Skip to main content
SpringerLink
Log in

Influence of pregnancy on immunoreactive parathyroid hormone levels

  • Clinical Investigation
  • Published:
Calcified Tissue International Aims and scope Submit manuscript

Summary

Parathyroid hormone (PTH) metabolism in pregnancy has not been clearly defined. Studies have reported either increased or unchanged values of immunoreactive PTH (iPTH). However, iPTH levels do not necessarily correlate with hormonal bioactivity due to the presence of immunoreactive but nonbioactive PTH fragments. In this study we evaluated PTH metabolism in the third trimester of pregnancy by determining iPTH blood levels as well as the biological effects of PTH, assessed by tubular maximum phosphate reabsorption (TmP) and nephrogenous cAMP (ncAMP) excretion, in 10 young, healthy pregnant patients (mean gestational age 35 weeks) and 10 young, healthy age-matched female controls. Pregnancy was associated with a significant increase in creatinine clearance (146±13 vs 106±9 ml/min,P<0.01), and a significant decrease in total fasting serum calcium (8.4±0.1 vs 9.0±0.1 mg/dl,P<0.001) and serum albumin (3.6±0.1 vs 4.2±0.1 g/dl,P<0.001). There was no significant difference in iPTH (3.7±0.4 vs 4.3±0.5 µlEq/ml), serum phosphorus (3.6±0.1 vs 3.8±0.2 mg/dl), TmP (3.61±0.13 vs 3.75±0.25 mg/100 ml GFR), or ncAMP (1.68±0.20 vs 1.88±0.23 nmoles/100 ml GFR) between the two groups. Pregnancy was attended by a significant increase in fasting urinary calcium to creatinine ratio (0.14±0.03 vs 0.06±0.01,P<0.05), an index of bone resorption. The data suggest that the biological effects of PTH are unchanged in pregnancy, and that reported increments in 1,25(OH)2 vitamin D in pregnancy are not regulated by changes in either PTH, calcium, or phosphate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Pitkin, R. M.: Calcium metabolism in pregnancy. A review, Am. J. Obstet. Gynecol.121:724–737, 1975

    CAS  PubMed  Google Scholar 

  2. Pitkin, R. M., Reynolds, W. A., Williams, G. A., Hargis, G. K.: Calcium metabolism in normal pregnancy: a longitudinal study, Am. J. Obstet. Gynecol.133:781–790, 1979

    CAS  PubMed  Google Scholar 

  3. Kumar, R., Cohen, W. R., Silva, P., Epstein, F. H.: Elevated 1,25 dihydroxy vitamin D plasma levels in normal human pregnancy and lactation, J. Clin. Invest.63:342–344, 1979

    CAS  PubMed  Google Scholar 

  4. Heaney, R. P., Skillman, T. G.: Calcium metabolism in normal human pregnancy, J. Clin. Endocrinol. Metab.33:661–670, 1971

    CAS  PubMed  Google Scholar 

  5. Lequin, R. M., Kackeng, W. H. L., Schopman, W.: A radioimmunoassay for parathyroid hormone in man, Acta Endocrinol. (Copenh.)63:655–666, 1970

    CAS  PubMed  Google Scholar 

  6. Cushard, W. G., Creditor, M. A., Canterbury, J. M., Reiss, E.: Physiologic hyperparathyroidism in pregnancy, J. Clin. Endocrinol. Metab.34:767–771, 1972

    CAS  PubMed  Google Scholar 

  7. Root, A., Cruskima, A., Reber, R. M., Stopa, A., Duckett, G.: Serum concentrations of parathyroid hormone in infants, children, and adolescents, J. Pediatr.85:329–336, 1974

    CAS  PubMed  Google Scholar 

  8. Watney, P. J. M., Rudd, B. T.: Calcium metabolism in pregnancy and in the newborn, J. Obstet. Gynecol. Br. Commonw.81:210–219, 1974

    CAS  Google Scholar 

  9. Reitz, R. E., Daane, T. A., Woods, J. R., Weinstein, R. L.: Calcium, magnesium, phosphorus, and parathyroid hormone interrelationships in pregnancy and newborn infants, Obstet. Gynecol.50:701–705, 1977

