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Matejek T, Zapletalova B, Stranik J, Zaloudkova L, Palicka V. Reference values of parathyroid hormone in very low birth weight infants. Ann Clin Biochem 2024; 61:372-385. [PMID: 38520177 DOI: 10.1177/00045632241245942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
PURPOSE The primary goal was to estimate reference values of parathyroid hormone (PTH) in very low birth weight infants without severe neonatal morbidity. A secondary objective was to assess the relationship between PTH serum levels and selected laboratory markers of bone metabolism. METHODS Ninety two infants with birth weight less than 1500 g met the inclusion criteria of the study. Serum levels of PTH, 25-hydroxyvitamin-D [25(OH)D], C3-epi-25(OH)D, total calcium, phosphorus, and alkaline phosphatase, and urinary levels of calcium, phosphorus, and creatinine were examined on day 14 and subsequently every 2 weeks until discharge. RESULTS Of the total 167 serum samples examined for PTH levels in infants without 25(OH)D deficiency the estimated range was 0.9-11.9 pmol/l (8.5-112.3 pg/mL). During the first month, no statistically significant correlation was observed between PTH level and that of 25(OH)D, C3-epimers of 25(OH)D, S-Ca, S-P, or ALP, nor with urinary excretion of calcium and phosphorus. From the second month of life, there was a moderately significant correlation between PTH and 25(OH)D (Rho = -0.40, P =< .001), between PTH and calcium/creatinine ratio (Rho = -0.56, P = < .001), and between PTH and phosphorus/creatinine ratio (Rho = 0.51, P = < .001). CONCLUSIONS The physiological range for PTH levels for preterm neonates without 25(OH)D deficiency was estimated as 0.9-11.9 pmol/l (8.5-112.3 pg/mL). It seems that elevation of serum PTH above this range can be considered as hyperparathyroidism in very low birth weight infants.
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Affiliation(s)
- Tomas Matejek
- Department of Paediatrics, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Bara Zapletalova
- Department of Paediatrics, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Jaroslav Stranik
- Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Lenka Zaloudkova
- Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Vladimir Palicka
- Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
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2
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Fekete Z, Ignat P, Jakab H, Todor N, László IP, Muntean AS, Curcean S, Nemeș A, Nuțu D, Kacsó G. Serum Calcium Level at Diagnosis Can Predict Lethal Prostate Cancer Relapse. J Clin Med 2024; 13:4845. [PMID: 39200986 PMCID: PMC11355581 DOI: 10.3390/jcm13164845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Revised: 08/08/2024] [Accepted: 08/15/2024] [Indexed: 09/02/2024] Open
Abstract
Background/Objectives: The most important prognostic factors in curatively treated prostate cancer are T and N stage, histology, grade group and initial PSA. A recent study found that men with blood calcium levels at the high end of the normal range are over two-and-a-half times more likely to develop fatal prostate cancer than those with lower calcium levels. However, there is limited evidence regarding the prognostic value of calcium levels at the time of prostate cancer diagnosis. We aimed to determine whether a calcium level in the upper range of normal values has any prognostic value in curatively treated prostate cancer. Methods: We conducted a retrospective analysis of 84 consecutive patients with prostate cancer who underwent curative-intent radiotherapy-either as primary treatment or adjuvant therapy-using external beam radiotherapy with or without brachytherapy. We analyzed all pertinent prognostic factors that could potentially impact disease-free survival. Results: The study revealed that calcium levels at diagnosis significantly predict disease-free survival, whereas the initial PSA level did not hold prognostic significance-likely due to interference from benign prostatic hyperplasia. Conclusions: If our findings are validated, calcium levels at the time of prostate cancer diagnosis could be incorporated into future predictive and prognostic models.
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Affiliation(s)
- Zsolt Fekete
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (P.I.); (H.J.); (S.C.); (A.N.); (D.N.); (G.K.)
- Oncology Institute, 400015 Cluj-Napoca, Romania; (N.T.); (I.P.L.); (A.-S.M.)
| | - Patricia Ignat
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (P.I.); (H.J.); (S.C.); (A.N.); (D.N.); (G.K.)
- Oncology Institute, 400015 Cluj-Napoca, Romania; (N.T.); (I.P.L.); (A.-S.M.)
| | - Henrietta Jakab
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (P.I.); (H.J.); (S.C.); (A.N.); (D.N.); (G.K.)
| | - Nicolae Todor
- Oncology Institute, 400015 Cluj-Napoca, Romania; (N.T.); (I.P.L.); (A.-S.M.)
| | - István Péter László
- Oncology Institute, 400015 Cluj-Napoca, Romania; (N.T.); (I.P.L.); (A.-S.M.)
| | | | - Sebastian Curcean
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (P.I.); (H.J.); (S.C.); (A.N.); (D.N.); (G.K.)
