Abstract |
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 receiver operating characteristic (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:
Parathyroid hormone 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%vs 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:
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Authors | Catherine Fillée, Thomas Keller, Michel Mourad, Thomas Brinkmann, Jean-Marie Ketelslegers |
Journal | Clinical endocrinology
(Clin Endocrinol (Oxf))
Vol. 76
Issue 6
Pg. 785-9
(Jun 2012)
ISSN: 1365-2265 [Electronic] England |
PMID | 22066864
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2012 Blackwell Publishing Ltd. |
Chemical References |
- Parathyroid Hormone
- Vitamin D
- Creatinine
- Calcium
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Topics |
- Adolescent
- Adult
- Age Factors
- Aged
- Calcium
(blood)
- Creatinine
(blood)
- Female
- Humans
- Hyperparathyroidism, Primary
(blood, diagnosis)
- Male
- Middle Aged
- Parathyroid Hormone
(blood)
- Vitamin D
(blood)
- Young Adult
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