of Internal Medicine and Medical Specialties, University of Rome La Sapienza, Viale del Policlinico 155, 00165 Rome, ItalyInternal Medicine and Secondary Hypertension Unit, Department of Internal Medicine and Medical Specialties, University of Rome La Sapienza, Viale del Policlinico 155, 00165 Rome, ItalyDepartment of Surgery, P.Valdoni, University of Rome La Sapienza, Viale del Policlinico 155, 00165 Rome, ItalyInternal Medicine and Secondary Hypertension Unit, Department of Internal Medicine and Medical Specialties, University of Rome La Sapienza, Viale del Policlinico 155, 00165 Rome, ItalyPrimary aldosteronism represents major cause of secondary hypertension, strongly associated with high cardiovascular morbidity and mortality. Aldosterone excess may influence mineral homeostasis, through higher urinary calcium excretion inducing secondary increase of parathyroid hormone. Recently, in a cohort of PA patients a significant increase of primary hyperparathyroidism was found, suggesting a bidirectional functional link between the adrenal and parathyroid glands. The aim of this study was to evaluate the impact of aldosterone excess on mineral metabolism and bone mass density. In 73 PA patients we evaluated anthropometric and biochemical parameters, renin-angiotensin-aldosterone system, calcium-phosphorus metabolism, and bone mineral density; control groups were 73 essential hypertension (EH) subjects and 40 healthy subjects. Compared to HS and EH, PA subjects had significantly lower serum calcium levels and higher urinary calcium excretion. Moreover, PA patients showed higher plasma PTH, lower serum 25(OH)-vitamin D levels, higher prevalence of vitamin D deficiency (65% versus 25% and 25%; P<0.001), and higher prevalence of osteopenia/osteoporosis (38.5 and 10.5%) than EH (28% and 4%) and NS (25% and 5%), respectively. This study supports the hypothesis that bone loss and fracture risk in PA patients are potentially the result of aldosterone mediated hypercalciuria and the consecutive secondary hyperparathyroidism.http://dx.doi.org/10.1155/2014/836529 |
| spellingShingle | Luigi Petramala Laura Zinnamosca Amina Settevendemmie Cristiano Marinelli Matteo Nardi Antonio Concistrè Francesco Corpaci Gianfranco Tonnarini Giorgio De Toma Claudio Letizia Bone and Mineral Metabolism in Patients with Primary Aldosteronism International Journal of Endocrinology |
| title | Bone and Mineral Metabolism in Patients with Primary Aldosteronism |
| title_full | Bone and Mineral Metabolism in Patients with Primary Aldosteronism |
| title_fullStr | Bone and Mineral Metabolism in Patients with Primary Aldosteronism |
| title_full_unstemmed | Bone and Mineral Metabolism in Patients with Primary Aldosteronism |
| title_short | Bone and Mineral Metabolism in Patients with Primary Aldosteronism |
| title_sort | bone and mineral metabolism in patients with primary aldosteronism |
| url | http://dx.doi.org/10.1155/2014/836529 |
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