- Oncology Institute, 400015 Cluj-Napoca, Romania; (N.T.); (I.P.L.); (A.-S.M.)
| | - Adina Nemeș
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (P.I.); (H.J.); (S.C.); (A.N.); (D.N.); (G.K.)
- Oncology Institute, 400015 Cluj-Napoca, Romania; (N.T.); (I.P.L.); (A.-S.M.)
| | - Dumitrița Nuțu
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (P.I.); (H.J.); (S.C.); (A.N.); (D.N.); (G.K.)
- Oncology Institute, 400015 Cluj-Napoca, Romania; (N.T.); (I.P.L.); (A.-S.M.)
| | - Gabriel Kacsó
- Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania; (P.I.); (H.J.); (S.C.); (A.N.); (D.N.); (G.K.)
- Amethyst Radiotherapy Center, 407280 Cluj-Napoca, Romania
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Cavalier E. Determination of parathyroid hormone: from radioimmunoassay to LCMS/MS. Clin Chem Lab Med 2023; 61:946-953. [PMID: 36640443 DOI: 10.1515/cclm-2022-0942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023]
Abstract
Parathyroid hormone (PTH) determination is of paramount importance for the exploration of diseases related with calcium metabolism and for the follow-up of patients suffering from bone and mineral disorders associated with chronic kidney diseases (CKD-MBD). Unfortunately, the biologically active form of PTH, i.e. 1-84 PTH, circulates in the blood stream with many fragments and post-translationally modified forms, which decreases the specificity of immunoassays. The assays used to measure PTH, either from 2nd or 3rd generation, are not standardised, which may lead to interpretation errors and clinical consequences. Reference ranges for PTH have neither been always correctly established and the stability of the peptide is also a matter of concern. Fortunately, these last years, newer techniques using mass spectrometry (either high resolution or triple quadripole) coupled with liquid chromatography have been developed, which will help to standardise the different assays. Indeed, PTH assays standardisation is one of the task of the IFCC Committee for Bone Metabolism. Such standardisation will allow a better consistency in the interpretation of the results and will promote studies aiming at the establishment of correct reference ranges.
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Affiliation(s)
- Etienne Cavalier
- Department of Clinical Chemistry, CHU de Liège, CIRM, University of Liege, Liège, Belgium
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Ladang A, Rousselle O, Huyghebaert L, Bekaert AC, Kovacs S, Le Goff C, Cavalier E. Parathormone, bone alkaline phosphatase and 25-hydroxyvitamin D status in a large cohort of 1200 children and teenagers. Acta Clin Belg 2022; 77:4-9. [PMID: 32441564 DOI: 10.1080/17843286.2020.1769285] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objectives: 25-Hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH) and bone alkaline phosphatase (BALP) are biomarkers of calcium/phosphate metabolism and bone turnover. Although vitamin D deficiency is a well-known cause of secondary hyperparathyroidism, few studies have considered vitamin D status when establishing reference ranges. In this study, we report PTH levels according to the vitamin D status and BALP levels in a large cohort of 1200 children. Additionally, we provide PTH pediatric reference values according to 25(OH)D status as well as BALP pediatric reference ranges.Methods: Serum samples from 1200 children (equally distributed from 5 months to 20 years old) who underwent blood sampling for allergy exploration were used to quantify 25(OH)D, PTH and BALP.Results: The percentage of vitamin D deficient children (<20 ng/ml) progressively increased during childhood starting from 7% in the 0 to 2 year-old subgroup to a mean of at least 50% among teenagers. PTH levels inversely mirrored 25(OH)D concentrations for all age and gender subgroups, and 25(OH)D deficient subgroups presented higher PTH levels than their non-deficient counterparts. In the non-deficient 25(OH)D population, PTH levels were the highest at 11 years old for girls and 14 years old for boys. BALP results were slightly increased during childhood and showed a constant decrease during teenage years starting from 12 years old for girls and 14 years old for boys.Conclusion: Our results highlight the inverse relationship between PTH and 25(OH)D in children and the need for a well characterized 25(OH)D population to establish pediatric reference ranges for PTH.
