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Published in: BMC Endocrine Disorders 1/2009

Open Access 01-12-2009 | Research article

Age-related increases in parathyroid hormone may be antecedent to both osteoporosis and dementia

Authors: Eric R Braverman, Thomas JH Chen, Amanda LC Chen, Vanessa Arcuri, Mallory M Kerner, Anish Bajaj, Javier Carbajal, Dasha Braverman, B William Downs, Kenneth Blum

Published in: BMC Endocrine Disorders | Issue 1/2009

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Abstract

Background

Numerous studies have reported that age-induced increased parathyroid hormone plasma levels are associated with cognitive decline and dementia. Little is known about the correlation that may exist between neurological processing speed, cognition and bone density in cases of hyperparathyroidism. Thus, we decided to determine if parathyroid hormone levels correlate to processing speed and/or bone density.

Methods

The recruited subjects that met the inclusion criteria (n = 92, age-matched, age 18-90 years, mean = 58.85, SD = 15.47) were evaluated for plasma parathyroid hormone levels and these levels were statistically correlated with event-related P300 potentials. Groups were compared for age, bone density and P300 latency. One-tailed tests were used to ascertain the statistical significance of the correlations. The study groups were categorized and analyzed for differences of parathyroid hormone levels: parathyroid hormone levels <30 (n = 30, mean = 22.7 ± 5.6 SD) and PTH levels >30 (n = 62, mean = 62.4 ± 28.3 SD, p ≤ 02).

Results

Patients with parathyroid hormone levels <30 showed statistically significantly less P300 latency (P300 = 332.7 ± 4.8 SE) relative to those with parathyroid hormone levels >30, which demonstrated greater P300 latency (P300 = 345.7 ± 3.6 SE, p = .02). Participants with parathyroid hormone values <30 (n = 26) were found to have statistically significantly higher bone density (M = -1.25 ± .31 SE) than those with parathyroid hormone values >30 (n = 48, M = -1.85 ± .19 SE, p = .04).

