Calcium-regulating hormones and parathyroid hormone-related peptide in normal human pregnancy and postpartum: a longitudinal study

1997 ◽  
pp. 402-409 ◽  
Author(s):  
MS Ardawi ◽  
HA Nasrat ◽  
HS BA'Aqueel
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Parathyroid Hormone ◽  
Longitudinal Study ◽  
First Trimester ◽  
Second Trimester ◽  
Human Pregnancy ◽  
Pregnancy And Postpartum ◽  
Normal Human ◽  
Parathyroid Hormone Related Peptide

OBJECTIVES: To evaluate calcium-regulating hormones and parathyroid hormone-related peptide (PTHrP) in normal human pregnancy and postpartum in women not deficient in vitamin D. DESIGN: A prospective longitudinal study was conducted in pregnant Saudi women during the course of pregnancy (n = 40), at term and 6 weeks postpartum (n = 18). Maternal concentrations of serum calcidiol and calcitriol were determined, together with those of serum intact-parathyroid hormone (PTH), PTHrP, calcitonin, osteocalcin, human placental lactogen (hPL), prolactin, vitamin D binding protein, alkaline phosphatase, calcium, phosphate and magnesium. A group of non-pregnant women (n = 280) were included for comparative purposes. RESULTS: The calcidiol concentrations decreased (mean +/- S.D.) significantly from 54 +/- 10 nmol/l in the first trimester to 33 +/- 8 nmol/l in the third trimester (P < 0.001) and remained decreased at term and postpartum (both P < 0.001). The calcitriol concentration increased through pregnancy, from 69 +/- 17 pmol/l in the first trimester to 333 +/- 83 pmol/l at term (P < 0.001). Intact-PTH concentrations increased from 1.31 +/- 0.25 pmol/l in the first trimester to 2.26 +/- 0.39 pmol/l in the second trimester, but then declined to values of the first trimester and increased significantly postpartum (4.02 +/- 0.36 pmol/l) (P < 0.001). PTHrP concentration increased through pregnancy from 0.81 +/- 0.12 pmol/l in the first trimester to 2.01 +/- 0.22 pmol/l at term and continued its increase postpartum (2.63 +/- 0.15 pmol/l) (P < 0.001). Significant positive correlations were evident between PTHrP and alkaline phosphatase up to term (r = 0.051, P < 0.001) and between PTHrP and calcitriol (r = 0.46, P < 0.001), osteocalcin (r = 0.23, P < 0.05) and prolactin (r = 0.41, P < 0.05) during pregnancy. Osteocalcin started to increase from 0.13 +/- 0.01 nmol/l in the second trimester, through pregnancy and postpartum (P < 0.001). Calcitonin was increased more than twofold by the second trimester compared with the first trimester (P < 0.001) and subsequently decreased (P < 0.001). Prolactin concentrations were significantly greater in the second (6724 +/- 1459 pmol/l) and third (8394 +/- 2086 pmol/l) trimesters compared with values before pregnancy (P < 0.001). hPL, increased throughout the course of pregnancy, reaching a maximum at term (7.61 +/- 2.57 microIU/ml). There was no direct correlation between serum calcitriol concentrations during pregnancy and serum prolactin (r = -0.12, P < 0.19) or serum hPL (r = 0.17, P < 0.21). Significant changes were observed in the serum concentrations of calcium and phosphate, but not in that of magnesium, during the course of pregnancy; calcium concentrations showed a maximal decrease at term. CONCLUSIONS: Changes in serum PTHrP during the course of pregnancy, at term and postpartum have been demonstrated, suggesting that the placenta (during pregnancy) and mammary glands (postpartum) are the main sources of PTHrP. No support for the concept of 'physiological hyperparathyroidism' of pregnancy could be demonstrated in the present work. The pregnancy-induced increase in calcitriol concentration may thus be the primary mediator of the changes in maternal calcium metabolism, but the involvement of other factors cannot be excluded.

Changes in calciotrophic hormones and biochemical markers of bone turnover in normal human pregnancy

1994 ◽  
Vol 131 (4) ◽  
pp. 369-374 ◽  
Author(s):  
Stephen J Gallacher ◽  
William D Fraser ◽  
Owen J Owens ◽  
Frances J Dryburgh ◽  
Fraser C Logue ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Parathyroid Hormone ◽  
Bone Turnover ◽  
Biochemical Markers ◽  
Plasma Concentrations ◽  
First Trimester ◽  
Creatinine Ratio ◽  
Human Pregnancy ◽  
Markers Of Bone Turnover ◽  
Normal Human

