Circulating ionized calcium and parathyroid hormone levels following coronary artery by-pass surgery
| Autor: | F Carlstedt, Sverker Ljunghall, J. Rastad, PO Joachimsson, Lars Lind, L. Wide |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Calcitonin
Male medicine.medical_specialty Calcitonin Gene-Related Peptide Clinical Biochemistry Parathyroid hormone chemistry.chemical_element Calcium Biological fluid Internal medicine Humans Medicine Magnesium Derivation Coronary Artery Bypass Protein Precursors Aged Calcium metabolism business.industry General Medicine Middle Aged Surgery Endocrinology medicine.anatomical_structure chemistry Parathyroid Hormone Cytokines Female business hormones hormone substitutes and hormone antagonists Artery |
| Zdroj: | Scandinavian Journal of Clinical and Laboratory Investigation. 59:47-53 |
| ISSN: | 1502-7686 0036-5513 |
| Popis: | In critically ill patients, hypocalcaemia is a common finding. Also variable derangements in the normally tight Ca2+-mediated control of the parathyroid hormone (PTH) secretion have been found. Utilizing coronary artery by-pass grafting (CABG) as a standardized model of severe trauma, 18 patients underwent determinations of blood levels of calcium, magnesium (Mg), ionized calcium (Ca2+), serum levels of intact PTH, procalcitonin (PCT) and the proinflammatory cytokines tumour necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6). Samples were collected before, directly after, the morning after and 5 days after surgery. A significant, but minor, decrease in blood Ca2+ levels (mean 0.04 mmol/L, p0.05) was seen shortly after CABG, not accompanied by any significant change of serum PTH levels. This alteration of the Ca2+ control of the steady-state PTH levels contrasted with the maintenance of the PTH secretory response to a sequential citrate and calcium infusion (CiCa clamp), which was normal in two patients evaluated in the morning following surgery. Serum Mg levels were transiently increased after operation (+0.25 mmol/L, p0.001) and correlated to the TNF-alpha (r=0.62, p0.01) and PCT (r=0.67, p0.006) levels in the morning after surgery. Serum levels of IL-6 and TNF-alpha were significantly (p0.0001) increased immediately after surgery, while the peak in serum PCT levels (p0.001) occurred in the morning after CABG. Serum PTH levels correlated positively with IL-6 (r=0.68, p0.008) 5 days after surgery. In conclusion, CABG caused a decrease in ionized calcium levels without a rise in steady-state PTH levels, but rapid changes in Ca2+ during CiCa clamping revealed a normal PTH secretory response. These findings might relate to elevated serum Mg levels, while a direct action of TNF-alpha or IL-6 on the PTH release seem less possible. |
| Databáze: | OpenAIRE |
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