Conclusion

Our findings of a statistically lower bone density and prolonged P300 in patients with high parathyroid hormone levels may suggest that increased parathyroid hormone levels coupled with prolonged P300 latency may become putative biological markers of both dementia and osteoporosis and warrant intensive investigation.
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Literature
1.
go back to reference Dotzenrath CM, Kaetsch AK, Pfingsten H, Cupisti K, Weyerbrock N, Vossough A, Verde PE, Ohmann C: Neuropsychiatric and cognitive changes after surgery for primary hyperparathyroidism. World J Surg. 2006, 30 (5): 680-5. 10.1007/s00268-005-0444-8.CrossRefPubMed Dotzenrath CM, Kaetsch AK, Pfingsten H, Cupisti K, Weyerbrock N, Vossough A, Verde PE, Ohmann C: Neuropsychiatric and cognitive changes after surgery for primary hyperparathyroidism. World J Surg. 2006, 30 (5): 680-5. 10.1007/s00268-005-0444-8.CrossRefPubMed
2.
go back to reference Flicker L, Ames D: Metabolic and endocrinological causes of dementia. Int Psychogeriatr. 2005, 17 (Suppl 1): S79-92. 10.1017/S1041610205001961.CrossRefPubMed Flicker L, Ames D: Metabolic and endocrinological causes of dementia. Int Psychogeriatr. 2005, 17 (Suppl 1): S79-92. 10.1017/S1041610205001961.CrossRefPubMed
3.
go back to reference Washimi Y: Dementia in parathyroid disease. Nippon Rinsho. 2004, 62 (Suppl): 349-52.PubMed Washimi Y: Dementia in parathyroid disease. Nippon Rinsho. 2004, 62 (Suppl): 349-52.PubMed
4.
go back to reference Braverman ER, Blum K: P300 (latency) event-related potential: an accurate predictor of memory impairment. Clin Electroencephalogr. 2003, 34 (3): 124-39.CrossRefPubMed Braverman ER, Blum K: P300 (latency) event-related potential: an accurate predictor of memory impairment. Clin Electroencephalogr. 2003, 34 (3): 124-39.CrossRefPubMed
5.
go back to reference Cohen SN, Syndulko K, Rever B, Kraut J, Coburn J, Tourtellotte WW: Visual evoked potentials and long latency event-related potentials in chronic renal failure. Neurology. 1983, 33 (9): 1219-22.CrossRefPubMed Cohen SN, Syndulko K, Rever B, Kraut J, Coburn J, Tourtellotte WW: Visual evoked potentials and long latency event-related potentials in chronic renal failure. Neurology. 1983, 33 (9): 1219-22.CrossRefPubMed
6.
go back to reference Silver J, Bushinsky D: Harnessing the parathyroids to create stronger bones. Curr Opi Nephrol Hypertens. 2004, 13 (4): 471-6. 10.1097/01.mnh.0000133984.47806.00.CrossRef Silver J, Bushinsky D: Harnessing the parathyroids to create stronger bones. Curr Opi Nephrol Hypertens. 2004, 13 (4): 471-6. 10.1097/01.mnh.0000133984.47806.00.CrossRef
7.
go back to reference DeGroot LJ, Jameson JL: Endocrinology. 2006, Elsevier, Philadelphia, 2: 1534-1538. Fifth DeGroot LJ, Jameson JL: Endocrinology. 2006, Elsevier, Philadelphia, 2: 1534-1538. Fifth
8.
go back to reference Rubin MR, Bilezikian JP: Parathyroid hormone as an anabolic skeletal therapy. Drugs. 2005, 65 (17): 2481-98. 10.2165/00003495-200565170-00005.CrossRefPubMed Rubin MR, Bilezikian JP: Parathyroid hormone as an anabolic skeletal therapy. Drugs. 2005, 65 (17): 2481-98. 10.2165/00003495-200565170-00005.CrossRefPubMed
9.