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Affiliation(s)
- Aurélie Ladang
- Clinical Chemistry Department, CHU De Liège, Liège, Belgium
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Berner C, Marculescu R, Frommlet F, Kurnikowski A, Schairer B, Aigner C, Bieglmayer C, Hecking M. Parathyroid Hormone Concentrations in Maintenance Hemodialysis: Longitudinal Evaluation of Intact and Biointact Assays. Kidney Med 2021; 3:343-352.e1. [PMID: 34136780 PMCID: PMC8178455 DOI: 10.1016/j.xkme.2020.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
RATIONALE & OBJECTIVE Management of chronic kidney disease mineral and bone disorder requires parathyroid hormone (PTH) concentrations. "Biointact" PTH immunoassays detect "whole" PTH (wPTH), whereas "intact" immunoassays measure PTH plus PTH fragments (iPTH). We aimed to determine whether longitudinal changes in PTH concentrations can be evaluated using biointact and intact immunoassays alike. STUDY DESIGN Open noninterventional longitudinal cohort study. SETTING & PARTICIPANTS PTH concentrations were measured quarterly up to 5 times in 102 hemodialysis patients. PREDICTORS & TESTS COMPARED Age, sex, phosphate levels, and others as clinical predictors for PTH trend. Tests compared were iPTH immunoassays from Siemens and Roche and wPTH immunoassays from Roche and DiaSorin. OUTCOMES PTH concentration trend; regression equations; test bias. ANALYTICAL APPROACH Predictive regression-to-the-mean model for PTH slope; Bland-Altman plots, Passing-Bablok regression, and reference change values for test comparisons. RESULTS wPTH concentrations were similar with both immunoassays (wPTH-Roche = 11.7 + 0.97 × wPTH-DiaSorin, r = 0.99; mean ± 1.96 SD bias, 8.2 ± 43.3 pg/mL [17.5% ± 40.9%], by Bland-Altman plots). iPTH-Siemens concentrations were higher than iPTH-Roche concentrations (iPTH-Siemens = -5.4 + 1.33 × iPTH-Roche, r = 0.99; mean ± 1.96 SD bias, 84.0 ± 180.2 pg/mL [21.1% ± 29.8%], by Bland-Altman plots). iPTH-Roche and iPTH-Siemens concentrations were 2- and 2.5-fold higher than wPTH concentrations, respectively. Full agreement among all 4 immunoassays in detecting both significant and insignificant changes in PTH concentrations, upward or downward from one quarter to the next, was reached in 87% of consecutive measurements. In a predictive model, baseline PTH concentrations > 199 pg/mL (wPTH-Roche), 204 pg/mL (wPTH-DiaSorin), 386 pg/mL (iPTH-Roche), and 417 pg/mL (iPTH-Siemens) correctly predicted declining PTH concentration trend in 62% to 68% of patients, but age, sex, hemodialysis vintage, and calcium and phosphate levels were no significant predictors. LIMITATIONS Limited number of immunoassays, only 59 patients attended all quarterly samplings. CONCLUSIONS wPTH-Roche and wPTH-DiaSorin concentrations were similar, while iPTH was higher than wPTH concentrations. The iPTH-Siemens immunoassay is either higher calibrated or detects more fragments than iPTH-Roche. However, longitudinal PTH concentration changes largely coincided with all tested immunoassays.
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Affiliation(s)
- Carolin Berner
- Division of Nephrology & Dialysis, Department of Medicine III, Medical University of Vienna
- Nephrology & Dialysis, 1st Medical Department, Kaiser Franz Josef Hospital Vienna, Medical University of Vienna, Vienna, Austria
| | - Rodrig Marculescu
- Clinical Institute for Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria
| | - Florian Frommlet
- Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Statistics, Medical University of Vienna, Vienna, Austria
| | - Amelie Kurnikowski
- Division of Nephrology & Dialysis, Department of Medicine III, Medical University of Vienna
| | - Benjamin Schairer
- Division of Nephrology & Dialysis, Department of Medicine III, Medical University of Vienna
| | - Christof Aigner
- Division of Nephrology & Dialysis, Department of Medicine III, Medical University of Vienna
| | - Christian Bieglmayer
- Clinical Institute for Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria
| | - Manfred Hecking
- Division of Nephrology & Dialysis, Department of Medicine III, Medical University of Vienna
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Xu F, Huang Y, Zeng M, Zhang L, Ren W, Qian H, Cui Y, Yang G, Zhou W, Wang S, Huang H, Chen H, Xiao Y, Gao X, Gao Z, Wang J, Liu C, Zhang J, Zhao B, Bian A, Li F, Wan H, Xing C, Zha X, Wang N. Diagnostic Values of Intraoperative (1-84) Parathyroid Hormone Levels are Superior to Intact Parathyroid Hormone for Successful Parathyroidectomy in Patients With Chronic Kidney Disease. Endocr Pract 2021; 27:1065-1071. [PMID: 33895317 DOI: 10.1016/j.eprac.2021.