Nonoxidized, Biologically Active Parathyroid Hormone Determines Mortality in Hemodialysis Patients
Background: It was shown that nonoxidized PTH (n-oxPTH) is bioactive, whereas the oxidation of PTH results in a loss of biological activity. Methods: In this study we analyzed the association of n-oxPTH on mortality in hemodialysis patients using a recently developed assay system. Results: Hemodialy...
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| Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2013-12, Vol.98 (12), p.4744-4751 |
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| container_title | The journal of clinical endocrinology and metabolism |
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| creator | Tepel, Martin Armbruster, Franz Paul Grön, Hans Jürgen Scholze, Alexandra Reichetzeder, Christoph Roth, Heinz Jürgen Hocher, Berthold |
| description | Background:
It was shown that nonoxidized PTH (n-oxPTH) is bioactive, whereas the oxidation of PTH results in a loss of biological activity.
Methods:
In this study we analyzed the association of n-oxPTH on mortality in hemodialysis patients using a recently developed assay system.
Results:
Hemodialysis patients (224 men, 116 women) had a median age of 66 years. One hundred seventy patients (50%) died during the follow-up period of 5 years. Median n-oxPTH levels were higher in survivors (7.2 ng/L) compared with deceased patients (5.0 ng/L; P = .002). Survival analysis showed an increased survival in the highest n-oxPTH tertile compared with the lowest n-oxPTH tertile (χ2, 14.3; P = .0008). Median survival was 1702 days in the highest n-oxPTH tertile, whereas it was only 453 days in the lowest n-oxPTH tertile. Multivariable-adjusted Cox regression showed that higher age increased odds for death, whereas higher n-oxPTH reduced the odds for death. Another model analyzing a subgroup of patients with intact PTH (iPTH) concentrations at baseline above the upper normal range of the iPTH assay (70 ng/L) revealed that mortality in this subgroup was associated with oxidized PTH but not with n-oxPTH levels.
Conclusions:
The predictive power of n-oxPTH and iPTH on the mortality of hemodialysis patients differs substantially. Measurements of n-oxPTH may reflect the hormone status more precisely. The iPTH-associated mortality is most likely describing oxidative stress-related mortality. |
| doi_str_mv | 10.1210/jc.2013-2139 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1465863960</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1465863960</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5146-acfbca353db8e72d678bfe96c674c75c8b75837e4de9b0c6f73d6995ef0c6c6e3</originalsourceid><addsrcrecordid>eNptkMtv1DAQhy0EokvhxhnlgsShKX4kdnws5bFI5XEAiZvl2BPWi2MvdkIJfz2OdoELlixrpG_mN_4QekzwJaEEP9-bS4oJqylh8g7aENm0tSBS3EUbjCmppaBfztCDnPcYk6Zp2X10RhtSECI3qH8fQ_zprPsF9qJ64aKPX53R3i_VlZncD6g-6qSn3ZKis9U2pjEGqF7CBGl0AXL1LqZJezctlQvVFsZonfZLdrk0Tg7ClB-ie4P2GR6d3nP0-fWrT9fb-ubDm7fXVze1aUnDa22G3mjWMtt3IKjlousHkNxw0RjRmq4XbccENBZkjw0fBLNcyhaGUhgO7Bw9O849pPh9hjyp0WUD3usAcc6qhLQdZ5Ljgl4cUZNizgkGdUhu1GlRBKvVqtobtVpVq9WCPzlNnvsR7F_4j8YCPD0BOhd5Q9LBuPyP6zCjnK65zZG7jb4YzN_8fAtJ7UD7aadwOU35dr0mE1qqulzKSxs7tkGw0aTi_ZAgZ7WPcwpF6f-3_g3Rf6H8</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1465863960</pqid></control><display><type>article</type><title>Nonoxidized, Biologically Active Parathyroid Hormone Determines Mortality in Hemodialysis Patients</title><source>Journals@Ovid Ovid Autoload</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Tepel, Martin ; Armbruster, Franz Paul ; Grön, Hans Jürgen ; Scholze, Alexandra ; Reichetzeder, Christoph ; Roth, Heinz Jürgen ; Hocher, Berthold</creator><creatorcontrib>Tepel, Martin ; Armbruster, Franz Paul ; Grön, Hans Jürgen ; Scholze, Alexandra ; Reichetzeder, Christoph ; Roth, Heinz Jürgen ; Hocher, Berthold</creatorcontrib><description>Background:
It was shown that nonoxidized PTH (n-oxPTH) is bioactive, whereas the oxidation of PTH results in a loss of biological activity.
