The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss [Turk J Hematol]
Turk J Hematol. 2016; 33(4): 293-298 | DOI: 10.4274/tjh.2015.0087  

The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss

Göknur Yorulmaz1, Aysen Akalın2, Olga Meltem Akay3, Garip Şahin4, Cengiz Bal5
1Eskişehir State Hospital, Clinic of Endocrinology, Eskişehir, Turkey
2Eskişehir Osmangazi University Faculty of Medicine, Department of Endocrinology, Eskişehir, Turkey
3Eskişehir Osmangazi University Faculty of Medicine, Department of Hematology, Eskişehir, Turkey
4Eskişehir Osmangazi University Faculty of Medicine, Department of Nephrology, Eskişehir, Turkey
5Eskişehir Osmangazi University Faculty of Medicine, Department of Biostatistics and Medical Informatics, Eskişehir, Turkey

Objective: Coagulation and fibrinolysis defects were reported in primary hyperparathyroid patients. However, there are not enough data regarding platelet functions in this group of patients. Our aim was to evaluate the platelet functions in primary and secondary hyperparathyroid patients and to compare them with healthy subjects.
Materials and Methods: In our study 25 subjects with primary hyperparathyroidism (PHPT), 25 subjects with secondary hyperparathyroidism (SHPT), and 25 healthy controls were included. Platelet functions of the subjects were evaluated by using plateletrich plasma and platelet aggregation tests induced with epinephrine, adenosine diphosphate (ADP), collagen, and ristocetin. Serum P selectin levels, which indicate platelet activation level, were measured in all subjects. Bone mineral densitometry was performed for all patients.
Results: There was no significant difference between the groups with PHPT and SHPT and the control group regarding the platelet aggregation tests and serum P selectin levels. There was also no significant correlation between parathormone levels and aggregation parameters (ristocetin, epinephrine, collagen, and ADP: respectively p=0.446, 0.537, 0.346, and 0.302) and between P selectin (p=0.516) levels. When we separated the patients according to serum calcium levels, there was also no significant difference between aggregation parameters and serum P selectin levels between the patients with hypercalcemia and the patients with normocalcemia. We could not find any significant correlation between aggregation parameters, P selectin levels, and serum calcium levels in this group of patients. Bone loss was greater in patients with PHPT.
Conclusion: There is no significant effect of PHPT or SHPT and serum calcium levels on platelet functions when evaluated by aggregation tests.

Keywords: Hyperparathyroidism, Platelet function, P selectin, Calcium, Bone loss


Hiperparatiroidi Durumun Trombosit Fonksiyonları ve Kemik Kaybı Üzerine Olan Etkisi

Göknur Yorulmaz1, Aysen Akalın2, Olga Meltem Akay3, Garip Şahin4, Cengiz Bal5
1Eskişehir State Hospital, Clinic of Endocrinology, Eskişehir, Turkey
2Eskişehir Osmangazi University Faculty of Medicine, Department of Endocrinology, Eskişehir, Turkey
3Eskişehir Osmangazi University Faculty of Medicine, Department of Hematology, Eskişehir, Turkey
4Eskişehir Osmangazi University Faculty of Medicine, Department of Nephrology, Eskişehir, Turkey
5Eskişehir Osmangazi University Faculty of Medicine, Department of Biostatistics and Medical Informatics, Eskişehir, Turkey

Amaç: Koagülasyon ve fibrinoliz bozuklukları primer hiperparatiroidili hastalarda rapor edilmekle beraber bu hasta grubunda trombosit işlevlerine ilişkin yeterli veri yoktur. Bu nedenle primer ve sekonder hiperparatiroidisi olan hastalarda ve sağlıklı kontrol grubunda
trombosit fonksiyonlarını değerlendirmeyi ve gruplar arasında farkı karşılaştırmayı amaçladık.
Gereç ve Yöntem: Çalışmamıza 25 primer hiperparatiroidisi (PHPT) olan hasta, 25 sekonder hiperparatiroidisi (SHPT) olan hasta ve 25 kontrol grubu dahil edildi. Trombosit fonksiyonları trombositten zengin plazma ve epinefrin, adenozin difosfat (ADP), kollajen ve ristosetinle trombosit agregasyon testleri yapılarak değerlendirildi. Trombosit aktivasyon düzeyini gösteren serum P selektin düzeyleri tüm hastalarda ölçüldü. Kemik mineral dansitometresi tüm hastalarda
değerlendirildi.
Bulgular: PHPT ve SHPT’li hastalar ve kontrol grubunun trombosit fonksiyon testleri ve serum P selektin düzeyleri arasında istatistiksel açıdan anlamlı bir fark saptanmadı. Parathormon düzeyi ile agregasyon parametreleri (ristosetin, epinefrin, kollajen, ve ADP: sırasıyla p=0,446, 0,537, 0,346 ve 0,302) ve P selektin (p=0,516) düzeyi arasında da anlamlı bir korelasyon saptanmadı. Hastalar kalsiyum düzeylerine göre hiperkalsemik ve normokalsemik olarak ayrıldıklarında da agregasyon parametreleri ve P selektin düzeyleri arasında anlamlı fark saptanmadı. Hasta gruplarımızda trombosit fonksiyonları, P selektin düzeyi, serum kalsiyum düzeyileri arasında istatistiksel açıdan anlamlı fark bulunmadı. Kemik kaybı PHPT’li olan grupta daha belirgindi.
Sonuç: Agregasyon testleri ile değerlendirildiğinde PHPT veya SHPT ve serum kalsiyum düzeylerinin trombosit fonksiyonları üzerine belirgin etkisi yoktur.

Anahtar Kelimeler: Hiperparatiroidism, Trombosit fonksiyonları, P selektin, Kalsiyum, Kemik kaybı


Göknur Yorulmaz, Aysen Akalın, Olga Meltem Akay, Garip Şahin, Cengiz Bal. The Effect of Hyperparathyroid State on Platelet Functions and Bone Loss. Turk J Hematol. 2016; 33(4): 293-298

Corresponding Author: Göknur Yorulmaz, Türkiye


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