Interactions between adrenal-regulatory and calcium-regulatory hormones in human health
Open accessAbstract
PURPOSE OF REVIEW: To summarize the evidence characterizing the interactions between adrenal-regulating and calcium-regulating hormones, and the relevance of these interactions to human cardiovascular and skeletal health. RECENT FINDINGS: Human studies support the regulation of parathyroid hormone (PTH) by the renin-angiotensin-aldosterone system (RAAS): angiotensin II may stimulate PTH secretion via an acute and direct mechanism, whereas aldosterone may exert a chronic stimulation of PTH secretion. Studies in primary aldosteronism, congestive heart failure, and chronic kidney disease have identified associations between hyperaldosteronism, hyperparathyroidism, and bone loss, which appear to improve when inhibiting the RAAS. Conversely, elevated PTH and insufficient vitamin D status have been associated with adverse cardiovascular outcomes, which may be mediated by the RAAS. Studies of primary hyperparathyroidism implicate PTH-mediated stimulation of the RAAS, and recent evidence shows that the vitamin D-vitamin D receptor complex may negatively regulate renin expression and RAAS activity. Ongoing human interventional studies are evaluating the influence of RAAS inhibition on PTH and the influence of vitamin D receptor agonists on RAAS activity. SUMMARY: Although previously considered independent endocrine systems, emerging evidence supports a complex web of interactions between adrenal-regulating and calcium-regulating hormones, with implications for human cardiovascular and skeletal health.
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Yutzey, K. E., Demer, L. L., Body, S. C., Huggins, G. S., Towler, D. A., Giachelli, C. M., Bowman, M. A. H., Mortlock, D. P., Rogers, M. B., Sadeghi, M. M., et al. (2014) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.114.302523 · Cited by 374 · see citing works
The renin–angiotensin–aldosterone system and calcium-regulatory hormones
Vaidya, A., Brown, J. M., & Williams, J. S. (2015) · Journal of Human Hypertension · doi:10.1038/jhh.2014.125 · Cited by 93 · see citing works
Self-citationBrown, J., de Boer, I. H., Robinson-Cohen, C., Siscovick, D. S., Kestenbaum, B., Allison, M., & Vaidya, A. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2014-3949 · Cited by 71 · see citing works
Self-citationAcute catabolic bone metabolism response to exercise in young and older adults: A narrative review
Wherry, S. J., Swanson, C. M., & Kohrt, W. M. (2021) · Experimental Gerontology · doi:10.1016/j.exger.2021.111633 · Cited by 32 · see citing works
Hypertension, Antihypertensive Medications, and Risk of Incident Primary Hyperparathyroidism
Vaidya, A., Curhan, G. C., Paik, J. M., Kronenberg, H. M., & Taylor, E. N. (2015) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2015-1619 · Cited by 29 · see citing works
Self-citationInterrelated aldosterone and parathyroid hormone mutually modify cardiovascular mortality risk
Tomaschitz, A., Pilz, S., Rus-Machan, J., Meinitzer, A., Brandenburg, V. M., Scharnagl, H., Kapl, M., Grammer, T., Ritz, E., Horina, J. H., et al. (2015) · International Journal of Cardiology · doi:10.1016/j.ijcard.2015.03.062 · Cited by 27 · see citing works
Low serum 25-hydroxyvitamin D levels and secondary hyperparathyroidism in Fontan patients
Holler, F., Hannes, T., Germund, I., Emmel, M., Hoyer‐Kuhn, H., Khalil, M., Sreeram, N., & ten Cate, F. E. A. U. (2015) · Cardiology in the Young · doi:10.1017/s1047951115001444 · Cited by 27 · see citing works
Bayomy, O. F., Zaheer, S., Williams, J. S., Curhan, G. C., & Vaidya, A. (2020) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgaa123 · Cited by 27 · see citing works
Self-citationCardiovascular Risk in Patients with Primary Hyperparathyroidism
Tournis, S., Makris, K., Cavalier, E., & Trovas, G. (2020) · Current Pharmaceutical Design · doi:10.2174/1381612824999201105165642 · Cited by 28 · see citing works
Zhao, J., Yang, H., Chen, B., & Zhang, R. (2019) · International Immunopharmacology · doi:10.1016/j.intimp.2019.04.023 · Cited by 26 · see citing works
Parathyroid Gland Function in Primary Aldosteronism
Bekeran, M., Reincke, M., & Asbach, E. (2015) · Hormone and Metabolic Research · doi:10.1055/s-0035-1565224 · Cited by 22 · see citing works
Wang, A., Wang, Y., Liu, H., Hu, X., Li, J., Xu, H., Nie, Z., Zhang, L., & Lyu, Z. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.1027841 · Cited by 19 · see citing works
Adrenal disorders: Is there Any role for vitamin D?
