Primary and Secondary Hyperparathyroidism in Patients with Primary Aldosteronism – Findings From the German Conn’s Registry
Open accessAbstract
Context Recent studies support a bidirectional interaction between aldosterone and parathyroid hormone (PTH), possibly increasing the individual cardiovascular risk. Primary aldosteronism (PA) and primary hyperparathyroidism can occur simultaneously. Objective Our aim was to investigate the prevalence of hyperparathyroidism in PA. Patients We performed a case finding of primary hyperparathyroidism in a retrospective series of 503 patients with PA (cohort 1). We analysed primary and secondary hyperparathyroidism in 141 prospective PA patients who underwent PTH, serum calcium and phosphate measurements at time of diagnosis of PA (cohort 2). Results The prevalence for primary hyperparathyroidism was 1.2% in cohort 1, and 2.1% in cohort 2. Secondary hyperparathyroidism was found in 54.6% of the patients. Patients with secondary hyperparathyroidism had significantly higher aldosterone and lower potassium levels and took more antihypertensive medications compared to those with normal PTH levels. In multivariate analysis, aldosterone and 25-hydroxyvitamin D levels were significantly correlated with serum PTH levels. There was a nonsignificant trend to a higher cardiovascular morbidity in patients with secondary hyperparathyroidism. Patients with aldosterone producing adenoma had significantly higher PTH levels compared to patients with bilateral adrenal hyperplasia. After treatment, there was a significant decrease of PTH levels in both groups. Conclusion Patients with PA frequently have primary or secondary hyperparathyroidism, which is alleviated by correction of PA by surgical or medical means. Patients affected by secondary hyperparathyroidism seem to have a more severe phenotype of PA and have a trend towards more cardiovascular co-morbidities.
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- Authors
- Asbach, E., Bekeran, M., König, A., Lang, K., Hanslik, G., Treitl, M., Ladurner, R., Bidlingmaier, M., Beuschlein, F., Quinkler, M., & Reincke, M.
- Affiliations
- LMU Klinikum (DE)
- Medizinische Hochschule Hannover (DE)
- University of Würzburg (DE)
- Charité – Universitätsmedizin Berlin (DE)
- Ludwig-Maximilians-Universität München (DE)
- Endokrinologie in Charlottenburg, Berlin, Germany
- Endocrinology, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München, München, Germany
- ORCID
- Venue
- Experimental and Clinical Endocrinology & Diabetes
- Publisher
- Georg Thieme Verlag KG
- Published
- 2019-11-07
- Volume
- 128
- Issue
- 04
- Pages
- 246-254
- ISSN
- 0947-7349 (ISSN-L)
- 1439-3646
- OpenAlex
- W2988510016
- Cited by
- 25
- References
- 44
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 2 · 2023: 2 · 2022: 4 · 2021: 4 · 2020: 5
- FWCI
- 2.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Experimental and Clinical Endocrinology & Diabetes (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
- Funders
- German Conns Registry-Else-Kröner Hyperaldosteronism Registry (2013_A182, 2015_A171)
- European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (694913)
- Deutsche Forschungsgemeinschaft (DFG) (within the CRC/Transregio 205/1 “The Adrenal: Central Relay in Health and Disease” to FB and MR
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Potassium and Related Disorders
- Keywords
- primary aldosteronism, secondary hyperparathyroidism, primary hyperparathyroidism, parathyroid hormone, aldosterone, 25-hydroxyvitamin D, aldosterone-producing adenoma, bilateral adrenal hyperplasia, hypokalemia, antihypertensive drugs, cardiovascular morbidity
- MeSH terms
- Adult, Cardiovascular Diseases, Female, Germany, Humans, Hydroxycholecalciferols, Hyperaldosteronism, Hyperparathyroidism, Secondary, Male, Middle Aged, Parathyroid Hormone, Phenotype, Registries, Retrospective Studies, Severity of Illness Index, Comorbidity
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