go back to reference Anastasilakis AD, Polyzos SA, Goulis DG, Slavakis A, Efstathiadou Z, Kita M, Koukoulis G, Avramidis A: Endogenous intact PTH is suppressed during Teriparitide (rhPTH 1-34) administration in postmenopausal women with established osteoporosis. Endocr J. 2008, 55 (3): 613-6. 10.1507/endocrj.K07E-123.CrossRefPubMed Anastasilakis AD, Polyzos SA, Goulis DG, Slavakis A, Efstathiadou Z, Kita M, Koukoulis G, Avramidis A: Endogenous intact PTH is suppressed during Teriparitide (rhPTH 1-34) administration in postmenopausal women with established osteoporosis. Endocr J. 2008, 55 (3): 613-6. 10.1507/endocrj.K07E-123.CrossRefPubMed
10.
go back to reference National Kidney Foundation: K/DOQ1 clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kid Dis. 2003, 42 (Suppl 3): S1- National Kidney Foundation: K/DOQ1 clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kid Dis. 2003, 42 (Suppl 3): S1-
11.
go back to reference Coresh J, Selvin E, Stevens LA, Manzi J, Krusek JW, Eggers P, Van Lente F, Levey AS: Prevalence of chronic kidney disease in the United States. JAMA. 2007, 298 (17): 2038-47. 10.1001/jama.298.17.2038.CrossRefPubMed Coresh J, Selvin E, Stevens LA, Manzi J, Krusek JW, Eggers P, Van Lente F, Levey AS: Prevalence of chronic kidney disease in the United States. JAMA. 2007, 298 (17): 2038-47. 10.1001/jama.298.17.2038.CrossRefPubMed
13.
go back to reference Mazzaglia PJ, Berber E, Kovach A, Milas M, Esselstyn C, Siperstein AE: The changing presentation of hyperparathyroidism over 3 decades. Arch Surg. 2008, 143 (3): 260-6.CrossRefPubMed Mazzaglia PJ, Berber E, Kovach A, Milas M, Esselstyn C, Siperstein AE: The changing presentation of hyperparathyroidism over 3 decades. Arch Surg. 2008, 143 (3): 260-6.CrossRefPubMed
14.
go back to reference National Osteoporosis Foundation: Physicians Guide to Prevention and Treatment of Osteoporosis. 2003, Washington DC: National Osteoporosis Foundation National Osteoporosis Foundation: Physicians Guide to Prevention and Treatment of Osteoporosis. 2003, Washington DC: National Osteoporosis Foundation
15.
go back to reference Hightower L: Osteoporosis: pediatric disease with geriatric consequences. Orthop Nurs. 2000, 19 (5): 59-62. 10.1097/00006416-200019050-00010.CrossRefPubMed Hightower L: Osteoporosis: pediatric disease with geriatric consequences. Orthop Nurs. 2000, 19 (5): 59-62. 10.1097/00006416-200019050-00010.CrossRefPubMed
16.
go back to reference Chesnut CH: Is osteoporosis a pediatric disease? Peak bone mass attainment in the adolescent female. Public Health Rep. 1989, 104 (Suppl): 50-4.PubMedPubMedCentral Chesnut CH: Is osteoporosis a pediatric disease? Peak bone mass attainment in the adolescent female. Public Health Rep. 1989, 104 (Suppl): 50-4.PubMedPubMedCentral
17.
go back to reference Kanji G: 100 Statistical Tests. 1993, London, Newbury Park, California: Sage Publications Kanji G: 100 Statistical Tests. 1993, London, Newbury Park, California: Sage Publications
18.
go back to reference Sachs L: Applied Statistics: A Handbook of Techniques. 1984, Springer-Verlag, Berlin, Germany, 2CrossRef Sachs L: Applied Statistics: A Handbook of Techniques. 1984, Springer-Verlag, Berlin, Germany, 2CrossRef
19.
go back to reference Cohen J: Statistical Power Analysis for Behavioral Sciences. 1988, Eribaum Associates, Hillsdale, NJ, 2 Cohen J: Statistical Power Analysis for Behavioral Sciences. 1988, Eribaum Associates, Hillsdale, NJ, 2
20.
go back to reference Kirk RE: Statistics: an Introduction. 1999, Harcourt Brace College Publishers, Fort Worth, 4 Kirk RE: Statistics: an Introduction. 1999, Harcourt Brace College Publishers, Fort Worth, 4
21.
