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Primary Aldosteronism and Bone Metabolism: A Systematic Review and Meta-Analysis
BACKGROUND: Currently, increasing evidence shows that excess aldosterone may have an impact on bone health, and primary aldosteronism (PA) may be a secondary cause of osteoporosis. This problem is worthy of attention because secondary osteoporosis is always potentially reversible, which affects the...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7546890/ https://www.ncbi.nlm.nih.gov/pubmed/33101208 http://dx.doi.org/10.3389/fendo.2020.574151 |
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author | Shi, Shaomin Lu, Chunyan Tian, Haoming Ren, Yan Chen, Tao |
author_facet | Shi, Shaomin Lu, Chunyan Tian, Haoming Ren, Yan Chen, Tao |
author_sort | Shi, Shaomin |
collection | PubMed |
description | BACKGROUND: Currently, increasing evidence shows that excess aldosterone may have an impact on bone health, and primary aldosteronism (PA) may be a secondary cause of osteoporosis. This problem is worthy of attention because secondary osteoporosis is always potentially reversible, which affects the selection of treatment for PA to some extent. The present systematic review will assess and summarize the available data regarding the relationship between PA and osteoporosis. METHODS: Pubmed and Embase were searched for clinical trials related to the association between PA and bone metabolism. The results were limited to full-text articles published in English, without restrictions for the publication time. The quality of clinical trials was appraised, and the data were extracted. Biochemical parameters of bone turnover in PA patients were assessed using random-effect meta-analysis. Descriptive analysis was performed for other parameters, for data is insufficient. RESULTS: A final total of 15 articles were included in this review. The meta-analysis of six studies showed that subjects with PA had higher serum PTH levels (MD=21.50 pg/ml, 95% CI (15.63, 27.37), P<0.00001) and slightly increased urinary calcium levels (MD = 1.65 mmol/24 h, 95% CI (1.24, 2.06), P < 0.00001) than the EH controls. PA is associated with an increased risk of bone fracture. Bone loss in patients with PA may be reversed by MR antagonists or adrenal surgery. CONCLUSIONS: PA may be a secondary cause of osteoporosis and is associated with an increased risk of bone fracture. The clarification of the relationships between PA and bone metabolism requires additional prospective randomized controlled studies in a large sample. |
format | Online Article Text |
id | pubmed-7546890 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-75468902020-10-22 Primary Aldosteronism and Bone Metabolism: A Systematic Review and Meta-Analysis Shi, Shaomin Lu, Chunyan Tian, Haoming Ren, Yan Chen, Tao Front Endocrinol (Lausanne) Endocrinology BACKGROUND: Currently, increasing evidence shows that excess aldosterone may have an impact on bone health, and primary aldosteronism (PA) may be a secondary cause of osteoporosis. This problem is worthy of attention because secondary osteoporosis is always potentially reversible, which affects the selection of treatment for PA to some extent. The present systematic review will assess and summarize the available data regarding the relationship between PA and osteoporosis. METHODS: Pubmed and Embase were searched for clinical trials related to the association between PA and bone metabolism. The results were limited to full-text articles published in English, without restrictions for the publication time. The quality of clinical trials was appraised, and the data were extracted. Biochemical parameters of bone turnover in PA patients were assessed using random-effect meta-analysis. Descriptive analysis was performed for other parameters, for data is insufficient. RESULTS: A final total of 15 articles were included in this review. The meta-analysis of six studies showed that subjects with PA had higher serum PTH levels (MD=21.50 pg/ml, 95% CI (15.63, 27.37), P<0.00001) and slightly increased urinary calcium levels (MD = 1.65 mmol/24 h, 95% CI (1.24, 2.06), P < 0.00001) than the EH controls. PA is associated with an increased risk of bone fracture. Bone loss in patients with PA may be reversed by MR antagonists or adrenal surgery. CONCLUSIONS: PA may be a secondary cause of osteoporosis and is associated with an increased risk of bone fracture. The clarification of the relationships between PA and bone metabolism requires additional prospective randomized controlled studies in a large sample. Frontiers Media S.A. 2020-09-25 /pmc/articles/PMC7546890/ /pubmed/33101208 http://dx.doi.org/10.3389/fendo.2020.574151 Text en Copyright © 2020 Shi, Lu, Tian, Ren and Chen http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Shi, Shaomin Lu, Chunyan Tian, Haoming Ren, Yan Chen, Tao Primary Aldosteronism and Bone Metabolism: A Systematic Review and Meta-Analysis |
title | Primary Aldosteronism and Bone Metabolism: A Systematic Review and Meta-Analysis |
title_full | Primary Aldosteronism and Bone Metabolism: A Systematic Review and Meta-Analysis |
title_fullStr | Primary Aldosteronism and Bone Metabolism: A Systematic Review and Meta-Analysis |
title_full_unstemmed | Primary Aldosteronism and Bone Metabolism: A Systematic Review and Meta-Analysis |
title_short | Primary Aldosteronism and Bone Metabolism: A Systematic Review and Meta-Analysis |
title_sort | primary aldosteronism and bone metabolism: a systematic review and meta-analysis |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7546890/ https://www.ncbi.nlm.nih.gov/pubmed/33101208 http://dx.doi.org/10.3389/fendo.2020.574151 |
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