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      Peripheral Effects of PTH Are Not Altered after Thyroid Surgery in Euthyroid Patients

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          Abstract

          Background: We have previously found decreased serum levels of both ionized calcium and 1,25(OH)<sub>2</sub>D and an increase in serum phosphate levels at 1 year after hemithyroidectomy. However, basal and stimulated parathyroid hormone (PTH) secretions were not altered. To investigate whether the observed biochemical changes after unilateral thyroid surgery may be due to a relative end-organ resistance to PTH, we studied the peripheral effects of infused hPTH-(1–34) in 6 patients preoperatively and 3 months after hemithyroidectomy. Methods: Serum levels of TSH, FT<sub>4</sub> and FT<sub>3</sub> were measured pre- and postoperatively. hPTH-(1–34) was infused at 0.9 IU/kg/h during 6 h. Blood samples for analysis of ionized calcium, intact PTH, phosphate, 25(OH)D, 1,25(OH)<sub>2</sub>D and urinary samples for calcium, phosphate and nephrogenous(n)-cAMP analysis were taken at baseline, when the infusion was discontinued after 6 h and at 24 h. Results: Three months after hemithyroidectomy, serum levels of FT<sub>3</sub> were decreased and TSH levels increased. Pre- and postoperative hPTH-(1–34) infusions induced increased serum levels of ionized calcium, 1,25(OH)<sub>2</sub>D, increased urinary excretion of phosphate and elevated n-cAMP levels. The changes in the studied biochemical variables during the hPTH-(1–34) infusions did not differ between the two study occasions. Conclusion: By using a 6-hour hPTH-(1–34) infusion protocol, we have shown that the peripheral PTH effect is not altered by a slight reduction in thyroid hormone levels at 3 months after hemithyroidectomy.

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          Subcutaneous administration of the amino-terminal fragment of human parathyroid hormone-(1-34): kinetics and biochemical response in estrogenized osteoporotic patients

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            Decreased Levels of Ionized Calcium One Year after Hemithyroidectomy: Importance of Reduced Thyroid Hormones

            Background: Previously we have found reduced levels of total serum calcium and 1,25(OH) 2 D 3 despite an unaltered stimulated parathyroid hormone (PTH) secretion 1 year after hemithyroidectomy. The present study was undertaken to elucidate the possible relationship between calcium homeostasis, thyroid hormones and bone resorption in a group of 45 consecutive patients subjected to hemithyroidectomy because of a solitary nodule. All patients had free T 4 and T 3 levels within normal range preoperatively. Methods: Thyroid hormones, bone mineral and biochemical variables known to reflect calcium homeostasis were studied. Patients were divided into three separate groups depending on their pre- and postoperative thyroid hormone status. Results: One year postoperatively, serum levels of free T 4 were decreased and that of thyrotropin (TSH) increased in the entire group of patients. The concentration of ionized calcium was reduced from 1.25 ± 0.05 to 1.22 ± 0.04 (p 4 . Patients with subclinical hyperthyroidism preoperatively presented the lowest postoperative levels of ionized calcium, significantly reduced levels of 1CTP and increased levels of phosphate and creatinine. Multiple linear regression analysis showed that age (p 4 (p < 0.01) were independently associated with altered levels of ionized calcium. Conclusion: We conclude that the reduction in ionized calcium 1 year after hemithyroidectomy was not due to PTH deficiency. Instead our results suggest that the reduced effects of thyroid hormones on bone and kidney function is essential.
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              Author and article information

              Journal
              HRE
              Horm Res Paediatr
              10.1159/issn.1663-2818
              Hormone Research in Paediatrics
              S. Karger AG
              1663-2818
              1663-2826
              2001
              2001
              15 February 2002
              : 56
              : 3-4
              : 105-109
              Affiliations
              Departments of aSurgery and bClinical Chemistry, Lund University Hospital, Lund, Sweden
              Article
              48100 Horm Res 2001;56:105–109
              10.1159/000048100
              11847471
              © 2002 S. Karger AG, Basel

              Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

              Page count
              Tables: 3, References: 22, Pages: 5
              Categories
              Original Paper

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