Plasma metabolite biomarkers related to secondary hyperparathyroidism and parathyroid hormone

J Cell Biochem. 2019 Sep;120(9):15766-15775. doi: 10.1002/jcb.28846. Epub 2019 May 8.

Abstract

Background: Hyperphosphatemia, hypocalcemia, and elevation of parathyroid hormone (PTH) are typical abnormalities of uremic patients with Secondary hyperparathyroidism (SHPT). However, metabolic imbalance associated with SHPT is not well understood.

Methods: A total of 15 SHPT patients with an intact parathyroid hormone (iPTH) level > 600 pg/mL were set as preoperative (PR) group, 15 age- and gender-matched controls who had undergone parathyroidectomy plus forearm transplantation because of hyperparathyroidism and achieved an iPTH level <150 pg/mL were set as postoperative (PO) group. Metabolite profiling of these 30 uremic patients and five healthy controls (HC) was performed using ultra performance liquid chromatography-mass spectrometry.

Results: Five differential metabolites, including allyl isothiocyanate, L-phenylalanine, D-Aspartic acid, indoleacetaldehyde, and D-galactose correlated with PTH were identified in this study. Taking them as a biomarker signature, PR group can be distinguished from HC group with an area under the curve (AUC) of 0.947 (95% CI, 0.76-1) and PO group with an AUC of 0.6 (95% CI, 0.38-0.807).

Conclusions: The serum metabolome correlated with PTH is successfully demonstrated for a better understanding of the pathogenesis of SHPT.

Keywords: end-stage renal disease; long-term dialysis; metabolites; parathyroid hormone; secondary hyperparathyroidism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Area Under Curve
  • Biomarkers / blood*
  • Chromatography, High Pressure Liquid
  • D-Aspartic Acid / blood
  • Female
  • Galactose / blood
  • Humans
  • Hyperparathyroidism, Secondary / blood*
  • Indoles / blood
  • Isothiocyanates / blood
  • Male
  • Metabolomics / methods*
  • Middle Aged
  • Parathyroid Hormone / blood*
  • Phenylalanine / blood
  • Uremia / blood*

Substances

  • Biomarkers
  • Indoles
  • Isothiocyanates
  • Parathyroid Hormone
  • indole-3-acetaldehyde
  • Phenylalanine
  • D-Aspartic Acid
  • allyl isothiocyanate
  • Galactose