go back to reference Yirmiya R, Goshen I, Bajayo A, Kreisel T, Feldman S, Tarn J, Trembovler V, Csernus V, Shohami E, Bab I: Depression induces bone loss through stimulation of the sympathetic nervous system. Proc Natl Acad Sci USA. 2006, 103 (45): 16876-81. 10.1073/pnas.0604234103.CrossRefPubMedPubMedCentral Yirmiya R, Goshen I, Bajayo A, Kreisel T, Feldman S, Tarn J, Trembovler V, Csernus V, Shohami E, Bab I: Depression induces bone loss through stimulation of the sympathetic nervous system. Proc Natl Acad Sci USA. 2006, 103 (45): 16876-81. 10.1073/pnas.0604234103.CrossRefPubMedPubMedCentral
22.
go back to reference Kahl KG: Bone mineral density, bone turnover, and osteoprotegerin in personality disorder. Psychosom Med. 2006, 68: 669-74. 10.1097/01.psy.0000237858.76880.3d.CrossRefPubMed Kahl KG: Bone mineral density, bone turnover, and osteoprotegerin in personality disorder. Psychosom Med. 2006, 68: 669-74. 10.1097/01.psy.0000237858.76880.3d.CrossRefPubMed
23.
go back to reference Milliken LA, Wilhelmy J, Martin CJ, Finkenthal N, Cussler E, Metcalfe L, Guido TA, Going SB, Lohman TG: Depressive symptoms and changes in body weight exert independent and site-specific effects on bone in postmenopausal women exercising for 1 year. J Gerontol A Biol Sci Med Sci. 2006, 61 (5): 488-94.CrossRefPubMed Milliken LA, Wilhelmy J, Martin CJ, Finkenthal N, Cussler E, Metcalfe L, Guido TA, Going SB, Lohman TG: Depressive symptoms and changes in body weight exert independent and site-specific effects on bone in postmenopausal women exercising for 1 year. J Gerontol A Biol Sci Med Sci. 2006, 61 (5): 488-94.CrossRefPubMed
24.
go back to reference Ilias I, Alesci S, Gold PW, Chrousos GP: Depression and osteoporosis in men: association or causal link?. Hormones (Athens). 2006, 5 (l): 9-16.CrossRef Ilias I, Alesci S, Gold PW, Chrousos GP: Depression and osteoporosis in men: association or causal link?. Hormones (Athens). 2006, 5 (l): 9-16.CrossRef
25.
go back to reference Halbreich U, Palter S: Accelerated osteoporosis in psychiatric patients: possible pathophysiological processes. Schizophr Bull. 1996, 22 (3): 447-54.CrossRefPubMed Halbreich U, Palter S: Accelerated osteoporosis in psychiatric patients: possible pathophysiological processes. Schizophr Bull. 1996, 22 (3): 447-54.CrossRefPubMed
26.
go back to reference Khudaverdyan DN, Asratyan AA: Effect of the parathyroid hormone-Calcium system on functional activity of the hypothalamus-neurohypophysis complex. Bulletin of Experimental Biology and Medicine. 1996, 122 (5): 1069-71. 10.1007/BF02447647.CrossRef Khudaverdyan DN, Asratyan AA: Effect of the parathyroid hormone-Calcium system on functional activity of the hypothalamus-neurohypophysis complex. Bulletin of Experimental Biology and Medicine. 1996, 122 (5): 1069-71. 10.1007/BF02447647.CrossRef
27.
go back to reference Cermik TF, Kaya M, Ugur-Altun B, Bedel D, Berkarda S, Yigitbasi ON: Regional cerebral blood flow abnormalities in patients with primary hyperparathyroidism. Newroradiology. 2007, 49 (4): 379-85. 10.1007/s00234-006-0198-5.CrossRef Cermik TF, Kaya M, Ugur-Altun B, Bedel D, Berkarda S, Yigitbasi ON: Regional cerebral blood flow abnormalities in patients with primary hyperparathyroidism. Newroradiology. 2007, 49 (4): 379-85. 10.1007/s00234-006-0198-5.CrossRef
28.
go back to reference Margolin D, Hammerstad J, Orwoll E, McClung M, Calhoun D: Intracranial calcification in hyperparathyroidism associated with gait apraxia and parkinsonism. Neurology. 1980, 30 (9): 1005-7.CrossRefPubMed Margolin D, Hammerstad J, Orwoll E, McClung M, Calhoun D: Intracranial calcification in hyperparathyroidism associated with gait apraxia and parkinsonism. Neurology. 1980, 30 (9): 1005-7.CrossRefPubMed
