Cardiovascular autonomic neuropathy as a cause of fatigue in chronic hypoparathyroidism

Tabacco, Gaia; Naciu, Anda Mihaela; Cesareo, Roberto; Maggi, Daria; Lelli, Diana; Santonati, Assunta; Bosco, Daniela; Tommaso, Alfonso Maria Di; Pozzilli, Paolo; Manfrini, Silvia; Palermo, Andrea

doi:10.1007/s12020-019-02101-w

Cited by 3 publications

(1 citation statement)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…SF-36 and FACIT are validated but are not diseasespecific questionnaires, which may not be sensitive enough for QOL evaluation of HypoPT subjects. (29)(30)(31)(32) It is very likely that the high amount of calcium that is necessary to maintain normocalcemia in these patients completely abolished the possible advantages given by Ca-Cit in other categories of patients who generally are prescribed lower doses of calcium. It is also possible that this short-term study was not conducted long enough to see a difference in the QOL parameters.…”

Section: Discussionmentioning

confidence: 99%

Calcium Citrate Versus Calcium Carbonate in the Management of Chronic Hypoparathyroidism: A Randomized, Double-Blind, Crossover Clinical Trial

Naciu

Tabacco

Bilezikian

et al. 2020

Journal of Bone and Mineral Research

Self Cite

View full text Add to dashboard Cite

In hypoparathyroidism (HypoPT), calcium supplementation is virtually always required, although the disease is likely to be associated with an increased risk of nephrolithiasis. The use of calcium citrate (Ca‐Cit) theoretically could have a positive impact on the nephrolithiasis risk because citrate salts are used to reduce this risk. Our objective was to evaluate the potential therapeutic advantage of Ca‐Cit in comparison with calcium carbonate (CaCO3) in HypoPT, on nephrolithiasis risk factors, as well as to their ability to maintain desirable serum calcium levels. We also evaluated these preparations on quality of life (QOL). This randomized, double‐blind, crossover trial recruited 24 adults with postsurgical chronic hypoparathyroidism at Campus Bio‐Medico University of Rome. Participants were randomized 1:1 to Ca‐Cit or CaCO3 for 1 month and then crossed over to the other treatment for another month. The primary outcomes were changes in albumin‐adjusted serum calcium and in ion activity product of calcium oxalate levels (AP[CaOx] index). Secondary efficacy outcomes included changes in SF‐36 survey score, fatigue score, constipation, and adverse events. No difference in terms of AP(CaOx) index was observed between the two groups. However, Ca‐Cit was associated with a significant reduction in the oxalate/creatinine ratio compared with CaCO3 (−2.46 mmol/mol [SD 11.93] versus 7.42 mmol/mol [SD 17.63], p = 0.029). Serum calcium and phosphorus concentration was not different between the two calcium preparations. Ca‐Cit was associated with less constipation (p = 0.047). No difference was found in QOL scores. Although Ca‐Cit did not modify the AP(CaOx) index when compared with CaCO3, it was associated with a reduction in urinary oxalate excretion that could have a potential beneficial effect on nephrolithiasis risk. These results are likely to have clinical implications in HypoPT, particularly those who do not tolerate CaCO3 and those affected by nephrolithiasis. A longer‐term experience is needed to confirm these findings. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).

show abstract

Section: Discussionmentioning

confidence: 99%

Calcium Citrate Versus Calcium Carbonate in the Management of Chronic Hypoparathyroidism: A Randomized, Double-Blind, Crossover Clinical Trial

Naciu

Tabacco

Bilezikian

et al. 2020

Journal of Bone and Mineral Research

Self Cite

View full text Add to dashboard Cite

show abstract

Conseguenze cliniche e complicanze a lungo termine dell’ipoparatiroidismo

Masi

2020

L'Endocrinologo

View full text Add to dashboard Cite

Autonomic and Immune Stress Response Networks in Patients Living With HIV

Mueller,

Mehta,

Campbell

et al. 2024

Preprint

View full text Add to dashboard Cite

Background and Objectives: Pre-clinical studies have demonstrated direct influences of the sympathetic and vagal/parasympathetic branches of the autonomic nervous system (ANS) on the immune system. The relevance of these pathways to the development of inflammatory disorders in humans remains unknown. We hypothesized that a comprehensive examination of the ANS-immune network in patients with HIV, would reveal that the type and severity of autonomic neuropathy (AN) would predict immune phenotypes with distinct clinical and demographic characteristics. Methods: This is a cross-sectional study of 79 adult people with a history of well-controlled HIV on stable combination antiretroviral treatment (CART) recruited from a primary care clinic network within the Mount Sinai Health System in New York City. All participants underwent a standardized battery of autonomic function tests summarized as the Composite Autonomic Severity Score (CASS) and vagal and adrenergic baroreflex sensitivity (BRS-V and BRS-A). Immune profiling included: 1) measurement of interleukin-6 (IL-6) as part of the Olink assay Target 96 Inflammation Panel, 2) non-negative matrix factorization (NMF) clustering analyses on Olink immune biomarkers, and 3) mass cytometry (CyTOF) on a subset of participants with and without autonomic neuropathy (N = 10). Results: Reduced activity of caudal vagal circuitry involved in the cholinergic anti-inflammatory pathway (CAP) predicted higher levels of IL-6 (Spearman's rho = -0.352, p=0.002). The comprehensive assessment of the ANS-immune network showed four immunotypes defined by NMF analyses. A pro-inflammatory immunotype defined by elevations in type 1 cytokines (IL-6, IL-17) and increased numbers of CD8+ T-cells was associated with autonomic neuropathy (AN). This association was driven by deficits in the cardiovascular sympathetic nervous system and remained strongly significant after controlling for the older age and greater burden of co-morbid illness among participants with this immunotype (aOR=4.7, p=0.017). Discussion: Our results provide novel support for the clinical relevance of the CAP in patients with chronic inflammatory AN. These data also provide insight regarding the role of the sympathetic nervous system and aging in the progression and development of co-morbidities in patients with chronic HIV and support future research aimed at developing therapies focused on modulation of the sympathetic and parasympathetic/vagal nervous system.

show abstract

Cardiovascular autonomic neuropathy as a cause of fatigue in chronic hypoparathyroidism

Cited by 3 publications

References 21 publications

Calcium Citrate Versus Calcium Carbonate in the Management of Chronic Hypoparathyroidism: A Randomized, Double-Blind, Crossover Clinical Trial

Calcium Citrate Versus Calcium Carbonate in the Management of Chronic Hypoparathyroidism: A Randomized, Double-Blind, Crossover Clinical Trial

Conseguenze cliniche e complicanze a lungo termine dell’ipoparatiroidismo

Autonomic and Immune Stress Response Networks in Patients Living With HIV

Contact Info

Product

Resources

About