Yıl: 2016 Cilt: 33 Sayı: 4 Sayfa Aralığı: 293 - 298 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss

Öz:
Amaç: Koagülasyon ve fibrinoliz bozuklukları primer hiperparatiroidili hastalarda rapor edilmekle beraber bu hasta grubunda trombosit işlevlerine ilişkin yeterli veri yoktur. Bu nedenle primer ve sekonder hiperparatiroidisi olan hastalarda ve sağlıklı kontrol grubunda trombosit fonksiyonlarını değerlendirmeyi ve gruplar arasında farkı karşılaştırmayı amaçladık. Gereç ve Yöntemler: Çalışmamıza 25 primer hiperparatiroidisi (PHPT) olan hasta, 25 sekonder hiperparatiroidisi (SHPT) olan hasta ve 25 kontrol grubu dahil edildi. Trombosit fonksiyonları trombositten zengin plazma ve epinefrin, adenozin difosfat (ADP), kollajen ve ristosetinle trombosit agregasyon testleri yapılarak değerlendirildi. Trombosit aktivasyon düzeyini gösteren serum P selektin düzeyleri tüm hastalarda ölçüldü. Kemik mineral dansitometresi tüm hastalarda değerlendirildi. Bulgular: PHPT ve SHPT'li hastalar ve kontrol grubunun trombosit fonksiyon testleri ve serum P selektin düzeyleri arasında istatistiksel açıdan anlamlı bir fark saptanmadı. Parathormon düzeyi ile agregasyon parametreleri (ristosetin, epinefrin, kollajen, ve ADP: sırasıyla p=0,446, 0,537, 0,346 ve 0,302) ve P selektin (p=0,516) düzeyi arasında da anlamlı bir korelasyon saptanmadı. Hastalar kalsiyum düzeylerine göre hiperkalsemik ve normokalsemik olarak ayrıldıklarında da agregasyon parametreleri ve P selektin düzeyleri arasında anlamlı fark saptanmadı. Hasta gruplarımızda trombosit fonksiyonları, P selektin düzeyi, serum kalsiyum düzeyileri arasında istatistiksel açıdan anlamlı fark bulunmadı. Kemik kaybı PHPT'li olan grupta daha belirgindi.Sonuç: Agregasyon testleri ile değerlendirildiğinde PHPT veya SHPT ve serum kalsiyum düzeylerinin trombosit fonksiyonları üzerine belirgin etkisi yoktur
Anahtar Kelime:

Konular: Hematoloji

Hiperparatiroidi Durumun Trombosit Fonksiyonları ve Kemik Kaybı Üzerine Olan Etkisi

Öz:
Objective: Coagulation and fibrinolysis defects were reported in primary hyperparathyroid patients. However, there are not enough data regarding platelet functions in this group of patients. Our aim was to evaluate the platelet functions in primary and secondary hyperparathyroid patients and to compare them with healthy subjects. Materials and Methods: In our study 25 subjects with primary hyperparathyroidism (PHPT), 25 subjects with secondary hyperparathyroidism (SHPT), and 25 healthy controls were included. Platelet functions of the subjects were evaluated by using plateletrich plasma and platelet aggregation tests induced with epinephrine, adenosine diphosphate (ADP), collagen, and ristocetin. Serum P selectin levels, which indicate platelet activation level, were measured in all subjects. Bone mineral densitometry was performed for all patients. Results: There was no significant difference between the groups with PHPT and SHPT and the control group regarding the platelet aggregation tests and serum P selectin levels. There was also no significant correlation between parathormone levels and aggregation parameters (ristocetin, epinephrine, collagen, and ADP: respectively p=0.446, 0.537, 0.346, and 0.302) and between P selectin (p=0.516) levels. When we separated the patients according to serum calcium levels, there was also no significant difference between aggregation parameters and serum P selectin levels between the patients with hypercalcemia and the patients with normocalcemia. We could not find any significant correlation between aggregation parameters, P selectin levels, and serum calcium levels in this group of patients. Bone loss was greater in patients with PHPT. Conclusion: There is no significant effect of PHPT or SHPT and serum calcium levels on platelet functions when evaluated by aggregation tests.
Anahtar Kelime:

