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      Effects of Parathyroid Hormone and 1,25(OH 2)D 3 on Protein Glycation in Moderate Uraemia

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          Glucose intolerance in uraemia may be a consequence of secondary hyperparathyroidism. In this study fructosamine and glycated albumin have been used as markers of long-term glycaemic control in a group of pre-end-stage, non-diabetic uraemic patients with secondary hyperparathyroidism. The serum fructosamine level (μmol/l00 g total protein) was significantly higher (p = 0.005) in uraemic patients (364 ± 42) than in a group of 25 non-uraemic controls (332 ± 27), but the content of glycated albumin did not differ (p > 0.05; 1.6 ± 0.5 vs. 1.5 ± 0.3%). In the uraemic patients, there was a significant relationship between serum 1,25-dihydroxycholecalciferol [1,25(OH<sub>2</sub>)D] (median 4.2, range 1.0-38 ng/l) and fructosamine (r = -0.66, p < 0.01; fructosamine = -2.76 1,25(OH<sub>2</sub>)D + 389), but not glycated albumin (r = -0.22, p > 0.1). No relationship existed between serum parathyroid hormone (median 15.4, range 7.0-55 pmol/l) and either glycated albumin or fructosamine (p > 0.1). In patients treated with oral calcitriol (0.25 μg/day), significant reductions in serum parathyroid hormone after both 4 (p = 0.03) and 8 weeks (p = 0.02) and concomitant increases in serum 1,25(OH<sub>2</sub>)D (p < 0.02) after 8 weeks of treatment were not accompanied by any change in fructosamine, glycated albumin, total calcium, or ionized calcium (p > 0.05). Elevation of serum fructosamine in these patients is consistent with the impaired glucose tolerance of uraemia. The evidence presented supports a relationship between long-term glycaemic control and 1,25(OH<sub>2</sub>)D<sub>3</sub>, but not parathyroid hormone, in moderately uraemic patients with secondary hyperparathyroidism; however, serum fructosamine was not altered by treatment with calcitriol over an 8-week period.

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          Author and article information

          S. Karger AG
          24 December 2008
          : 74
          : 2
          : 295-300
          Departments of aChemical Pathology and bNephrology, St. Bartholomew’s Hospital, London, cDepartment of Chemical Pathology, Homerton Hospital, London, dDepartment of Medical Biochemistry, University of Wales College of Medicine, Cardiff, UK
          189324 Nephron 1996;74:295-300
          © 1996 S. Karger AG, Basel

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          Pages: 6
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