Methods:
In this study we analyzed the association of n-oxPTH on mortality in hemodialysis patients using a recently developed assay system.
Results:
Hemodialysis patients (224 men, 116 women) had a median age of 66 years. One hundred seventy patients (50%) died during the follow-up period of 5 years. Median n-oxPTH levels were higher in survivors (7.2 ng/L) compared with deceased patients (5.0 ng/L; P = .002). Survival analysis showed an increased survival in the highest n-oxPTH tertile compared with the lowest n-oxPTH tertile (χ2, 14.3; P = .0008). Median survival was 1702 days in the highest n-oxPTH tertile, whereas it was only 453 days in the lowest n-oxPTH tertile. Multivariable-adjusted Cox regression showed that higher age increased odds for death, whereas higher n-oxPTH reduced the odds for death. Another model analyzing a subgroup of patients with intact PTH (iPTH) concentrations at baseline above the upper normal range of the iPTH assay (70 ng/L) revealed that mortality in this subgroup was associated with oxidized PTH but not with n-oxPTH levels.
Conclusions:
The predictive power of n-oxPTH and iPTH on the mortality of hemodialysis patients differs substantially. Measurements of n-oxPTH may reflect the hormone status more precisely. The iPTH-associated mortality is most likely describing oxidative stress-related mortality.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2013-2139</identifier><identifier>PMID: 24171919</identifier><identifier>CODEN: JCEMAZ</identifier><language>eng</language><publisher>Bethesda, MD: Endocrine Society</publisher><subject>Aged ; Biological and medical sciences ; Biomarkers - blood ; Biomarkers - chemistry ; Biomarkers - metabolism ; Cohort Studies ; Denmark - epidemiology ; Endocrinopathies ; Feeding. Feeding behavior ; Female ; Follow-Up Studies ; Fundamental and applied biological sciences. Psychology ; Germany - epidemiology ; Humans ; Kidney Failure, Chronic - diagnosis ; Kidney Failure, Chronic - metabolism ; Kidney Failure, Chronic - mortality ; Kidney Failure, Chronic - therapy ; Male ; Medical sciences ; Middle Aged ; Mortality ; Oxidation-Reduction ; Oxidative Stress ; Parathyroid Hormone - blood ; Parathyroid Hormone - chemistry ; Parathyroid Hormone - metabolism ; Prognosis ; Prospective Studies ; Protein Stability ; Renal Dialysis - adverse effects ; Survival Analysis ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology</subject><ispartof>The journal of clinical endocrinology and metabolism, 2013-12, Vol.98 (12), p.4744-4751</ispartof><rights>Copyright © 2013 by The Endocrine Society</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5146-acfbca353db8e72d678bfe96c674c75c8b75837e4de9b0c6f73d6995ef0c6c6e3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28032620$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24171919$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tepel, Martin</creatorcontrib><creatorcontrib>Armbruster, Franz Paul</creatorcontrib><creatorcontrib>Grön, Hans Jürgen</creatorcontrib><creatorcontrib>Scholze, Alexandra</creatorcontrib><creatorcontrib>Reichetzeder, Christoph</creatorcontrib><creatorcontrib>Roth, Heinz Jürgen</creatorcontrib><creatorcontrib>Hocher, Berthold</creatorcontrib><title>Nonoxidized, Biologically Active Parathyroid Hormone Determines Mortality in Hemodialysis Patients</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Background:
It was shown that nonoxidized PTH (n-oxPTH) is bioactive, whereas the oxidation of PTH results in a loss of biological activity.
Methods:
In this study we analyzed the association of n-oxPTH on mortality in hemodialysis patients using a recently developed assay system.