Tirabassi, G., Salvio, G., Altieri, B., Ronchi, C. L., Casa, S. D., Pontecorvi, A., & Balercia, G. (2016) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-016-9391-y · Cited by 18 · see citing works
Postmenopausal osteoporosis is associated with elevated aldosterone/renin ratio
the Chongqing Primary Aldosteronism Study(CONPASS) Group, Shu, X., Mei, M., Ma, L., Wang, Z., Yang, S., Hu, J., Song, Y., He, W., Luo, T., et al. (2018) · Journal of Human Hypertension · doi:10.1038/s41371-018-0069-7 · Cited by 15 · see citing works
Wherry, S. J., Blatchford, P. J., Swanson, C. M., Wellington, T., Boxer, R. S., & Kohrt, W. M. (2021) · Bone · doi:10.1016/j.bone.2021.116108 · Cited by 15 · see citing works
Weiss, A. K. H., Albertini, E., Holzknecht, M., Cappuccio, E., Dorigatti, I., Krahbichler, A., Damisch, E., Gstach, H., & Jansen‐Dürr, P. (2020) · Mechanisms of Ageing and Development · doi:10.1016/j.mad.2020.111284 · Cited by 12 · see citing works
Vitamin D–Parathyroid Hormone–Fibroblast Growth Factor 23 Axis and Cardiac Remodeling
Deng, C., & Wu, Y. (2024) · American Journal of Cardiovascular Drugs · doi:10.1007/s40256-024-00688-8 · Cited by 11 · see citing works
Vitamin D and adrenal gland: Myth or reality? A systematic review
Refaie, A. F. A., Baldassini, L., Vita, M. D., Gonnelli, S., & Caffarelli, C. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.1001065 · Cited by 11 · see citing works
PTH Is a Promising Auxiliary Index for the Clinical Diagnosis of Aldosterone-Producing Adenoma
Zhang, L., Gu, W., Li, Y., Wang, Y., Wang, W., Wang, A., Shen, L., Zang, L., Yang, G., Lü, Z., et al. (2015) · American Journal of Hypertension · doi:10.1093/ajh/hpv146 · Cited by 10 · see citing works
Solesio, M. E., Mitaishvili, E., & Lymperopoulos, A. (2019) · Pharmacology Research & Perspectives · doi:10.1002/prp2.497 · Cited by 10 · see citing works
The Relationship Between Renal Stones and Primary Aldosteronism
Chang, C.-K., Chang, C., Wu, V., Geng, J., & Lee, H. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.828839 · Cited by 9 · see citing works
Vitamin D serum levels in women using contraception containing drospirenone – a preliminary study
Ciebiera, M., Włodarczyk, M., Słabuszewska-Jóźwiak, A., Ciebiera, M., Nowicka, G., & Jakiel, G. (2017) · Archives of Medical Science · doi:10.5114/aoms.2017.70887 · Cited by 8 · see citing works
The Bone-Cardiovascular Axis: Mechanisms and Clinical Relevance
Verheyen, N., Grübler, M. R., Catena, C., Fahrleitner‐Pammer, A., & van Ballegooijen, A. J. (2018) · International Journal of Endocrinology · doi:10.1155/2018/9689106 · Cited by 8 · see citing works
Nana, M., Morgan, H., Shrikrishnapalasuriyar, N., & Kalhan, A. (2019) · Journal of Endocrinology and Metabolism · doi:10.14740/jem573 · Cited by 7 · see citing works
Saline suppression testing-induced hypocalcemia and implications for clinical interpretations
Parksook, W. W., Brown, J. M., Milks, J., Tsai, L. C., Chan, J., Moore, A., Niebuhr, Y., Honzel, B., Newman, A. J., & Vaidya, A. (2024) · European Journal of Endocrinology · doi:10.1093/ejendo/lvae099 · Cited by 6 · see citing works
Self-citationZhang, W., Wang, Y., Wei, Z. C., Chang, G., Luo, Q., Abudusailamu, N., Nurula, M., Tao, S., Li, H., & Chen, Y. (2019) · Springer eBooks · doi:10.1007/978-981-15-0591-1_9 · Cited by 5 · see citing works
Hyperparathyroidism in patients with overt and mild primary aldosteronism
Gravvanis, C., Papanastasiou, L., Glycofridi, S., Voulgaris, N., Tyfoxylou, E., Kounadi, T., Piaditis, G. P., & Markou, Α. (2021) · HORMONES · doi:10.1007/s42000-021-00319-w · Cited by 5 · see citing works
Dobreva, E. A., Евгеньевна, Б. Е., Константиновна, Е. А., Rebrova, O. Y., Nikankina, L. V., Malysheva, N. M., & Mokrysheva, N. G. (2020) · Arterial’naya Gipertenziya (Arterial Hypertension) · doi:10.18705/1607-419x-2019-25-6-630-638 · Cited by 5 · see citing works
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“Недавно описана новая «эндокринная ось», включающая двунаправленную связь между ПТГ как основным регулятором фосфорнокальциевого обмена и компонентами РААС [10, 11].”
