Endocrine Abstracts

Introduction: Elevated parathyroid hormone (PTH) levels are associated with increased cardiovascular diseases (CVD) in the patients with impaired kidney function. We aimed to investigate whether PTH levels are associated with CVD in persons without significant renal diseases.

Methods: This is a cross-sectional study and we included 1951 Korean subjects aged ≥30 years (men 46.6%), who underwent 64-slice multidetector-row cardiac computed tomography (MDCT) to evaluate subclinical coronary artery disease. Anthropometric and biochemical parameters including intact PTH and 25-hydroxyvitamin D levels were measured. The study subjects were classified into three groups by tertiles of PTH levels (≤26, 26–38, and >38 pg/ml). The coronary artery calcium score (CACS), coronary artery stenosis, and multivessel involvement (≥2 vessels among major three coronary arteries) were assessed with MDCT.

Results: The PTH levels showed positive association with CACS after adjusting for cardiovascular risk factors and 25-hydroxyvitamin D (R=0.293, P<0.001). The prevalence of significant coronary artery stenosis (≥50%) were 6.4, 13.6, and 20.0% (P<0.001) and mutlivessel involvement were 1.2, 3.7, and 4.3% (P<0.001) according to the PTH tertiles. After adjusting for same cardiovascular risk factors, odds ratios (ORs) of significant coronary artery stenosis were 2.12 (95% CI 1.41–3.19) in the second tertile and 2.96 (1.99–4.39) in the third tertile of PTH. Regarding the multivessel involvement, the adjusted ORs were 2.66 (1.14–6.19) in the second tertile and 2.61 (1.12–6.07) in the third tertile of PTH compared to the first tertile of PTH. These positive associations were observed both in vitamin D sufficient (25-hydroxyvitamin D ≥20 ng/ml) and deficient (25-hydroxyvitamin D <20 ng/ml) groups.

Conclusion: Our results indicate that PTH level is an independent risk factor for CVD in the subjects without renal impairment and it affects the severity of diseases regardless of vitamin D status.