Gallacher SJ, Fraser WD, Owens OJ, Dryburgh FJ, Logue FC, Jenkins A, Kennedy J, Boyle IT. Changes in calciotrophic hormones and biochemical markers of bone turnover in normal human pregnancy. Eur J Endocrinol 1994;131:369–74. ISSN 0804–4643 Plasma concentrations of parathyroid hormone-related protein (PTHrP), parathyroid hormone, alkaline phosphatase, osteocalcin and albumin-adjusted calcium were measured along with nephrogenous cyclic adenosine monophosphate (NcAMP) in 10 normal women longitudinally through pregnancy. In addition, an assessment of bone resorption was made in these same subjects by the measurement in true fasting urine specimens of the calcium/creatinine ratio (Ca/Cr), hydroxyproline/ creatinine ratio (HP/Cr), pyridinoline/creatinine ratio (Pyr/Cr) and deoxypyridinoline/creatinine ratio (Dpyr/Cr). The PTHrP level rose through pregnancy from (mean±sem) 0.8 ± 0.2 pmol/l in the first trimester to 2.7 ± 0.2 pmol/l 6 weeks postpartum (p < 0.0001). Serum alkaline phosphatase rose from 94 ± 8 U/l (first trimester) to 347 ± 25 U/l at term (p < 0.0001). A significant positive correlation was evident between PTHrP and alkaline phosphatase up to term (r = 0.44, p < 0.005). Parathyroid hormone concentrations remained unchanged during pregnancy but rose significantly postpartum from 1.8 ± 0.2 pmol/l (first trimester) to 3.1 ± 0.5 pmol/l (p < 0.0001). Similarly, osteocalcin, a marker of bone formative activity, remained unchanged through pregnancy but rose significantly at 6 weeks after delivery to 0.38 ± 0.05 nmol/l from 0.19 ± 0.03 nmol/l (first trimester) (p = 0.019). No significant change was noted in serum-adjusted calcium or NcAMP, either through pregnancy or at the postpartum assessment. Fasting urinary Ca/Cr fell through pregnancy from 0.70 ± 0.11 (first trimester) to a nadir of 0.19 ± 0.04 6 weeks postpartum (p = 0.007). Fasting urinary HP/Cr rose from 0.026 ± 0.003 (first trimester) to a peak of 0.049 ± 0.012 (third trimester), thereafter falling to 0.024 ± 0.002 6 weeks after delivery. Fasting urinary Pyr/Cr rose from 30.5 ± 1.7 (first trimester) to a peak of 58.3 ± 6.6 (term) (p = 0.009); Dpyr/Cr also increased through pregnancy from 9.9 ± 1.3 (first trimester) to 16.1 ± 1.7 (term) (p = 0.01). Previous studies have suggested that the placenta (during pregnancy) and breast milk (postpartum) are the main sources of PTHrP in pregnancy. This study illustrates that changes in plasma concentrations of PTHrP also can be demonstrated— although whether or not circulating PTHrP has a specific endocrine function is not clear. SJ Gallacher, University Department of Medicine, Queen Elizabeth Building, Glasgow Royal Infirmary, 10 Alexandra Parade, Glasgow G31 2ER, UK

scholarly journals Thecomparisonofserumbiomarkersin patients with osteoarthritisand rheumatoidarthritis

2018 ◽  
Vol 6 (2) ◽  
pp. 1-11
Author(s):  
Almandlawi S G ◽  
Ahmed A S
Keyword(s):  
Rheumatoid Arthritis ◽  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Parathyroid Hormone ◽  
Calcium Phosphate ◽  
Serum Vitamin ◽  
Type Ii Collagen ◽  
Healthy Controls ◽  
Type Ii ◽  
Serum Vitamin D

Introduction: This study aims to assess the status of serum vitamin D, parathyroid hormone, type II collagen, calcium, phosphate,albumin, and alkaline phosphatase in osteoarthritis and rheumatoidarthritis patients and to study their association with rheumatoid arthritis disease activity. Materials and Methods: This prospectivecross-sectional study was conducted at the clinical analysis department, College of Pharmacy, Hawler Medical University in 2017.They study samples were collected at Rizgary Teaching Hospitalduring the period September 2015 to January 2016. A total of(N=156) participants were included: (N=53) patients with rheumatoid arthritis (RA), (N=53) with osteoarthritis (OA), and (N=50)healthy controls. Enzyme Linked Immuno Sorbent Assay kits determined serum vitamin D, parathyroid hormone, and type II collagen; and serum albumin, calcium, phosphate and alkaline phosphatase, were determined by standard colorimetric methods. Resultsand Discussion: Statistically significant higher levels of parathyroid hormone and type II collagen, with lower levels of Vitamin D,were found in the osteoarthritis group than the rheumatoid arthritisgroup and the healthy controls (P=0.007, P<0.001, P= 0.005) respectively. Multiple linear regression showed a statistically significant difference in serum type II collagen as a dependent variable, inpatients suffering from RA or OA compared to the healthy controlgroup; after adjusting for the effect of other independent studyvariables, there was a mean increase of (45.90 nmol/L, P<0.001)in RA patients, and OA patients showed greater levels of type IIcollagen (73.950 nmol/L) than the health control group (P<0.001).Conclusions: Elevated type II collagen levels, in conjunction witha low vitamin D status, may be strong discriminator between osteoarthritis and rheumatoid arthritis patients.