29.
go back to reference Ohtera K, Ishii S, Matsuyama T: Influence of Vitamin D Receptor Alleles on Human Osteoblast-Like Cells. J Born Joint Surg Br. 2000, 83: 134-138. 10.1302/0301-620X.83B1.10050.CrossRef Ohtera K, Ishii S, Matsuyama T: Influence of Vitamin D Receptor Alleles on Human Osteoblast-Like Cells. J Born Joint Surg Br. 2000, 83: 134-138. 10.1302/0301-620X.83B1.10050.CrossRef
30.
go back to reference Kurbel S, Radi R, Kotromanovic Z, Puseljic Z, Kratofil BA: calcium homeostasis model: orchestration of fast acting PTH and calcitonin with slow calcitriol Med. Hypotheses. 2003, 61 (3): 346-50. 10.1016/S0306-9877(03)00107-5.CrossRef Kurbel S, Radi R, Kotromanovic Z, Puseljic Z, Kratofil BA: calcium homeostasis model: orchestration of fast acting PTH and calcitonin with slow calcitriol Med. Hypotheses. 2003, 61 (3): 346-50. 10.1016/S0306-9877(03)00107-5.CrossRef
31.
go back to reference Scillitani A, Guarnieri V, Battista C, De Geronimo S, Muscarella LA, Chiodini I, Cignarelli M, Minisola S, Bertoldo F, Francucci CM, Malavolta N, Piovesan A, Mascia ML, Muscarella S, Hendy GN, D'Agruma L, Cole DE: Primary hyperparathyroidism and the presence of kidney stones are associated with different haplotypes of the calcium-sensing receptor. J Clin Endocrinol Metabl. 2007, 92 (l): 277-83.CrossRef Scillitani A, Guarnieri V, Battista C, De Geronimo S, Muscarella LA, Chiodini I, Cignarelli M, Minisola S, Bertoldo F, Francucci CM, Malavolta N, Piovesan A, Mascia ML, Muscarella S, Hendy GN, D'Agruma L, Cole DE: Primary hyperparathyroidism and the presence of kidney stones are associated with different haplotypes of the calcium-sensing receptor. J Clin Endocrinol Metabl. 2007, 92 (l): 277-83.CrossRef
32.
go back to reference Hock JM, Fonseca J: Anabolic effect of human synthetic parathyroid hormone-(l-34) depends on growth hormone. Endocrinology. 1990, 127 (4): 1804-10. 10.1210/endo-127-4-1804.CrossRefPubMed Hock JM, Fonseca J: Anabolic effect of human synthetic parathyroid hormone-(l-34) depends on growth hormone. Endocrinology. 1990, 127 (4): 1804-10. 10.1210/endo-127-4-1804.CrossRefPubMed
33.
go back to reference White HD, Ahmad AM, Durham BH, Patwala A, Whittingham P, Fraser WD, Vora JP: Growth hormone replacement is important for the restoration of parathyroid hormone sensitivity and improvement in bone metabolism in older adult growth hormone-deficient patients. J Clin Endocrinol Metab. 2005, 90 (6): 3371-80. 10.1210/jc.2004-1650.CrossRefPubMed White HD, Ahmad AM, Durham BH, Patwala A, Whittingham P, Fraser WD, Vora JP: Growth hormone replacement is important for the restoration of parathyroid hormone sensitivity and improvement in bone metabolism in older adult growth hormone-deficient patients. J Clin Endocrinol Metab. 2005, 90 (6): 3371-80. 10.1210/jc.2004-1650.CrossRefPubMed
34.
go back to reference Walker MD, McMahon DJ, Inabnet WB, azar RM, Brown I, Vardy S, Cosman F, Silverberg S: Neuropsychological Features in Primary Hyperparathyroidism: A Prospective Study. J Clin Endocrinol Metab. 2009, 94 (6): 1951-1958. 10.1210/jc.2008-2574.CrossRefPubMedPubMedCentral Walker MD, McMahon DJ, Inabnet WB, azar RM, Brown I, Vardy S, Cosman F, Silverberg S: Neuropsychological Features in Primary Hyperparathyroidism: A Prospective Study. J Clin Endocrinol Metab. 2009, 94 (6): 1951-1958. 10.1210/jc.2008-2574.CrossRefPubMedPubMedCentral
