Abnormalities of parathyroid hormone secretion in elderly women that are reversible by short term therapy with 1,25-dihydroxyvitamin D3

G. A. Ledger, M. F. Burritt, P. C. Kao, W. M. O'Fallon, B. L. Riggs, Sundeep Khosla

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Abstract

Serum PTH concentrations increase with aging and may play an important causal role in age-related bone loss. To better define possible PTH secretory abnormalities with aging, we studied 10 young (aged 27 34 yr) and 10 elderly (aged 71-77 yr) women using sequential infusions of calcium and EDTA. To assess possible age-related resistance of PTH secretion to modulation by 1,25-dihydroxyvitamin D [1,25-(OH)2D], the infusions were repeated after 1 week of oral 1,25-(OH)2D3 therapy (1 μg/day). Baseline serum intact PTH concentrations were higher in the elderly compared to the young women (mean ± SEM, 3.8 ± 0.5 vs. 2.7 ± 0.4 pmol/L; P = 0.03). In addition, the elderly women had a significantly higher maximal PTH response to hypocalcemia compared to the young women (16.6 ± 1.1 vs. 12.8 ± 1.0 pmol/L; P = 0.03). The elderly women also had a greater nonsuppressible component of PTH secretion (0.8 ± 0.1 vs. 0.4 ± 0.1 pmol/L; P < 0.001). The set-point for PTH secretion, however, was identical in the elderly and young women (1.18 ± 0.01 vs. 1.19 ± 0.01 mmol/L; P = NS). After 1,25-(OH)2D3 administration, both groups had similar reductions in baseline and maximally stimulated PTH levels, indicating that elderly women have normal responsiveness to 1,25- (OH)2D3 suppression of PTH secretion. In addition, maximally stimulated PTH levels in the 1,25-(OH)2D3-treated elderly women decreased to the pretreatment values of young women (13.3 ± 1.1 vs. 12.8 ± 1.0 pmol/L; P = NS). Thus, elderly women have greater basal, maximal, and nonsuppressible levels of PTH secretion, without alterations in the set-point. These abnormalities are similar to those found in patients with secondary hyperparathyroidism and parathyroid hyperplasia. Further, the abnormal PTH secretory dynamics in elderly women are reversible by short term 1,25- (OH)2D3 therapy.

Original languageEnglish (US)
Pages (from-to)211-216
Number of pages6
JournalJournal of Clinical Endocrinology and Metabolism
Volume79
Issue number1
DOIs
StatePublished - Jul 1994

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Calcitriol
Parathyroid Hormone
Aging of materials
Edetic Acid
Bone
Modulation
Calcium
Scanning electron microscopy
Therapeutics
Secondary Hyperparathyroidism
Hypocalcemia
Serum
Osteoporosis
Hyperplasia
1,25-dihydroxyvitamin D

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Abnormalities of parathyroid hormone secretion in elderly women that are reversible by short term therapy with 1,25-dihydroxyvitamin D3 . / Ledger, G. A.; Burritt, M. F.; Kao, P. C.; O'Fallon, W. M.; Riggs, B. L.; Khosla, Sundeep.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 79, No. 1, 07.1994, p. 211-216.

Research output: Contribution to journalArticle

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abstract = "Serum PTH concentrations increase with aging and may play an important causal role in age-related bone loss. To better define possible PTH secretory abnormalities with aging, we studied 10 young (aged 27 34 yr) and 10 elderly (aged 71-77 yr) women using sequential infusions of calcium and EDTA. To assess possible age-related resistance of PTH secretion to modulation by 1,25-dihydroxyvitamin D [1,25-(OH)2D], the infusions were repeated after 1 week of oral 1,25-(OH)2D3 therapy (1 μg/day). Baseline serum intact PTH concentrations were higher in the elderly compared to the young women (mean ± SEM, 3.8 ± 0.5 vs. 2.7 ± 0.4 pmol/L; P = 0.03). In addition, the elderly women had a significantly higher maximal PTH response to hypocalcemia compared to the young women (16.6 ± 1.1 vs. 12.8 ± 1.0 pmol/L; P = 0.03). The elderly women also had a greater nonsuppressible component of PTH secretion (0.8 ± 0.1 vs. 0.4 ± 0.1 pmol/L; P < 0.001). The set-point for PTH secretion, however, was identical in the elderly and young women (1.18 ± 0.01 vs. 1.19 ± 0.01 mmol/L; P = NS). After 1,25-(OH)2D3 administration, both groups had similar reductions in baseline and maximally stimulated PTH levels, indicating that elderly women have normal responsiveness to 1,25- (OH)2D3 suppression of PTH secretion. In addition, maximally stimulated PTH levels in the 1,25-(OH)2D3-treated elderly women decreased to the pretreatment values of young women (13.3 ± 1.1 vs. 12.8 ± 1.0 pmol/L; P = NS). Thus, elderly women have greater basal, maximal, and nonsuppressible levels of PTH secretion, without alterations in the set-point. These abnormalities are similar to those found in patients with secondary hyperparathyroidism and parathyroid hyperplasia. Further, the abnormal PTH secretory dynamics in elderly women are reversible by short term 1,25- (OH)2D3 therapy.",
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AU - Khosla, Sundeep

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N2 - Serum PTH concentrations increase with aging and may play an important causal role in age-related bone loss. To better define possible PTH secretory abnormalities with aging, we studied 10 young (aged 27 34 yr) and 10 elderly (aged 71-77 yr) women using sequential infusions of calcium and EDTA. To assess possible age-related resistance of PTH secretion to modulation by 1,25-dihydroxyvitamin D [1,25-(OH)2D], the infusions were repeated after 1 week of oral 1,25-(OH)2D3 therapy (1 μg/day). Baseline serum intact PTH concentrations were higher in the elderly compared to the young women (mean ± SEM, 3.8 ± 0.5 vs. 2.7 ± 0.4 pmol/L; P = 0.03). In addition, the elderly women had a significantly higher maximal PTH response to hypocalcemia compared to the young women (16.6 ± 1.1 vs. 12.8 ± 1.0 pmol/L; P = 0.03). The elderly women also had a greater nonsuppressible component of PTH secretion (0.8 ± 0.1 vs. 0.4 ± 0.1 pmol/L; P < 0.001). The set-point for PTH secretion, however, was identical in the elderly and young women (1.18 ± 0.01 vs. 1.19 ± 0.01 mmol/L; P = NS). After 1,25-(OH)2D3 administration, both groups had similar reductions in baseline and maximally stimulated PTH levels, indicating that elderly women have normal responsiveness to 1,25- (OH)2D3 suppression of PTH secretion. In addition, maximally stimulated PTH levels in the 1,25-(OH)2D3-treated elderly women decreased to the pretreatment values of young women (13.3 ± 1.1 vs. 12.8 ± 1.0 pmol/L; P = NS). Thus, elderly women have greater basal, maximal, and nonsuppressible levels of PTH secretion, without alterations in the set-point. These abnormalities are similar to those found in patients with secondary hyperparathyroidism and parathyroid hyperplasia. Further, the abnormal PTH secretory dynamics in elderly women are reversible by short term 1,25- (OH)2D3 therapy.

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