Results:
Hemodialysis patients (224 men, 116 women) had a median age of 66 years. One hundred seventy patients (50%) died during the follow-up period of 5 years. Median n-oxPTH levels were higher in survivors (7.2 ng/L) compared with deceased patients (5.0 ng/L; P = .002). Survival analysis showed an increased survival in the highest n-oxPTH tertile compared with the lowest n-oxPTH tertile (χ2, 14.3; P = .0008). Median survival was 1702 days in the highest n-oxPTH tertile, whereas it was only 453 days in the lowest n-oxPTH tertile. Multivariable-adjusted Cox regression showed that higher age increased odds for death, whereas higher n-oxPTH reduced the odds for death. Another model analyzing a subgroup of patients with intact PTH (iPTH) concentrations at baseline above the upper normal range of the iPTH assay (70 ng/L) revealed that mortality in this subgroup was associated with oxidized PTH but not with n-oxPTH levels.
Conclusions:
The predictive power of n-oxPTH and iPTH on the mortality of hemodialysis patients differs substantially. Measurements of n-oxPTH may reflect the hormone status more precisely. The iPTH-associated mortality is most likely describing oxidative stress-related mortality.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Biomarkers - chemistry</subject><subject>Biomarkers - metabolism</subject><subject>Cohort Studies</subject><subject>Denmark - epidemiology</subject><subject>Endocrinopathies</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Germany - epidemiology</subject><subject>Humans</subject><subject>Kidney Failure, Chronic - diagnosis</subject><subject>Kidney Failure, Chronic - metabolism</subject><subject>Kidney Failure, Chronic - mortality</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Oxidation-Reduction</subject><subject>Oxidative Stress</subject><subject>Parathyroid Hormone - blood</subject><subject>Parathyroid Hormone - chemistry</subject><subject>Parathyroid Hormone - metabolism</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Protein Stability</subject><subject>Renal Dialysis - adverse effects</subject><subject>Survival Analysis</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkMtv1DAQhy0EokvhxhnlgsShKX4kdnws5bFI5XEAiZvl2BPWi2MvdkIJfz2OdoELlixrpG_mN_4QekzwJaEEP9-bS4oJqylh8g7aENm0tSBS3EUbjCmppaBfztCDnPcYk6Zp2X10RhtSECI3qH8fQ_zprPsF9qJ64aKPX53R3i_VlZncD6g-6qSn3ZKis9U2pjEGqF7CBGl0AXL1LqZJezctlQvVFsZonfZLdrk0Tg7ClB-ie4P2GR6d3nP0-fWrT9fb-ubDm7fXVze1aUnDa22G3mjWMtt3IKjlousHkNxw0RjRmq4XbccENBZkjw0fBLNcyhaGUhgO7Bw9O849pPh9hjyp0WUD3usAcc6qhLQdZ5Ljgl4cUZNizgkGdUhu1GlRBKvVqtobtVpVq9WCPzlNnvsR7F_4j8YCPD0BOhd5Q9LBuPyP6zCjnK65zZG7jb4YzN_8fAtJ7UD7aadwOU35dr0mE1qqulzKSxs7tkGw0aTi_ZAgZ7WPcwpF6f-3_g3Rf6H8</recordid><startdate>201312</startdate><enddate>201312</enddate><creator>Tepel, Martin</creator><creator>Armbruster, Franz Paul</creator><creator>Grön, Hans Jürgen</creator><creator>Scholze, Alexandra</creator><creator>Reichetzeder, Christoph</creator><creator>Roth, Heinz Jürgen</creator><creator>Hocher, Berthold</creator><general>Endocrine Society</general><general>Copyright by The Endocrine Society</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201312</creationdate><title>Nonoxidized, Biologically Active Parathyroid Hormone Determines Mortality in Hemodialysis Patients</title><author>Tepel, Martin ; Armbruster, Franz Paul ; Grön, Hans Jürgen ; Scholze, Alexandra ; Reichetzeder, Christoph ; Roth, Heinz Jürgen ; Hocher, Berthold</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5146-acfbca353db8e72d678bfe96c674c75c8b75837e4de9b0c6f73d6995ef0c6c6e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Biomarkers - chemistry</topic><topic>Biomarkers - metabolism</topic><topic>Cohort Studies</topic><topic>Denmark - epidemiology</topic><topic>Endocrinopathies</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Germany - epidemiology</topic><topic>Humans</topic><topic>Kidney Failure, Chronic - diagnosis</topic><topic>Kidney Failure, Chronic - metabolism</topic><topic>Kidney Failure, Chronic - mortality</topic><topic>Kidney Failure, Chronic - therapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Oxidation-Reduction</topic><topic>Oxidative