Konular: Hematoloji
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • Shebuski RJ, Kilgore KS. Role of inflammatory mediators in thrombogenesis. J Pharmacol Exp Ther 2002;300:729-735.
  • Hayward CP, Pai M, Liu Y, Moffat KA, Seecharan J, Webert KE, Cook RJ, Heddle NM. Diagnostic utility of light transmission platelet aggregometry: results from a prospective study of individuals referred for bleeding disorder assessments. J Thromb Haemost 2009;7:676-684.
  • Rand ML, Leung R, Packham MA. Platelet function assays. Transfus Apher Sci 2003;28:307-317.
  • Zucker MB, Nachmias VT. Platelet activation. Arteriosclerosis 1985;5:2-18.
  • Hedback G, Tisell LE, Bengtsson BA, Hedman I, Oden A. Premature death in patients operated on for PHPT. World J Surg 1990;14:829-835.
  • Hedback G, Oden A. Increased risk of death from primary hyperparathyroidism: an update. Eur J Clin Invest 1998;28:271-276.
  • Stefenelli T, Mayr H, Berger-Klein J, Globits S, Wolosczcuk W, Niederle B. Primary hyperparathyroidism: incidence of cardiac abnormalities and partial reversibility after successful parathyroidectomy. Am J Med 1993;95:197-202.
  • Erem C, Kocak M, Hacihasanoglu A, Yilmaz M, Saglam F, Ersoz HO. Blood coagulation, fibrinolysis and lipid profile in patients with primary hyperparathyroidism: increased plasma factor VII and X activities and D-dimer levels. Exp Clin Endocrinol Diabetes 2008;116:619-624.
  • Erem C, Kocak M, Nuhoglu I, Yilmaz M, Ucuncu O. Increased plasma activator inhibitor-1, decreased tissue factor pathway inhibitor, and unchanged thrombin-activatable fibrinolysis inhibitor levels in patients with primary hyperparathyroidism. Eur J Endocrinol 2009;160:863-868.
  • Franchello A, Camandona M, Gasparri G. Acute hyperparathyroidism and vascular thrombosis: an unrecognized association. J Endocrinol Invest 2010;33:683.
  • Li ZL, Chen XM, Yang LC, Deng XL, Fu SH, Cai LL, Zhou Y, Chen J, Bai J, Cong YL. Effects of extracellular calcium concentration on platelets aggregation, coagulation indices and thromboelastography. Zhonghua Yi Xue Za Zhi 2010;90:1547-1550.
  • Anderson JL, Vanwoerkum R, Horne BD, Bair TL, May HT, Lappe DL, Muhlestein JB. Parathyroid hormone, vitamin D, renal dysfunction, and cardiovascular disease: dependent or independent risk factors? Am Heart J 2011;162:331-339.
  • Han D, Trooskin S, Wang X. Prevalence of cardiovascular risk factors in male and female patients with primary hyperparathyroidism. J Endocrinol Invest 2012;35:548-552.
  • Kiernan TJ, O'Flynn AM, McDermott JH, Kearney P. Primary hyperparathyroidism and the cardiovascular system. Int J Cardiol 2006;113:E89-92.
  • Walker MD, Fleischer J, Rundek T, McMahon DJ, Homma S, Sacco R, Silverberg SJ. Carotid vascular abnormalities in primary hyperparathyroidism. J Clin Endocrinol Metab 2009;94:3849-3856.
  • Smallman LA. Renal vein thrombosis complicating primary hyperparathyroidism. Postgrad Med J 1982;58:441-442.
  • Huertas VE, Maletz RM, Weller JM. Dermal necrosis due to thrombosis in severe secondary hyperparathyroidism. Arch Intern Med 1976;136:712-716.
  • Remuzzi G, Benigni A, Dodesini P, Schieppati A, Livio M, Poletti E, Mecca G, de Gaetano G. Parathyroid hormone inhibits human platelet function. Lancet 1981;12:1321-1323.
  • Leithner C, Kovarik J, Sinzinger H, Woloszcuk W. Parathyroid hormone does not inhibit platelet aggregation. Lancet 1984;18:367-368.
  • Chertok-Shacham E, Ishay A, Lavi I, Luboshitzky R. Biomarkers of hypercoagulability and inflammation in primary hyperparathyroidism. Med Sci Monit 2008;14:628-632.
  • Sitges-Serra A, García L, Prieto R, Peña MJ, Nogués X, Sancho JJ. Effect of parathyroidectomy for primary hyperparathyroidism on bone mineral density in postmenopausal women. Br J Surg 2010;97:1013-1019.
  • Yilmaz H. Assessment of mean platelet volume (MPV) in primary hyperparathyroidism: effects of successful parathyroidectomy on MPV levels. Endocr Regul 2014;48:182-188.
APA YORULMAZ G, AKALIN A, AKAY O, ŞAHİN G, BAL C (2016). The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss. , 293 - 298.
Chicago YORULMAZ Göknur,AKALIN AYSEN,AKAY Olga Meltem,ŞAHİN Garip,BAL CENGIZ The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss. (2016): 293 - 298.
MLA YORULMAZ Göknur,AKALIN AYSEN,AKAY Olga Meltem,ŞAHİN Garip,BAL CENGIZ The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss. , 2016, ss.293 - 298.
AMA YORULMAZ G,AKALIN A,AKAY O,ŞAHİN G,BAL C The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss. . 2016; 293 - 298.
Vancouver YORULMAZ G,AKALIN A,AKAY O,ŞAHİN G,BAL C The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss. . 2016; 293 - 298.
IEEE YORULMAZ G,AKALIN A,AKAY O,ŞAHİN G,BAL C "The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss." , ss.293 - 298, 2016.
ISNAD YORULMAZ, Göknur vd. "The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss". (2016), 293-298.
APA YORULMAZ G, AKALIN A, AKAY O, ŞAHİN G, BAL C (2016). The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss. Turkish Journal of Hematology, 33(4), 293 - 298.
Chicago YORULMAZ Göknur,AKALIN AYSEN,AKAY Olga Meltem,ŞAHİN Garip,BAL CENGIZ The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss. Turkish Journal of Hematology 33, no.4 (2016): 293 - 298.
MLA YORULMAZ Göknur,AKALIN AYSEN,AKAY Olga Meltem,ŞAHİN Garip,BAL CENGIZ The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss. Turkish Journal of Hematology, vol.33, no.4, 2016, ss.293 - 298.
AMA YORULMAZ G,AKALIN A,AKAY O,ŞAHİN G,BAL C The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss. Turkish Journal of Hematology. 2016; 33(4): 293 - 298.
Vancouver YORULMAZ G,AKALIN A,AKAY O,ŞAHİN G,BAL C The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss. Turkish Journal of Hematology. 2016; 33(4): 293 - 298.
IEEE YORULMAZ G,AKALIN A,AKAY O,ŞAHİN G,BAL C "The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss." Turkish Journal of Hematology, 33, ss.293 - 298, 2016.
ISNAD YORULMAZ, Göknur vd. "The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss". Turkish Journal of Hematology 33/4 (2016), 293-298.