Document Detail


The use in clinical practice of parathyroid hormone normative values established in vitamin D-sufficient subjects.
MedLine Citation:
PMID:  12915625     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have found recently that excluding subjects with low serum 25OHD has a significant impact on the PTH reference range (10-46 ng/liter instead of 10-65 ng/liter with the same assay). However, before being used routinely, this new range had to be clinically validated. We thus reviewed the chart of 708 consecutive osteopenic patients who were referred to our unit for a biological exploration in search of secondary causes for their low bone mass. They were classified into two groups. Group 1 (n = 360) included the patients for whom no reasons for high PTH were found after examination of their chart. Group 2 (n = 348) included patients with one of the following potential reasons for an increased PTH concentration: hyper- or hypocalcemia, normocalcemic primary hyperparathyroidism (PHPT), renal hypercalciuria, vitamin D insufficiency, chronic renal failure, use of bisphosphonates, and any chronic disease known to potentially alter calcium metabolism. Among the 360 group 1 patients, 15 (4.2%) had a serum PTH level more than 46 ng/liter, which is not different from the theoretical rate of 3% of normal subjects whose serum PTH may be above the 97th centile of the reference (chi(2) = 2.8; NS). Forty-two group 2 patients had a surgically proven PHPT. Among these, serum PTH was </=65 ng/liter in 17 (40.5%) and </=46 ng/liter in 5 (12%). In conclusion, our proposed PTH reference range allows to identify fewer patients with mild surgically proven PHPT who have a normal serum PTH concentration, without inducing an increase in the rate of falsely high PTH.
Authors:
Jean-Claude Souberbielle; Ethel Lawson-Body; Boualem Hammadi; Emile Sarfati; Andrè Kahan; Catherine Cormier
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  88     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2003-08-13     Completed Date:  2003-09-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3501-4     Citation Subset:  AIM; IM    
Affiliation:
Laboratoire d'Explorations Fonctionnelles, Hôpital Necker-Enfants Malades, Paris, France. jean-claude.souberbielle@nck.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bone Diseases, Metabolic / blood
Calcium / blood
Diphosphonates / adverse effects,  therapeutic use
False Negative Reactions
False Positive Reactions
Female
Humans
Kidney / metabolism
Kidney Failure, Chronic / metabolism
Male
Middle Aged
Parathyroid Hormone / blood*
Reference Values
Vitamin D / blood*
Chemical
Reg. No./Substance:
0/Diphosphonates; 0/Parathyroid Hormone; 1406-16-2/Vitamin D; 7440-70-2/Calcium
Comments/Corrections
Comment In:
J Clin Endocrinol Metab. 2003 Aug;88(8):3499-500   [PMID:  12915624 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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