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J Ren Nutr. 2011 May;21(3):219-25. doi: 10.1053/j.jrn.2010.04.006. Epub 2010 Jul 21.

Targeting parathyroid hormone level in diabetic patients with stage 3 to 5 chronic kidney disease: does metabolic syndrome matter?

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1
Department of Nephrology, Zonguldak Ataturk State Hospital, Zonguldak, Turkey. renginels@yahoo.com

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.

PMID:
20650655
DOI:
10.1053/j.jrn.2010.04.006
[Indexed for MEDLINE]
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