    CAS  PubMed  Google Scholar 

  10. Drake, T. S., Kaplan, R. A., Lewis, T. A.: The physiologic hyperparathyroidism of pregnancy, Obstet. Gynecol.53:746–749, 1979

    CAS  PubMed  Google Scholar 

  11. Hillman, L. S., Slatopolsky, E., Haddad, J. G.: Perinatal vitamin D metabolism: maternal and cord serum 24,24-dihydroxy vitamin D concentrations, J. Clin. Endocrinol. Metab.47:1073–1077, 1978

    CAS  PubMed  Google Scholar 

  12. Steichen, J. J., Tsang, R. C., Gratton, T. L., Hamstra, A., DeLuca, H. F.: Vitamin D homeostasis in the perinatal period: 1,25 dihydroxy vitamin D in maternal cord, and neonatal blood, N. Engl. J. Med.302:315–319, 1980

    Article  CAS  PubMed  Google Scholar 

  13. Martin, K., Hruska, K., Freitag, J., Klahr, S., Slatopolsky, E.: The peripheral metabolism of parathyroid hormone, N. Engl. J. Med.301:1092–1098, 1979

    Article  CAS  PubMed  Google Scholar 

  14. Broadus, A., Mahaffey, J., Bartter, F., Neer, R. M.: Nephrogenous cyclic adenosine monophosphate as a parathyroid function test, J. Clin. Invest.60:771–783, 1977

    CAS  PubMed  Google Scholar 

  15. Broadus, A.E., Deftos, L. J., Bartter, F. C.: Effects of intravenous administration of calcium on nephrogenous cyclic AMP, J. Clin. Endocrinol. Metab.46:477–487, 1978

    Article  CAS  PubMed  Google Scholar 

  16. Walton, R. J., Bijvoet, O. L. M.: Nomogram for derivation of renal threshold phosphate concentration, Lancet2:309–310, 1975

    Article  CAS  PubMed  Google Scholar 

  17. Baran, D. T., Hahn, T. J., Avioli, L. V.: Effect of oral glucose ingestion on renal phosphate reabsorption and clearance in vitamin D resistant rickets, J. Clin. Endocrinol. Metab.47:138–144, 1978

    CAS  PubMed  Google Scholar 

  18. Pybus, J., Feldman, F. J., Bowers, G. N. J.: Measurement of total calcium in serum by atomic absorption spectrophotometry with the use of strontium internal reference, Clin. Chem.16:998–1007, 1970

    CAS  PubMed  Google Scholar 

  19. Hruska, K. A., Kopelman, R., Rutherford, W. E., Klahr, S., Slatopolsky, E.: Metabolism of immunoreactive parathyroid hormone in the dog: the role of the kidney and the effects of chronic renal disease, J. Clin. Invest.56:39–48, 1975

    CAS  PubMed  Google Scholar 

  20. Tovey, K. C., Oldham, K. G., Whelan, J. A. M.: A simple direct assay for cyclic AMP in plasma and other biological samples using an improved competitive protein binding technique, Clin. Chem. Acta56:221–234, 1974

    Article  CAS  Google Scholar 

  21. Nordin, B. E. C., Gallagher, J. C., Aaron, J. E., Horsman, A.: Postmenopausal osteopenia and osteoporosis, Front. Horm. Res.3:133–148, 1975

    Google Scholar 

  22. Kukreja, S. C., Shemerdiak, W. P., Lad, T. E., Johnson, P. A.: Elevated nephrogenous cyclic AMP with normal serum parathyroid levels in patients with lung cancer, J. Clin. Endocrinol. Metab.51:167–169, 1980

    Article  CAS  PubMed  Google Scholar 

  23. Christiansen, C., Rodbro, P., Heinild, B.: Unchanged total body calcium in normal human pregnancy, Acta Obstet. Gynecol. Scand.55:141–143, 1976

