{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:58:41Z","timestamp":1791536321309,"version":"4.3.4"},"reference-count":37,"publisher":"The Endocrine Society","issue":"7","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100006506","name":"Brazilian Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006506","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002322","name":"Brazilian Federal Agency for Support and Evaluation of Graduate Education","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"S\u00e3o Paulo Research Foundation","doi-asserted-by":"publisher","award":["2019\/15873-6"],"award-info":[{"award-number":["2019\/15873-6"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"S\u00e3o Paulo Research Foundation","doi-asserted-by":"publisher","award":["2024\/140041-5"],"award-info":[{"award-number":["2024\/140041-5"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"publisher","award":["304091\/2021-9"],"award-info":[{"award-number":["304091\/2021-9"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Elevated parathyroid hormone (PTH) levels have been linked to higher cardiovascular (CV) and all-cause mortality in individuals with hyperparathyroidism or high-risk conditions (individuals with a mean age of 75-85 years and patients undergoing coronary angiography). However, it remains uncertain whether sex- and age-related differences influence these associations among normocalcemic and middle-aged adults from the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 4736 participants from the ELSA-Brasil study (mean age, 51.7 years; 55% females), followed for a median of 11.2 years. Baseline serum PTH was measured by electrochemiluminescence immunoassay. Associations of PTH with outcomes were assessed using Cox regression for all-cause mortality, reporting hazard ratios (HRs), and Fine-Gray models for CV mortality, accounting for competing risks and reporting subdistribution hazard ratios (sHRs), adjusted for total calcium, and other relevant covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A baseline PTH concentration &amp;gt;56 pg\/mL was independently associated with higher CV mortality (sHR 1.92; 95% CI 1.22-3.01) and all-cause mortality (HR 1.61; 95% CI 1.25-2.07). Sex- and age-stratified analyses showed that females with elevated PTH had a 179% increased CV mortality risk (sHR 2.79; 95% CI 1.37-5.70), whereas no significant association was seen in males. Elevated PTH was also associated with increased CV mortality in adults \u226464 years (sHR 1.80; 95% CI 1.05-3.09) but not in older individuals. For all-cause mortality, PTH &amp;gt;56 pg\/mL conferred a higher risk in both females (HR 1.75; 95% CI 1.15-2.66) and males (HR 1.59; 95% CI 1.16-2.19), with consistent associations across both age groups (\u226464 and &amp;gt;64 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large, community-based cohort, PTH levels at the upper end of the reference range were associated with greater CV and all-cause mortality. The excess CV risk was restricted to females and younger adults, suggesting that PTH may serve as an early, sex-sensitive biomarker of cardiometabolic risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgag076","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T12:36:18Z","timestamp":1771677378000},"page":"1830-1841","source":"Crossref","is-referenced-by-count":1,"title":["High normal parathyroid hormone and cardiovascular and total mortality: sex and age disparities in the ELSA-Brasil study"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2519-5073","authenticated-orcid":false,"given":"Jessica","family":"Okubo","sequence":"first","affiliation":[{"name":"Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM25, Disciplina de Endocrinologia e Metabologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo , Sao Paulo 01246-903 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo Z","family":"Kawahara","sequence":"additional","affiliation":[{"name":"Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM25, Disciplina de Endocrinologia e Metabologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo , Sao Paulo 01246-903 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3547-6781","authenticated-orcid":false,"given":"Gustavo H","family":"Mori","sequence":"additional","affiliation":[{"name":"Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM25, Disciplina de Endocrinologia e Metabologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo , Sao Paulo 01246-903 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2332-5863","authenticated-orcid":false,"given":"Vinicius F","family":"Calsavara","sequence":"additional","affiliation":[{"name":"Department of Computational Biomedicine, Biostatistics Shared Resource, Cedars-Sinai Medical Center , Los Angeles, CA 90048 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6782-693X","authenticated-orcid":false,"given":"Ana Claudia","family":"Latronico","sequence":"additional","affiliation":[{"name":"Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM25, Disciplina de Endocrinologia e Metabologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo , Sao Paulo 01246-903 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4856-8450","authenticated-orcid":false,"given":"Paulo A","family":"Lotufo","sequence":"additional","affiliation":[{"name":"Centro de Pesquisa Cl\u00ednica e Epidemiologica, Hospital Universitario, Faculdade de Medicina, Universidade de Sao Paulo , Sao Paulo 05508-000 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6723-5678","authenticated-orcid":false,"given":"Isabela M","family":"Bensenor","sequence":"additional","affiliation":[{"name":"Centro de Pesquisa Cl\u00ednica e Epidemiologica, Hospital Universitario, Faculdade de Medicina, Universidade de Sao Paulo , Sao Paulo 05508-000 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2957-6148","authenticated-orcid":false,"given":"Madson 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