High levels of intact parathyroid hormone (iPTH) may be a risk factor for death, cardiovascular events, and vascular calcification in patients with diabetic kidney disease (DKD), investigators concluded.
In a retrospective cohort study of 508 patients with DKD, iPTH significantly correlated with an adjusted 2.8-fold increased risk for all-cause mortality or cardiovascular events, Ling Qin, MD, of Tongji University School of Medicine, Shanghai, China, and colleagues reported in Diabetes Research & Clinical Practice. Cardiovascular events included acute myocardial infarction, coronary or cerebrovascular events requiring surgery or interventional treatment, and stroke.
Patients with vs without ectopic calcification had a higher prevalence of all-cause mortality or cardiovascular events: 26.8%vs 12.3%, the investigators reported. Ectopic calcification was significantly associated with a 3.2-fold increased risk for all-cause mortality or cardiovascular events.
In multivariate logistic regression analysis, iPTH significantly correlated with a significant 2.0-fold increased risk for ectopic calcification. Patients with an iPTH level of 31.7 pg/mL or higher had significantly increased prevalence of ectopic calcification overall, aortic artery calcifications, and valve calcifications, compared with patients with lower levels, the investigators reported. The high iPTH group also had shorter survival.
Longer diabetes duration and high triglyceride levels were significantly associated with ectopic calcification to a lesser extent compared with iPTH: 9% and 25%, respectively.
“We found that high iPTH level was a risk factor for all-cause death, cardiovascular events, and ectopic calcification in patients with DKD,” Dr Qin’s team concluded. How PTH affects the cardiovascular system is not well understood, they noted, so they encouraged further research, including large, multicenter, prospective trials.
Li M, Cheng J, Zhao J, et al. Relationship between intact parathyroid hormone and all-cause death, cardiovascular events, and ectopic calcification in patients with diabetic kidney disease: A retrospective study. Diabetes Res Clin Pract. 177:108926. doi:10.1016/j.diabres.2021.108926