35.
go back to reference Boyce BF, Yao Z, Zhang O, Guo R, Lu Y, Schwarz EM, Xing L: New roles for osteoclasts in bone. Ann N Y Acad Sci. 2007, 1116: 245-254. 10.1196/annals.1402.084.CrossRefPubMed Boyce BF, Yao Z, Zhang O, Guo R, Lu Y, Schwarz EM, Xing L: New roles for osteoclasts in bone. Ann N Y Acad Sci. 2007, 1116: 245-254. 10.1196/annals.1402.084.CrossRefPubMed
36.
go back to reference McCormick RK: Osteoporosis: integrating biomarkers and other diagnostic correlates into the management of bone fragility. Altern Med Rev. 2007, 12 (2): 113-145.PubMed McCormick RK: Osteoporosis: integrating biomarkers and other diagnostic correlates into the management of bone fragility. Altern Med Rev. 2007, 12 (2): 113-145.PubMed
37.
go back to reference Ostrowski K, Rohde T, Zacho M, Asp S, Pedersen BK: Evidence that interleukin-6 is produced in human skeletal muscle during prolonged running. J Physiol. 1998, 508: 949-953. 10.1111/j.1469-7793.1998.949bp.x.CrossRefPubMedPubMedCentral Ostrowski K, Rohde T, Zacho M, Asp S, Pedersen BK: Evidence that interleukin-6 is produced in human skeletal muscle during prolonged running. J Physiol. 1998, 508: 949-953. 10.1111/j.1469-7793.1998.949bp.x.CrossRefPubMedPubMedCentral
38.
go back to reference Lee NK, Sowa H, Hinoi E, Ferron M, Ahn JD, Confavreux C, Dacquin R, Mee PJ, McKee MD, Jung DY, Zhang Z, Kim JK, Mauvais-Jarvis F, Ducy P, Karsenty G: Endocrine regulation of energy metabolism by the skeleton. Cell. 2007, 130 (3): 456-469. 10.1016/j.cell.2007.05.047.CrossRefPubMedPubMedCentral Lee NK, Sowa H, Hinoi E, Ferron M, Ahn JD, Confavreux C, Dacquin R, Mee PJ, McKee MD, Jung DY, Zhang Z, Kim JK, Mauvais-Jarvis F, Ducy P, Karsenty G: Endocrine regulation of energy metabolism by the skeleton. Cell. 2007, 130 (3): 456-469. 10.1016/j.cell.2007.05.047.CrossRefPubMedPubMedCentral
39.
go back to reference Keys A, Brozek J, Henschel A, Mickelsen O, Taylor HL: The Biology of Human Starvation. 1950, Minneapolis University of Minnesota Press Keys A, Brozek J, Henschel A, Mickelsen O, Taylor HL: The Biology of Human Starvation. 1950, Minneapolis University of Minnesota Press
40.
go back to reference Dulloo A, Jacquet J: Adaptive reduction in basal metabolic rate in response to food deprivation in humans: a role for feedback signals from fat stores. Am J Clin Nutr. 1998, 68: 599-606.PubMed Dulloo A, Jacquet J: Adaptive reduction in basal metabolic rate in response to food deprivation in humans: a role for feedback signals from fat stores. Am J Clin Nutr. 1998, 68: 599-606.PubMed
41.
go back to reference Dulloo AG, Girardier L: Adaptive changes in energy expenditure during refeeding following low-calorie intake: evidence for a specific metabolic component favoring fat storage. Am J Clin Nutr. 1990, 52: 415-20.PubMed Dulloo AG, Girardier L: Adaptive changes in energy expenditure during refeeding following low-calorie intake: evidence for a specific metabolic component favoring fat storage. Am J Clin Nutr. 1990, 52: 415-20.PubMed
Metadata
Title
Age-related increases in parathyroid hormone may be antecedent to both osteoporosis and dementia
Authors
Eric R Braverman
Thomas JH Chen
Amanda LC Chen
Vanessa Arcuri
Mallory M Kerner
Anish Bajaj
Javier Carbajal
Dasha Braverman
B William Downs
Kenneth Blum
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Endocrine Disorders / Issue 1/2009
Electronic ISSN: 1472-6823
DOI
https://doi.org/10.1186/1472-6823-9-21

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