Expression of parathyroid hormone-related peptide (PTHrP) and PTH/PTHrP receptor in newborn human calvaria osteoblastic cells

1997 ◽  
Vol 136 (6) ◽  
pp. 640-648 ◽  
Author(s):  
Abderrahim Lomri ◽  
Cindy de Pollak ◽  
Michael Sebag ◽  
David Goltzman ◽  
Richard Kremer ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Parathyroid Hormone ◽  
Culture Media ◽  
Receptor Expression ◽  
Osteoblastic Cells ◽  
Pcr Analysis ◽  
Intracellular Camp ◽  
Related Peptide ◽  
Parathyroid Hormone Related Peptide ◽  
Pthrp Receptor

Abstract We examined the expression of parathyroid hormone-related peptide (PTHrP) and its receptor in normal newborn human calvaria osteoblastic (NHCO) cells. Northern blot analysis showed that NHCO cells express a single 1·6 kb transcript of PTHrP, which was increased within 1 h (2x) and peaked at 6 h (7x) after serum treatment. In the culture media, the release of PTHrP peptide was maximally increased (4x) 24 h after the addition of serum, as determined by immunoradiometric assay. NHCO cells exhibited a cytoplasmic immunostaining for PTHrP in the presence of serum, and most PTHrP-positive cells were alkaline phosphatase-negative, suggesting that PTHrP was expressed in undifferentiated cells. Furthermore, RT-PCR analysis showed that both PTHrP and PTH/PTHrP receptor were expressed in NHCO cells in basal conditions or after stimulation with serum. The maximal PTHrP expression induced by serum suppressed PTH/PTHrP receptor expression, suggesting that PTHrP down-regulated its receptor in NHCO cells. Treatment with 10 nm human PTH(1–34—which binds to PTH/PTHrP receptors, increased intracellular cAMP levels and alkaline phosphatase activity, and decreased cell growth, indicating that ligand binding to PTH/PTHrP receptors regulates NHCO cell proliferation and differentiation. The expression and synthesis of PTHrP and the presence of functional PTH/PTHrP receptors suggest a possible paracrine mechanism of action of PTHrP in normal human calvaria osteoblastic cells. European Journal of Endocrinology 136 640–648

scholarly journals Vitamin D status in pregnant Indian women across trimesters and different seasons and its correlation with neonatal serum 25-hydroxyvitamin D levels

2011 ◽  
Vol 106 (9) ◽  
pp. 1383-1389 ◽  
Author(s):  
R. K. Marwaha ◽  
N. Tandon ◽  
S. Chopra ◽  
N. Agarwal ◽  
M. K. Garg ◽  
...  
Keyword(s):  
Vitamin D ◽  
Hypovitaminosis D ◽  
First Trimester ◽  
Strong Positive Correlation ◽  
Vitamin D Status ◽  
Second Trimester ◽  
Third Trimester ◽  
Indian Women ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

The present cross-sectional study was conducted to determine the vitamin D status of pregnant Indian women and their breast-fed infants. Subjects were recruited from the Department of Obstetrics, Armed Forces Clinic and Army Hospital (Research and Referral), Delhi. A total of 541 apparently healthy women with uncomplicated, single, intra-uterine gestation reporting in any trimester were consecutively recruited. Of these 541 women, 299 (first trimester, ninety-seven; second trimester, 125; third trimester, seventy-seven) were recruited in summer (April–October) and 242 (first trimester, fifty-nine, second trimester, ninety-three; third trimester, ninety) were recruited in winter (November–March) to study seasonal variations in vitamin D status. Clinical, dietary, biochemical and hormonal evaluations for the Ca–vitamin D–parathormone axis were performed. A subset of 342 mother–infant pairs was re-evaluated 6 weeks postpartum. Mean serum 25-hydroxyvitamin D (25(OH)D) of pregnant women was 23·2 (sd 12·2) nmol/l. Hypovitaminosis D (25(OH)D < 50 nmol/l) was observed in 96·3 % of the subjects. Serum 25(OH)D levels were significantly lower in winter in the second and third trimesters, while serum intact parathormone (iPTH) and alkaline phosphatase levels were significantly higher in winter in all three trimesters. A significant negative correlation was found between serum 25(OH)D and iPTH in mothers (r − 0·367, P = 0·0001) and infants (r − 0·56, P = 0·0001). A strong positive correlation was observed between 25(OH)D levels of mother–infant pairs (r 0·779, P = 0·0001). A high prevalence of hypovitaminosis D was observed in pregnancy, lactation and infancy with no significant inter-trimester differences in serum 25(OH)D levels.

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