Serum Klotho levels in primary hyperparathyroidism patients before and after parathyroidectomy
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ORIGINAL ARTICLE
Serum Klotho levels in primary hyperparathyroidism patients before and after parathyroidectomy Chi Su1 Lingqiong Meng2 Stanley Z. Trooskin3 Sue A. Shapses2 Yuling He1 Aseel Al-Dayyeni1 Xiangbing Wang1 ●
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Received: 7 May 2020 / Accepted: 17 July 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To investigate Klotho level and its association with biochemical indices of primary hyperparathyroidism (PHPT). Methods Fifty PHPT patients and fifty-two age- and body mass index-(BMI) matched healthy control subjects were recruited. In addition, twenty-five PHPT patients underwent parathyroidectomy (PTX) and had 4-month follow-up visits. Intact parathyroid hormone (iPTH), 25-hydroxyvitamin D [25(OH)D], calcium, albumin, corrected calcium, and Klotho levels were determined. Results There was no significant difference in age and BMI between PHPT subjects and controls (p > 0.05). PHPT patients had Klotho levels (15.4 ± 1.2 ng/mL) about 23% higher compared with those of the controls (11.9 ± 0.8 ng/mL), but this difference was not significant (p = 0.063). However, postmenopausal PHPT patients had 45% higher Klotho levels (17.6 ± 1.5 ng/ml) compared with postmenopausal controls (12.1 ± 0.9 ng/mL, p = 0.008). For postmenopausal subjects, Klotho levels had positive correlation with levels of iPTH (r = 0.25, p = 0.026) and corrected calcium (r = 0.34, p = 0.003), but negative correlation with 25(OH)D (r = −0.23, p = 0.042). After PTX, levels of iPTH and corrected calcium decreased and 25(OH)D levels increased to normal range (p < 0.001). However, there was no significant change in Klotho levels after a 4-month follow-up. Conclusions Serum Klotho levels are higher in postmenopausal PHPT patients than in healthy postmenopausal control subjects. The etiology of elevated Klotho level and its clinical significance requires further investigation. Keywords Klotho Parathyroid hormone Hyperparathyroidism Post-menopausal Parathyroidectomy ●
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Abbreviations PHPT Primary hyperparathyroidism iPTH Intact parathyroid hormone FGF Fibroblast growth factor FGFR Fibroblast growth factor receptor
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BMI PTX 25(OH)D SEM
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Body mass index Parathyroidectomy 25-hydroxyvitamin D Standard error of the mean
Introduction Supplementary information The online version of this article (https:// doi.org/10.1007/s12020-020-02427-w) contains supplementary material, which is available to authorized users. * Xiangbing Wang [email protected] 1
Division of Endocrinology, Metabolism & Nutrition, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
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Department of Nutritional Sciences, School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ, USA
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Division of General Surgery, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA
Primary hyperparathyroidism (PHPT) is a common endocrine disorder affecting mainly postmenopausal women. Most patients with PHPT in the United Stat
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