Plasma metabolite biomarkers related to secondary hyperparathyroidism and parathyroid hormone

Abstract

Background Hyperphosphatemia, hypocalcemia, and elevation of parathyroid hormone (PTH) are typical abnormalities of uremic patients with Secondary hyperparathyroidism (SHPT). However, metabolic imbalance associated with SHPT is not well understood. Methods A total of 15 SHPT patients with an intact parathyroid hormone (iPTH) level > 600 pg/mL were set as preoperative (PR) group, 15 age‐ and gender‐matched controls who had undergone parathyroidectomy plus forearm transplantation because of hyperparathyroidism and achieved an iPTH level <150 pg/mL were set as postoperative (PO) group. Metabolite profiling of these 30 uremic patients and five healthy controls (HC) was performed using ultra performance liquid chromatography‐mass spectrometry. Results Five differential metabolites, including allyl isothiocyanate, L‐phenylalanine, D‐Aspartic acid, indoleacetaldehyde, and D‐galactose correlated with PTH were identified in this study. Taking them as a biomarker signature, PR group can be distinguished from HC group with an area under the curve (AUC) of 0.947 (95% CI, 0.76‐1) and PO group with an AUC of 0.6 (95% CI, 0.38‐0.807). Conclusions The serum metabolome correlated with PTH is successfully demonstrated for a better understanding of the pathogenesis of SHPT.

Disorders of Calcium and Phosphorus Metabolism and the Proteomics/Metabolomics-Based Research

“…Furthermore, the results suggest that metabolic pathway patterns also shift, involving routes of protein synthesis, amino acid metabolism, and steroid hormone metabolism in addition to the established metabolic pathways associated with phosphorus, calcium, PTH, and vitamin D (Levin et al, 2007), with evident promise for better understanding of the pathogenesis in CKD-MBD. Another similar article performed by Shen et al (2019) also found various biomarkers correlated to PTH in SHPT. However, in contrast to the above study, which mainly focused on the altered metabolites in CKD-MBD, this study primarily focused on those correlated with PTH.…”

“…Another similar article performed by Shen et al (2019) also found various biomarkers correlated to PTH in SHPT. However, in contrast to the above study, which mainly focused on the altered metabolites in CKD-MBD, this study primarily focused on those correlated with PTH.…”

“…However, in contrast to the above study, which mainly focused on the altered metabolites in CKD-MBD, this study primarily focused on those correlated with PTH. The results indicated that five differential metabolites, allyl isothiocyanate, L-phenylalanine, D-Aspartic acid, indoleacetaldehyde, and D-galactose correlated with PTH could serve as potential biomarkers to diagnose SHPT with good sensitivity and accuracy (Shen et al, 2019). Among them, L-phenylalanine is an activator of CaSR, which shows inhibitory role on PTH secretion, might be an explanation for its diagnostic value as a biomarker for SHPT (Gensure et al, 2003).…”

The Relationship between Quality of Life, Bone Pain, Skin Pruritus and Depression among Patients with Secondary Hyperparathyroidism undergoing Parathyroidectomy: A Cross-Sectional Study

“…Pruritus is an unpleasant feeling associated with the urge to scratch; it is a subjective symptom that is caused by many factors and has multiple dimensions [4]. The causes of skin pruritus in patients with SHPT may be related to the increase in parathyroid hormone (PTH), hyperphosphatemia and the accumulation of some medium and large molecular toxins, such as β2-mg, in vivo [5]. Parathyroidectomy (PTX) is the main treatment at present and might also reduce calcium-phosphorus product concentrations, PTH and in ammatory factors, thus controlling vascular calci cation and relieving bone pain and skin pruritus [6].…”

The Relationship between Quality of Life, Bone Pain, Skin Pruritus and Depression among Patients with Secondary Hyperparathyroidism: A Cross-Sectional Study

“…Pruritus is an unpleasant feeling associated with the urge to scratch; it is a subjective symptom that is caused by many factors and has multiple dimensions [4]. The causes of skin pruritus in patients with SHPT may be related to the increase in parathyroid hormone (PTH), hyperphosphatemia and the accumulation of some medium and large molecular toxins, such as β2-mg, in vivo [5]. Parathyroidectomy (PTX) is the main treatment at present and might also reduce calcium-phosphorus product concentrations, PTH and inflammatory factors, thus controlling vascular calcification and relieving bone pain and skin pruritus [6].…”