Targeting Parathyroid Hormone Level in Diabetic Patients With Stage 3 to 5 Chronic Kidney Disease: Does Metabolic Syndrome Matter?

Objectives: Patients with type 2 diabetes have lower intact parathyroid hormone (iPTH) levels when compared with non-diabetics. Patients with metabolic syndrome (MetSyn) have increased iPTH levels than normal subjects. We hypothesized that patients with type 2 diabetes and MetSyn might have higher iPTH levels as compared with those without MetSyn. Methods: The study had an observational design. A total of 84 patients with type 2 diabetes and stage 3 to stage 5 chronic kidney disease (CKD) were recruited (male/female, 40/44). Results: A total of 59 (70.2%) patients had MetSyn. Progress from stage 3 to stage 5 CKD lead to a significant increase in iPTH levels (P-trend = .018). Patients with diabetes and MetSyn had lower high-density lipoprotein cholesterol (P = .018) and higher waist circumference (P = .019), systolic blood pressure (P = .036), fasting plasma glucose (P = .005), HbA1c levels (P = .012), triglyceride (P < .0001), and iPTH (P = .009) as compared with patients without MetSyn. Serum iPTH was negatively correlated with estimated glomerular filtration rate, as measured by Modification of Diet in Renal Disease formula (r = -0.339, P = .002), serum calcium (r = -0.232, P = .037), glucose (r = -0.240, P = .03), and HbA1c (r = -0.301, P = .04) and was positively correlated with urinary albumin excretion rate (r = +0.225, P = .044). After adjusting for potential confounders, logPTH was higher in patients with MetSyn as compared with those without among type 2 diabetic patients with CKD (P = .039). Conclusions: MetSyn might influence iPTH levels in type 2 diabetic patients with stage 3 to 5 CKD. However, it is still debatable whether MetSyn should be taken into account in determining target iPTH levels in type 2 diabetic patients with CKD. (C) 2011 by the National Kidney Foundation, Inc. All rights reserved.

Yazar Elsurer, Rengin
Afsar, Baris
Guner, Ertugrul
Yildiz, Idris
Yayın Türü Article
Tek Biçim Adres https://hdl.handle.net/20.500.12628/3429
Tek Biçim Adres 10.1053/j.jrn.2010.04.006
Koleksiyonlar Araştırma Çıktıları | WoS | Scopus | TR-Dizin | PubMed | SOBİAD
PubMed İndeksli Yayınlar Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu
Dergi Adı JOURNAL OF RENAL NUTRITION
Dergi Cilt Bilgisi 21
Dergi Sayısı 3
Sayfalar 219 - 225
Yayın Yılı 2011
Eser Adı
[dc.title]
Targeting Parathyroid Hormone Level in Diabetic Patients With Stage 3 to 5 Chronic Kidney Disease: Does Metabolic Syndrome Matter?
Yazar
[dc.contributor.author]
Elsurer, Rengin
Yazar
[dc.contributor.author]
Afsar, Baris
Yazar
[dc.contributor.author]
Guner, Ertugrul
Yazar
[dc.contributor.author]
Yildiz, Idris
Yayın Yılı
[dc.date.issued]
2011
Yayıncı
[dc.publisher]
W B SAUNDERS CO-ELSEVIER INC
Yayın Türü
[dc.type]
article
Özet
[dc.description.abstract]
Objectives: Patients with type 2 diabetes have lower intact parathyroid hormone (iPTH) levels when compared with non-diabetics. Patients with metabolic syndrome (MetSyn) have increased iPTH levels than normal subjects. We hypothesized that patients with type 2 diabetes and MetSyn might have higher iPTH levels as compared with those without MetSyn. Methods: The study had an observational design. A total of 84 patients with type 2 diabetes and stage 3 to stage 5 chronic kidney disease (CKD) were recruited (male/female, 40/44). Results: A total of 59 (70.2%) patients had MetSyn. Progress from stage 3 to stage 5 CKD lead to a significant increase in iPTH levels (P-trend = .018). Patients with diabetes and MetSyn had lower high-density lipoprotein cholesterol (P = .018) and higher waist circumference (P = .019), systolic blood pressure (P = .036), fasting plasma glucose (P = .005), HbA1c levels (P = .012), triglyceride (P < .0001), and iPTH (P = .009) as compared with patients without MetSyn. Serum iPTH was negatively correlated with estimated glomerular filtration rate, as measured by Modification of Diet in Renal Disease formula (r = -0.339, P = .002), serum calcium (r = -0.232, P = .037), glucose (r = -0.240, P = .03), and HbA1c (r = -0.301, P = .04) and was positively correlated with urinary albumin excretion rate (r = +0.225, P = .044). After adjusting for potential confounders, logPTH was higher in patients with MetSyn as compared with those without among type 2 diabetic patients with CKD (P = .039). Conclusions: MetSyn might influence iPTH levels in type 2 diabetic patients with stage 3 to 5 CKD. However, it is still debatable whether MetSyn should be taken into account in determining target iPTH levels in type 2 diabetic patients with CKD. (C) 2011 by the National Kidney Foundation, Inc. All rights reserved.
Açıklama
[dc.description]
WOS: 000290030200004
Açıklama
[dc.description]
PubMed: 20650655
Kayıt Giriş Tarihi
[dc.date.accessioned]
2019-12-23
Açık Erişim Tarihi
[dc.date.available]
2019-12-23
Yayın Dili
[dc.language.iso]
eng
Haklar
[dc.rights]
info:eu-repo/semantics/closedAccess
ISSN
[dc.identifier.issn]
1051-2276
ISSN
[dc.identifier.issn]
1532-8503
İlk Sayfa Sayısı
[dc.identifier.startpage]
219
Son Sayfa Sayısı
[dc.identifier.endpage]
225
Dergi Adı
[dc.relation.journal]
JOURNAL OF RENAL NUTRITION
Dergi Sayısı
[dc.identifier.issue]
3
Dergi Cilt Bilgisi
[dc.identifier.volume]
21
Tek Biçim Adres
[dc.identifier.uri]
https://dx.doi.org/10.1053/j.jrn.2010.04.006
Tek Biçim Adres
[dc.identifier.uri]
https://hdl.handle.net/20.500.12628/3429
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patients MetSyn levels compared diabetes higher without diabetic Patients glucose correlated debatable National calcium Foundation Kidney formula Disease Modification rights reserved measured target positively determining whether should However filtration influence Conclusions logPTH confounders potential adjusting
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