Galasko, G. T. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-801238-3.05067-4 · Cited by 3 · see citing works
‘Hyperaldosteronaemic or normocalcaemic’ hyperparathyroidism?
Lee, P. C., & Greenfield, J. R. (2015) · Clinical Endocrinology · doi:10.1111/cen.12771 · Cited by 3 · see citing works
Corticosteroid rhythms in hypoparathyroid patients
Astor, M. C., Løvås, K., Methlie, P., Šimůnková, K., Aßmus, J., & Husebye, E. S. (2024) · European Journal of Endocrinology · doi:10.1093/ejendo/lvae102 · Cited by 2 · see citing works
Tang, W., Chai, Y., Jia, H., Wang, B., Liu, T., Wang, H., & Dai, C. (2022) · BMC Endocrine Disorders · doi:10.1186/s12902-022-00955-2 · Cited by 2 · see citing works
Bartter Syndrome Presenting as Arginine-Vasopressin Resistance: A Report of 2 Cases
Sousa, M., Medeiros, R., Rodrigues, A. L., & Pereira, B. D. (2024) · American Journal of Case Reports · doi:10.12659/ajcr.942872 · Cited by 1 · see citing works
Chronic urine acidification by fludrocortisone to treat infectious kidney stones
Lionet, A., Roger, C., Biardeau, X., Daudon, M., & Letavernier, E. (2021) · Comptes Rendus Chimie · doi:10.5802/crchim.126 · Cited by 1 · see citing works
Parksook, W. W., Heydarpour, M., Brown, J. M., Turchin, A., Mannstadt, M., & Vaidya, A. (2022) · Clinical Endocrinology · doi:10.1111/cen.14840 · Cited by 1 · see citing works
Self-citation韩, 江. (2023) · Advances in Clinical Medicine · doi:10.12677/acm.2023.1381922
Jones, A., Tan, J., Dao, T., Tan, J., Wong, P., Sztal‐Mazer, S., Milat, F., Yang, J., & Gilfillan, C. P. (2025) · Endocrine · doi:10.1007/s12020-025-04323-7
Zhang, M., Wang, Q., Pan, C., Li, R., Liu, Y., Jin, Y., & Li, Z. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1741253
- Authors
- Brown, J. M., & Vaidya, A.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Vaidya, Anand
- Venue
- Current Opinion in Endocrinology, Diabetes & Obesity
- Published
- 2014-06
- Volume
- 21
- Issue
- 3
- Pages
- 193-201
- ISSN
- 1752-296X (ISSN-L)
- PMC
- PMC4123208
- OpenAlex
- W2128507637
- Cited by
- 39
- References
- 91
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2023: 1 · 2022: 5 · 2021: 4 · 2020: 5 · 2019: 4 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 8 · 2014: 2
- FWCI
- 0.58
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Opinion in Endocrinology Diabetes and Obesity (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (L30 HL104553, K23HL111771)
- Topics
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Keywords
- parathyroid hormone, renin-angiotensin-aldosterone system, angiotensin II, aldosterone, hyperaldosteronism, primary hyperparathyroidism, vitamin D, vitamin D receptor, primary aldosteronism, congestive heart failure, chronic kidney disease, bone loss, cardiovascular outcomes, skeletal health
- MeSH terms
- Aldosterone, Mineralocorticoid Receptor Antagonists, Cardiovascular Diseases, Female, Humans, Hyperaldosteronism, Male, Osteoporosis, Parathyroid Hormone, Renin-Angiotensin System, Vitamin D, Hyperparathyroidism, Primary
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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