Association between vitamin D, parathyroid hormone and inflammatory markers in urolithiasis patients

Abstract

Implication for health policy/practice/research/medical education:As urolithiasis patients are at a constant inflammatory insult caused by the calculi, the levels of inflammatory markers can be used to monitor the success of treatment. Vitamin D and anti-inflammatory agents may be used in the management of nephrolithiasis patients. Please cite this paper as: Introduction:Hypercalciuria plays an important role in the pathogenesis of renal calculi. The role of vitamin D, parathyroid hormone (PTH), inflammatory markers highly sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) in the development of renal calculi has not well defined. Objectives: To assess the serum levels of vitamin D, PTH, hs-CRP and IL-6, urinary and serum calcium and phosphorus levels in patients with renal calculi and to compare these parameters with healthy controls Patients and methods: It was a cross-sectional study. About 41 confirmed renal calculi patients and 41 age and sex matched controls were recruited. Patients with malignancies, hyperparathyroidism, chronic disease, and patients taking vitamin D supplementations were excluded. Serum levels of 25(OH) vitamin D, i-PTH, hs-CRP, IL-6, calcium and phosphorous, 24 hours urine levels of calcium and phosphorus were estimated Results: There was a statistical significant difference in the serum levels of 25(OH) vitamin D (12.26 vs 19.61 ng/mL), i-PTH (75.5 vs. 33.5 pg/mL), hsCRP (5117.05 vs. 1721.87 ng/mL), IL-6 (13.49 vs. 1.47 pg/mL) calcium (11.5 vs. 9.4 mg/dL) and urinary calcium (370.5 vs. 342 mg/d) and phosphorous levels (1172 vs. 1432 mg/d) between the cases and the control. There was negative correlation between the levels of i-PTH and vitamin D (r = -0.765) and positive correlation between i-PTH and hsCRP, IL-6, Serum calcium and urine calcium (r = 0.353, 0.340, 0.522, 0.501 respectively) Conclusion: There was vitamin D inadequacy and increased levels of PTH, IL-6 and C-reactive protein, calcium in patients with renal calculi when compared with healthy controls.

Study of Dental Caries and PTH Gene

“…However, more studies should be developed to clarify the function of PTH in ameloblasts and odontoblasts and its impact on dental caries susceptibility and progression. Although PTH serum levels have been investigated in a variety of conditions (14)(15)(16)(17), the relationship between PTH serum levels and dental caries is not clarified yet. While Gyll et al (25) did not observe differences in PTH serum levels between caries and caries-free children, on the other hand, Schroth et al (26) and Deane et al (27) showed an increase in PTH levels in children with Severe Early Childhood Caries, apart from observing a decrease of calcium and 1,25-dihydroxy vitamin D levels in these children.…”

“…The authors suggest that changes in PTH levels can unbalance the levels of inflammatory mediators and un-regulate the host's response to dental caries. In fact, by a process not fully understood, the serum levels of some pro-inflammatory proteins, like interleukin-6 (IL-6) and IL-1β, are greater in patients diagnosed with primary or secondary hyperparathyroidism, a condition characterized by hypersecretion of PTH (17,28,29). Interestingly, IL-6 and IL-1β were already previously associated with dental caries (30)(31)(32).…”

“…Single nucleotide polymorphisms (SNPs) are a type of sequence variation within genomes that may modify the function and the quantity of protein expression. In fact, previous studies demonstrated that SNPs in PTH gene were associated with modifications of PTH serum levels (14)(15)(16)(17). These modifications in PTH serum levels may both influence tooth formation and the remineralization and demineralization equilibrium of the tooth in occlusion (2,18).…”

Relationship of Neutrophil Lymphocyte Ratio (NLR) with Parathyroid Hormone (PTH) in Maintenance Hemodialysis Patients

“…In Hemodialysis there is chronic inflammation and PTH is also usually high unless treated. [23]. However there are also a few recent papers that have shown association of PTH with resolution of inflammation and healing in several contexts e.g.…”

Correlation of hematological inflammatory biomarkers in patients with urolithiasis: A prospective case control study

“…There are number of studies reporting the association between increased in ammatory markers and urolithiasis, however the pathophysiology of urolithiasis remains unclear [2][3][4]. In ammation plays a crucial role in the initial stage and the progression of urinary stones.…”