Angiotensin-Converting Enzyme Inhibition and Parathyroid Hormone Secretion

作者：Zaheer Sarah; Brown Jenifer M; Connors Molly; Williams Jonathan S; Adler Gail K; Vaidya Anand

来源：International Journal of Endocrinology, 2017, 2017: 4138783.

DOI：10.1155/2017/4138783

<jats:p><jats:italic>Background</jats:italic>. Prior studies suggest that renin-angiotensin-aldosterone system (RAAS) inhibitors decrease parathyroid hormone (PTH) secretion. <jats:italic>Objective</jats:italic>. To evaluate the effect of angiotensin-converting enzyme inhibitors (ACEi) on serum PTH in participants with and without primary hyperparathyroidism (P-HPT). <jats:italic>Methods</jats:italic>. An open-label, single-arm, pilot study whereby participants with and without P-HPT had PTH were evaluated before and after 1 week of maximally tolerated lisinopril therapy. <jats:italic>Results</jats:italic>. A total of 12 participants with, and 15 participants without, P-HPT successfully completed the protocol. Following 1 week of lisinopril, participants with P-HPT had a decrease in systolic blood pressure (SBP) (−6.4 mmHg, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>0.01</mml:mn></mml:math>), an increase in plasma renin activity (PRA) (+1.50 ng/mL/h, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn>0.06</mml:mn></mml:math>), and a decrease in PTH (79.5 (21.6) to 70.9 (19.6) pg/mL, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mo>∆</mml:mo><mml:mo>=</mml:mo><mml:mo>−</mml:mo><mml:mn>8.6</mml:mn></mml:math> pg/mL, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mi>P</mml:mi><mml:mo>=</mml:mo><mml:mn>0.049</mml:mn></mml:math>); however, serum and urine calcium did not change. In contrast, although 1 week of lisinopril significantly decreased SBP and increased PRA among participants without P-HPT, there were no changes in PTH or calcium. <jats:italic>Conclusion</jats:italic>. In this short pilot investigation, 1 week of maximally titrated ACEi did not impact PTH in participants without P-HPT, but resulted in a modest and marginally significant reduction of PTH but not calcium, among participants with P-HPT. This trial is registered with ClinicalTrials.gov <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="https://clinicaltrials.gov/ct2/show/NCT01691781">NCT01691781</jats:ext-link>.</jats:p>

• 出版日期2017
• 单位Harvard Medical School; harvard medical school; Harvard medical school