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Role of 1,25-dihydroxy vitamin D3 and parathyroid hormone in urinary calcium excretion in calcium stone formers.

Authors
 Won Tae Kim  ;  Yong June Kim  ;  Seok Joong Yun  ;  Kyung Sub Shin  ;  Young Deuk Choi  ;  Sang Cheol Lee  ;  Wun Jae Kim 
Citation
 YONSEI MEDICAL JOURNAL, Vol.55(5) : 1326-1332, 2014 
Journal Title
YONSEI MEDICAL JOURNAL
ISSN
 0513-5796 
Issue Date
2014
MeSH
Adult ; Calcium/metabolism ; Calcium/urine* ; Female ; Humans ; Kidney Calculi ; Linear Models ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Parathyroid Hormone/blood ; Parathyroid Hormone/physiology* ; Parathyroid Hormone/urine ; Vitamin D/analogs & derivatives* ; Vitamin D/blood ; Vitamin D/physiology ; Vitamin D/urine
Keywords
1,25-dihydroxy-vitamin D₃ ; calcium ; parathyroid hormone ; urolithiasis
Abstract
PURPOSE: To find out the possible role of 1,25(OH)₂ vitamin D₃ [1,25(OH)₂D₃] and parathyroid hormone (PTH) as intrinsic factors in urinary calcium stone formers (SFs), we investigated their relationship with serum and urinary biochemical parameters.
MATERIALS AND METHODS: A total of 326 calcium SFs (male: 204, female: 122) were enrolled and underwent outpatient metabolic evaluations including 1,25(OH)₂D₃ and PTH as well as serum and 24-hour urinary biochemical parameters. As control, 163 age- and sex-matched (2:1) individuals (non-SFs) who have never urinary stone episode were included.
RESULTS: 1,25(OH)₂D₃ level was positively correlated with urinary calcium excretion (r=0.347, p<0.001). The hypercalciuric group and recurrent SFs had higher serum 1,25(OH)₂D₃ levels than the normocalciuric group (p<0.001) and first SFs (p=0.050). In the adjusted multiple linear regression analysis, serum 1,25(OH)₂D₃ level (β=0.259, p<0.001) and serum PTH level (β=-0.160, p<0.001) were significantly correlated with urinary calcium excretion. The patients in highest tertile of 1,25(OH)₂D₃ had a more than 3.1 fold risk of hypercalciuria than those in the lowest tertile (odds ratio=3.14, 95% confidence interval: 1.431-6.888, p=0.004). No correlation was observed between PTH and 1,25(OH)₂D₃ (R=0.005, p=0.929) in calcium SFs, while a negative correlation was found in controls (R=-0.269, p=0.001).
CONCLUSION: 1,25(OH)₂D₃ was closely correlated with urinary calcium excretion, and high 1,25(OH)₂D₃ levels were detected in the hypercalciuric group and in recurrent SFs. However, 1,25(OH)₂D₃ was not correlated with PTH in calcium SFs. These findings suggest that 1,25(OH)₂D₃ might be important intrinsic factor for altered calcium regulation in SFs.
Files in This Item:
T201405539.pdf Download
DOI
10.3349/ymj.2014.55.5.1326
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Tae(김원태)
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138733
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