    Article  CAS  PubMed  Google Scholar 

  24. Walker, A. R. P., Richardson, B., Walker, F.: The influence of numerous pregnancies and lactationss on bone dimensions in South African Bantu and caucasian mothers, Clin. Sci.42:189–196, 1972

    CAS  PubMed  Google Scholar 

  25. Riggs, B. L., Wahner, H. W., Dunn, W. L., Mazess, R. B., Offord, K. P., Melton, L. J.: Differential changes in bone mineral density of the appendicular and axial skeleton with aging: relationship to spinal osteoporosis, J. Clin. Invest.67:328–335, 1981

    CAS  PubMed  Google Scholar 

  26. Fraser, D. R., Kodicek, E.: Regulation of 25-hydroxycholecalciferol-1-hydroxylase activity in kidney by parathyroid hormone, Nature [New Biol.]241:163–166, 1973

    CAS  Google Scholar 

  27. Tanaka, Y., DeLuca, H. F.: The control of 25-hydroxy vitamin D metabolism by inorganic phosphorus, Arch. Biochem. Biophys.154:566–574, 1973

    Article  CAS  PubMed  Google Scholar 

  28. Booth, B. E., Tsai, H. C., Morris, R. C., Jr.: Parathyroidectomy reduced 25-hydroxy vitamin D3-1α-hydroxylase activity in the hypocalcemic vitamin D deficient chick, J. Clin. Invest.60:1314–1320, 1977

    Article  CAS  PubMed  Google Scholar 

  29. Kenny, A. D.: Vitamin D metabolism: physiological regulation in egg-laying Japanese quail, Am. J. Physiol.230:1609–1615, 1976

    CAS  PubMed  Google Scholar 

  30. Baksi, S. N., Kenny, A. D.: Vitamin D metabolism in Japanese quail: gonadal hormones and dietary calcium effects, Am. J. Physiol.234:E622–628, 1978

    CAS  PubMed  Google Scholar 

  31. Baran, D. T., Whyte, M. P., Haussler, M. R., Deftos, L. J., Slatopolsky, E., Avioli, L. V.: Effect of the menstrual cycle on calcium-regulating hormones in normal young women, J. Clin. Endocrinol. Metab.50:377–379, 1980

    CAS  PubMed  Google Scholar 

  32. Gallagher, J. C., Riggs, B. L., DeLuca, H. F.: Effect of estrogen on calcium absorption and serum vitamin D metabolites in post-menopausal osteoporosis, J. Clin. Endocrinol. Metab.51:1359–1364, 1980

    CAS  PubMed  Google Scholar 

  33. Spanos, E. J., Pike, W., Haussler, M. R., Galante, L. S., Cauley, S. J., MacIntyre, I.: Circulating 1,25 dihydroxy vitamin D in the chicken, enhancement by injection of prolactin and during egg laying, Life Sci.19:1751–1756, 1976

    Article  CAS  PubMed  Google Scholar 

  34. Adams, N. C., Garthwaite, T. L., Gray, R. W., Hagen, T. C., Lemann, J., Jr.: The inter-relationships among prolactin, 1,25-dihydroxy vitamin D, and parathyroid hormone in humans, J. Clin. Endocrinol. Metab.49:628–630, 1979

    CAS  PubMed  Google Scholar 

  35. Duggin, G. G., Dale, N. E., Lyneham, R. C., Evans, R. A., Tiller, D. G.: Calcium balance in pregnancy, Lancet2:926–927, 1974

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Obstetrics and Gynecology, and Medicine, University of Rochester Medical Center, 14642, Rochester, New York, USA

    Mary E. Gillette, Karl L. Insogna, Anne M. Lewis & Daniel T. Baran

Authors
  1. Mary E. Gillette
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karl L. Insogna
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anne M. Lewis
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Daniel T. Baran
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gillette, M.E., Insogna, K.L., Lewis, A.M. et al. Influence of pregnancy on immunoreactive parathyroid hormone levels. Calcif Tissue Int 34, 9–12 (1982). https://doi.org/10.1007/BF02411200

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02411200

Key words

Search

Navigation