Stress</topic><topic>Parathyroid Hormone - blood</topic><topic>Parathyroid Hormone - chemistry</topic><topic>Parathyroid Hormone - metabolism</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Protein Stability</topic><topic>Renal Dialysis - adverse effects</topic><topic>Survival Analysis</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tepel, Martin</creatorcontrib><creatorcontrib>Armbruster, Franz Paul</creatorcontrib><creatorcontrib>Grön, Hans Jürgen</creatorcontrib><creatorcontrib>Scholze, Alexandra</creatorcontrib><creatorcontrib>Reichetzeder, Christoph</creatorcontrib><creatorcontrib>Roth, Heinz Jürgen</creatorcontrib><creatorcontrib>Hocher, Berthold</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tepel, Martin</au><au>Armbruster, Franz Paul</au><au>Grön, Hans Jürgen</au><au>Scholze, Alexandra</au><au>Reichetzeder, Christoph</au><au>Roth, Heinz Jürgen</au><au>Hocher, Berthold</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nonoxidized, Biologically Active Parathyroid Hormone Determines Mortality in Hemodialysis Patients</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2013-12</date><risdate>2013</risdate><volume>98</volume><issue>12</issue><spage>4744</spage><epage>4751</epage><pages>4744-4751</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><coden>JCEMAZ</coden><abstract>Background:
It was shown that nonoxidized PTH (n-oxPTH) is bioactive, whereas the oxidation of PTH results in a loss of biological activity.
Methods:
In this study we analyzed the association of n-oxPTH on mortality in hemodialysis patients using a recently developed assay system.
Results:
Hemodialysis patients (224 men, 116 women) had a median age of 66 years. One hundred seventy patients (50%) died during the follow-up period of 5 years. Median n-oxPTH levels were higher in survivors (7.2 ng/L) compared with deceased patients (5.0 ng/L; P = .002). Survival analysis showed an increased survival in the highest n-oxPTH tertile compared with the lowest n-oxPTH tertile (χ2, 14.3; P = .0008). Median survival was 1702 days in the highest n-oxPTH tertile, whereas it was only 453 days in the lowest n-oxPTH tertile. Multivariable-adjusted Cox regression showed that higher age increased odds for death, whereas higher n-oxPTH reduced the odds for death. Another model analyzing a subgroup of patients with intact PTH (iPTH) concentrations at baseline above the upper normal range of the iPTH assay (70 ng/L) revealed that mortality in this subgroup was associated with oxidized PTH but not with n-oxPTH levels.
Conclusions:
The predictive power of n-oxPTH and iPTH on the mortality of hemodialysis patients differs substantially. Measurements of n-oxPTH may reflect the hormone status more precisely. The iPTH-associated mortality is most likely describing oxidative stress-related mortality.</abstract><cop>Bethesda, MD</cop><pub>Endocrine Society</pub><pmid>24171919</pmid><doi>10.1210/jc.2013-2139</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The journal of clinical endocrinology and metabolism, 2013-12, Vol.98 (12), p.4744-4751 |
| issn | 0021-972X 1945-7197 |
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| source | Journals@Ovid Ovid Autoload; Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Aged Biological and medical sciences Biomarkers - blood Biomarkers - chemistry Biomarkers - metabolism Cohort Studies Denmark - epidemiology Endocrinopathies Feeding. Feeding behavior Female Follow-Up Studies Fundamental and applied biological sciences. Psychology Germany - epidemiology Humans Kidney Failure, Chronic - diagnosis Kidney Failure, Chronic - metabolism Kidney Failure, Chronic - mortality Kidney Failure, Chronic - therapy Male Medical sciences Middle Aged Mortality Oxidation-Reduction Oxidative Stress Parathyroid Hormone - blood Parathyroid Hormone - chemistry Parathyroid Hormone - metabolism Prognosis Prospective Studies Protein Stability Renal Dialysis - adverse effects Survival Analysis Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology |
| title | Nonoxidized, Biologically Active Parathyroid Hormone Determines Mortality in Hemodialysis Patients |
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