| Impact of vitamin D-related serum PTH reference values on the diagnosis of mild primary hyperparathyroidism, using bivariate calcium/PTH reference regions. | |
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MedLine Citation:
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PMID: 22066864 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background, objective: An international consensus conference underlined the importance of defining upper parathyroid hormone (PTH) reference values based on 25-OH-Vitamin D (25(OH)D), to diagnose mild primary hyperparathyroidism. We determined the importance of this factor in a Belgian population. Design, patients, methods: Intact PTH and 25(OH)D were measured in 261 healthy controls (18 - 65 years, winter/summer). They were classified as 25(OH)D replete (50 - 153 nmol/L; n = 129) or deplete (8-50 nmol/L; n = 132). PTH was determined in 49 patients with surgically proven primary hyperparathyroidism. PTH thresholds for 95% specificities and corresponding sensitivities were computed from both 25(OH)D replete and deplete ROC curves. The 95% bivariate reference ellipses, relating PTH to calcium for 25(OH)D replete and deplete controls were compared to the PTH/calcium pairs of patients with primary hyperparathyroidism. Results: PTH correlated with 25(OH)D (r = -0.3232; P <0.0001). PTH normative values were 20% lower in 25(OH)D replete than deplete controls (P <0.0001). PTH thresholds, providing 95% specificities for primary hyperparathyroidism diagnosis were 7.6 pmol/L and 5.8 pmol/L, using ROC curves derived from 25(OH)D deplete or replete controls, respectively. Corresponding sensitivities were of 56% versus 88%, respectively (P <0.05). The 95% PTH/calcium bivariate reference ellipses for deplete and replete 25(OH)D controls differed, but the PTH/calcium pairs of patients with primary hyperparathyroidism did not overlap these ellipses. Conclusion: For a given specificity, primary hyperparathyroidism diagnostic PTH thresholds were lower and sensitivities higher using ROC curves, derived from 25(OH)D replete versus deplete controls. The 25(OH)D status does not affect the efficiency of primary hyperparathyroidism diagnosis, using bivariate PTH/calcium reference density ellipses. |
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Authors:
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Catherine Fillée; Thomas Keller; Michel Mourad; Thomas Brinkmann; Jean-Marie Ketelslegers |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-8 |
Journal Detail:
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Title: Clinical endocrinology Volume: - ISSN: 1365-2265 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-9 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0346653 Medline TA: Clin Endocrinol (Oxf) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Blackwell Publishing Ltd. |
Affiliation:
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Cliniques Universitaires St-Luc, Brussels, Belgium Acomed Statistik, Leipzig, Germany Faculty of Medicine, Ruhr-University of Bochum, Bochum, Germany. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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