ArticleMetabolism: clinical and experimental2017
Impaired calcium sensing distinguishes primary hyperparathyroidism (PHPT) patients with low bone mineral density.
Article in Metabolism: clinical and experimental, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 7 citations in OpenAlex.
- Precision stratified treatment of primary hyperparathyroidism based on multilevel emerging biomarkers.Frontiers in endocrinology · 2025Review
- The role of miR-139-5p in radioiodine-resistant thyroid cancer.Journal of endocrinological investigation · 2023Article
- Ex Vivo Intact Tissue Analysis Reveals Alternative Calcium-sensing Behaviors in Parathyroid Adenomas.The Journal of clinical endocrinology and metabolism · 2021Article
- Parathyroid adenoma combined with a rib tumor as the primary disease: A case report.World journal of clinical cases · 2020Article
- Transcriptional profiling reveals distinct classes of parathyroid tumors in PHPT.Endocrine-related cancer · 2018Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
contextA subset of PHPT patients exhibit a more severe disease phenotype characterized by bone loss, fractures, recurrent nephrolithiasis, and other dysfunctions, but the underlying reasons for this disparity in clinical presentation remain unknown.
objectiveWe sought to identify new mechanistic indices that could inform more personalized management of PHPT.
designPre-, peri-, and postoperative data and demographic, clinical, and pathological information from patients undergoing parathyroidectomy for PHPT were collected. Univariate and partial Spearman correlation was used to estimate the association of parathyroid tumor calcium sensing capacity with select variables. PATIENTS OR OTHER
participantsAn unselected series of 237 patients aged >18years and undergoing parathyroidectomy for PHPT were enrolled.
main outcome measuresCalcium sensing capacity, expressed as the concentration required for half-maximal biochemical response (EC50), was evaluated in parathyroid tumors from an unselected series of 74 patients and assessed for association with clinical parameters. The hypothesis was that greater disease severity would be associated with attenuated calcium sensitivity and biochemically autonomous parathyroid tumor behavior.
resultsParathyroid tumors segregated into two distinct groups of calcium responsiveness (EC50<3.0 and ≥3.0mM). The low EC50 group (n=27) demonstrated a mean calcium EC50 value of 2.49mM [95% confidence interval (CI): 2.43-2.54mM], consistent with reference normal activity. In contrast, the high EC50 group (n=47) displayed attenuated calcium sensitivity with a mean EC50 value of 3.48mM [95% CI: 3.41-3.55mM]. Retrospective analysis of the clinical registry data suggested that high calcium EC50 patients presented with a more significant preoperative bone mineral density (BMD) deficit with a t-score of -2.7, (95% CI: -3.4 to -1.9) versus 0.9, (95% CI: -2.1 to -0.4) in low EC50 patients (p<0.001). After adjusting for gender, age, BMI, 25 OH vitamin D level and preoperative iPTH, lowest t-score and calcium EC50 were inversely correlated, with a partial Spearman correlation coefficient of -0.35 (p=0.02).
conclusionsImpaired calcium sensing in parathyroid tumors is selectively observed in a subset of patients with more severe bone mineral density deficit. Assessment of parathyroid tumor biochemical behavior may be a useful predictor of disease severity as measured by bone mineral density in patients with PHPT.
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