Serum Parathyroid Hormone in Relation to All-Cause and Cardiovascular Mortality: The Hoorn Study
Context: Higher PTH concentrations have been associated with fatal cardiovascular diseases (CVDs), but data in the general population are scarce. Objective: We investigated whether higher PTH concentrations are prospectively associated with all-cause and CVD mortality. Design, Setting, Participants:...
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Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2013-04, Vol.98 (4), p.E638-E645 |
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Sprache: | eng |
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Zusammenfassung: | Context:
Higher PTH concentrations have been associated with fatal cardiovascular diseases (CVDs), but data in the general population are scarce.
Objective:
We investigated whether higher PTH concentrations are prospectively associated with all-cause and CVD mortality.
Design, Setting, Participants:
This study used data from the Hoorn Study, a prospective population-based cohort with baseline measurements between 2000 and 2001. We included 633 participants, mean age 70.1 ± 6.6 years, 51% female. Serum intact PTH was measured using a 2-site immunoassay.
Main Outcome Measures:
Outcomes were all-cause and CVD mortality based on clinical files and coded according to the International Classification of Diseases, ninth revision. We used Kaplan-Meier plots to estimate survival curves and Cox regression to estimate hazard ratios (HRs) using season-specific PTH quartiles.
Results:
During a median follow-up of 7.8 years, 112 participants died, of which 26 deaths (23%) were cardiovascular. Survival curves by PTH quartiles differed for all-cause mortality (log-rank P = .054) and CVD mortality (log-rank P = .022). In a multivariate model, the highest PTH quartile was associated with all-cause mortality; HR = 1.98 (1.08, 3.64). Kidney function slightly attenuated the PTH risk association, but risk persisted; HR = 1.93 (1.04, 3.58). The results for CVD mortality showed a similar pattern, although the association was significant only in a threshold model (quartile 4 vs quartile 1–3); HR = 2.56 (1.11, 5.94).
Conclusions:
Among a general older population, higher PTH concentrations were associated with higher all-cause mortality risk, mostly explained by fatal CVD events. We suggest to evaluate whether individuals with high PTH concentrations benefit from therapeutic approaches targeted to decrease PTH concentrations. |
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ISSN: | 0021-972X 1945-7197 |
DOI: | 10.1210/jc.2012-4007 |