Coronary Artery Calcification in Patients with Primary Hyperparathyroidism in Comparison with Control Subjects from the Multi-Ethnic Study of Atherosclerosis |
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| Institution: | 1. From the Division of Endocrinology, Diabetes, and Nutrition, Baltimore, Maryland.;2. From the Division of Cardiology, University of Maryland School of Medicine, Baltimore, Maryland.;3. From the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland.;1. Department of Biochemistry, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA;2. Center for Diabetes Research, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA;3. Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA;4. Center for Public Health Genomics, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA;5. Department of Biostatistical Sciences, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA;6. Department of Pathology, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA;7. Division of Public Health Sciences, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA;8. Department of Internal Medicine-Section on Nephrology, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA;9. Department of Radiology, Vanderbilt University School of Medicine, 2525 West End Ave, Suite 300-B, Nashville, TN 37203, USA;10. Department of Biostatistics, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35294, USA;11. Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35294, USA;12. Department of Medicine, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL, 35294, USA;2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;3. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland;4. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, St. Paul, Minnesota;6. Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland;5. Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland |
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| Abstract: | ObjectiveTo determine whether coronary artery calcification (CAC) is increased in patients with primary hyperparathyroidism (pHPT) because of the presence of hypercalcemia, which has been shown in vitro to promote vascular calcification.MethodsElectron beam computed tomography of the coronary arteries was performed on 20 patients with pHPT referred to our endocrinology clinic for evaluation of hypercalcemia. All patients were nonsmokers, with normal renal function, no history of diabetes, and no history of coronary artery disease. CAC in the patients with pHPT was compared with that in population-based control subjects from the Multi-Ethnic Study of Atherosclerosis (MESA). Two methods of analysis were used: (1) calculation of the odds ratio of CAC and (2) a nested case-control (1:4) study.ResultsOne patient with pHPT had a history of nephrolithiasis; the other 19 patients were asymptomatic. The mean age (± SD) of the patients with pHPT was 57.3 ± 9.1 years, the mean serum calcium concentration was 2.68 ± 0.18 mmol/L, and the mean intact parathyroid hormone level was 119 ± 76.5 pg/mL. Of the 20 patients, 14 had CAC scores of zero. The odds ratio for measurable CAC in the presence of pHPT in comparison with that in the MESA control subjects was 0.17, which was not significant. In the matched analysis, the CAC scores for the patients with pHPT did not differ significantly from those for the MESA control subjects (P = 0.25 with use of the Wilcoxon test).ConclusionWe found no evidence for a difference in CAC in patients with pHPT in comparison with the population-based control subjects in this small pilot study. (Endocr Pract. 2008;14:155-161) |
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