Parathyroid hormone and vitamin D3 changes perioperative period of oral and maxillofacial surgery

doi:10.19438/j.cjoms.2017.05.010

Abstract

Abstract: PURPOSE: To observe the changes of serum parathyroid hormone (PTH), calcium, phosphate, and vitamin D3 (VitD3) and its receptor (VDR) during perioperative period of oral and maxillofacial surgery and the relationship between these changes and gender, age, operation time, and bleeding. METHODS: From July 2013 to February 2014, we recruited 116 hospitalized patients undergoing oral and maxillofacial surgeries in Shengjing Hospital of China Medical University, from whom 2 mL of fasting venous blood were collected on the second day of admission and the first morning after surgery. Patients' serum VitD3 and VDR concentrations were determined by ELISA; concentrations of Ca²⁺, P3-, and PTH were obtained from clinical data. SAS 9.2 software package was used for independent samples t test and Spearman correlation analysis. RESULTS: PTH value was significantly increased after surgery, and the difference of PTH index between patients with different gender and different diseases were statistically significant. Ca²⁺, VitD3, and VDR values were significantly decreased postoperatively. The longer the surgery time, the higher the PTH value; the lower the Ca²⁺ value, the more bleeding, the higher the PTH value, the lower the Ca²⁺ value and the more significant was the VDR decrease. There was no significant difference in the change of PTH index between different genders. There was no correlation between the change of serum phosphate and surgery time or blood loss. CONCLUSIONS: The changes in PTH, VitD3, and Ca²⁺ concentrations in patients undergoing oral and maxillofacial surgery were related to gender, disease, length of surgery, and amount of intraoperative blood loss.

Key words: Parathyroid hormone, Ca²⁺, P^3-, Vitamin D3, Oral and maxillofacial surgery

CLC Number:

R782.05

WANG Qiu-xu, WANG Yao, XIAO Bo-yang, LIU Wei-xian.. Parathyroid hormone and vitamin D3 changes perioperative period of oral and maxillofacial surgery[J]. China Journal of Oral and Maxillofacial Surgery, 2017, 15(5): 427-430.

References

[1] Carrillo-López N, Fernández-Martín JL, Cannata-Andía JB. The role of calcium, calcitriol and their receptors in parathyroid regulation [J]. Nefrologia, 2009, 29(2): 103-108.
[2] Krishnan AV, Trump DL, Johnson CS, et al. The role of vitamin D in cancer prevention and treatment [J]. Rheu Dis Clin North Am, 2012, 38(1): 161-178.
[3] Bemardi RJ, Johnson CS, Modzelewski RA, et al. Antiproliferative effects of 1 alpha, 25-dihydroxyvitamin D(3) and vitamin D analogs on tumor-derived endothelial cells [J]. Endocrinology, 2002, 143 (7): 2508-2514.
[4] Ramagopalan SV, Heger A, Berlanga AJ, et al. A ChIP-seq defined genome-wide map of vitamin D receptor binding: associations with disease and evolution [J]. Genome Res, 2010, 20(10):1352-1360.
[5] Heaney RP, Horst RL, Cullen DM, et al. Vitamin D3 distribution and status in the body[J]. J Am Coll Nutr, 2009, 28(3): 252-256.
[6] Muldowney S, Lucey AJ, Paschos G, et al. Relationships between vitamin D status and cardio-metabolic risk factors in young European adults [J]. Ann Nutr Metab, 2011, 58(2): 85-93.
[7] SU L, Zhao XJ, Cao LC, et al. Significance of low serum vitamin D for infection risk, disease severity and mortality in critically ill patients [J]. Chin Med J, 2013, 126(14): 2725-2730.
[8] Almqvist EG, Bondeson AG, Bondeson L, et al. Cardiac dysfunction in mild primary hyperparathyroidism assessed by radionuclide angiography and echocardiography before and after parathyroidectomy [J]. Surgery, 2002, 132(6): 1126-1132.
[9] Pilzl S, Tomaschitzl A, Drechsler C, et al. Parathyroid hormone level is associated with mortality and cardiovascular events in patients undergoing coronary angiography [J]. Eur Heart J, 2010, 31(13): 1591-1598.
[10] Hagstrm E, Hellman P, Larsson TE, et al. Plasma parathyroid hormone and the risk of cardiovascular mortality in the community [J]. Circulation, 2009, 119(21): 2765-2771.
[11] Vestergaard P, Mollerup CL, Frokjaer VG, et al. Cardiovascular events before and after surgery for primary hyperparathyroidism [J]. World J Surg, 2003, 27(2): 216-222.
[12] Toulis KA, Anastasilakis AD, Polyzoa SA, et al. Targeting the osteoblast: approved and experimental anabolic agents for the treatment of osteoporosis [J]. Hormones (Athens), 2011, 10 (3): 174-195.
[13] Onyia JE, Helvering LM, Gelbert L, et al. Molecular profile of catabolic versus anabolic treatment regimens of parathyroid hormone (PTH) in rat bone: an analysis by DNA microarray [J]. J Cell Biochem, 2005, 95(2): 403-418.
[14] Li X, Liu H, Qin L, et al. Determination of dual effects of parathyroid hormone on skeletal gene expression in vivo by microarray and network analysis [J]. J Biol Chem, 2007, 282(45): 33086-33097.
[15] Jilka RL, O`brien CA, Ali AA, et al. Intermittent PTH stimulates periosteal bone formation by actions on post-mitotic preosteoblasts [J]. Bone, 2009, 44(2): 275-286.
[16] Augustine M, Horwitz MJ. Parathyroid hormone and parathyroid hormone-related protein analogs as therapies for osteoporosis [J]. Curr Osteoporos Rep, 2013, 11(4): 400-406.
[17] Tam CS, Heersche JN, Murray TM, et al. Parathyroid hormone stimulates the bone apposition rate independently of its resorptive action: differential effects of intermittent and continuous administration [J]. Endocrinology, 1982, 110(2): 506-512.
[18] Datta NS, Abou-Samra AB. PTH and PTHrP signaling in osteoblasts [J]. Cell Signal, 2009, 21(8): 1245-1254.
[19] Ishizuya T. Effects of parathyroid hormone on bone metabolism: differences between intermittent and continuous[J]. Clin Calcium, 2012, 22(3): 357-363.
[20] Jilka RL. Molecular and cellular mechanisms of the anabolic effect of intermittent PTH [J]. Bone, 2007, 40(6): 1434-1446.
[21] Cosman F, Nieves J, Zion M, et al. Daily and cyclic parathyroid hormone in women receiving alendronate [J]. New Engl J Med, 2005, 353(6): 566-575．
[22] Hodsman AB, Bauer DC, Dempster DW, et al. Parathyroid hormone and teriparatide for the treatment of osteoporosis: a review of the evidence and suggested guidelines for its use [J]. Endocr Revi, 2005, 26(5): 688-703.