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Persistent secondary hyperparathyroidism (SHPT) may occur because of residual cervicothoracic parathyroids in parathyroidectomy (PTX) patients with chronic kidney disease. We prospectively compared the predictive values of intraoperative plasma (1-84) parathyroid hormone (PTH) and intact PTH (iPTH) levels to improve the safety and efficacy of PTX. METHODS We included 100 healthy controls, 162 stage 5 chronic kidney disease patients without SHPT, and 214 patients who underwent PTX because of SHPT. Plasma iPTH and (1-84) PTH levels were measured before incision (io-iPTH0 and io-[1-84]PTH0, respectively) and 10 minutes (io-iPTH10 and io-[1-84]PTH10, respectively) and 20 minutes (io-iPTH20 and io-[1-84]PTH20, respectively) after removing all parathyroids. The percentage reduction of iPTH and (1-84) PTH at 10 minutes (io-iPTH10% and io-[1-84]PTH10%, respectively) and 20 minutes (io-iPTH20%, and io-[1-84]PTH20%, respectively) was calculated. iPTH and (1-84) PTH were measured using second- and third-generation PTH assays, respectively. RESULTS Compared with the controls and non-PTX patients, the PTX group had more obvious mineral metabolism disorders. There were 187 successful PTXs, 19 patients with persistent SHPT, and 8 patients lost to follow-up. The receiver operating characteristic curves revealed that io-(1-84)PTH10% >86.6% and io-(1-84)PTH20% >87.5% suggested successful PTX. The sensitivity of io-iPTH20% and io-(1-84)PTH20% were higher than those at the timepoint of 10 minutes. Moreover, the specificity and sensitivity of the (1-84) PTH reduction percentage were superior to that of iPTH. CONCLUSION Intraoperative reduction percentages of plasma (1-84) PTH levels are superior to iPTH for accurately predicting successful PTX, especially at 20 minutes after all cervicothoracic parathyroids had been resected.
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Affiliation(s)
- Fangyan Xu
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Yaoyu Huang
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Ming Zeng
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Lina Zhang
- Department of Nephrology, Henan Provincial Key Laboratory of Kidney Disease and Immunology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan, China
| | - Wenkai Ren
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Hanyang Qian
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Ying Cui
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China; Department of Nephrology, Northern Jiangsu People's Hospital, Jiangsu, China
| | - Guang Yang
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Wenbin Zhou
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Jiangsu, China
| | - Shui Wang
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Jiangsu, China
| | - Hui Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Jiangsu, China
| | - Huimin Chen
- Department of Nephrology, Taizhou People's Hospital, Jiangsu, China
| | - Yujie Xiao
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Xueyan Gao
- Department of General Medicine, Geriatric Hospital of Nanjing Medical University, Jiangsu, China
| | - Zhanhui Gao
- Department of Nephrology, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Jiangsu, China
| | - Jing Wang
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Cuiping Liu
- Department of Biological Specimen Repository, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Jiangsu, China
| | - Jing Zhang
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Baiqiao Zhao
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Anning Bian
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Fan Li
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Huiting Wan
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Changying Xing
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China
| | - Xiaoming Zha
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Jiangsu, China.
| | - Ningning Wang
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu, China.
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Cavalier E, Vasikaran S, Bhattoa HP, Heijboer AC, Makris K, Ulmer CZ. The path to the standardization of PTH: Is this a realistic possibility? a position paper of the IFCC C-BM. Clin Chim Acta 2021; 515:44-51. [PMID: 33412144 PMCID: PMC7920929 DOI: 10.1016/j.cca.2020.12.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/07/2020] [Accepted: 12/18/2020] [Indexed: 11/18/2022]
Abstract
Parathyroid hormone (PTH) determination is of greatest importance for patients suffering from parathyroid gland disorders and for the follow-up of bone turnover in patients suffering from chronic kidney disease (CKD). Two generations of PTH assays are simultaneously present on the market for PTH quantification. As these assays are not yet standardized, this results in a significant level of confusion in the care of CKD patients. One key objective of the IFCC Committee for Bone Metabolism is to improve this situation. In this position paper, we will highlight the current state of PTH testing and propose a pathway to ultimately overcome issues resulting from PTH assay variability.
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Affiliation(s)
- Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Domaine du Sart-Tilman, B-4000 Liège, Belgium.
| | - Samuel Vasikaran
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Harjit P Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen Hungary
| | - Annemieke C Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam Gastroenterology & Metabolism, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, 14561 Athens, Greece; Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", Medical School, University of Athens, Athens, Greece
| | - Candice Z Ulmer
- Clinical Chemistry Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Buford, Atlanta, GA, USA
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8
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Khalil H, Borai A, Dakhakhni M, Bahijri S, Faizo H, Bokhari FF, Ferns G, Mirza AA. Stability and validity of intact parathyroid hormone levels in different sample types and storage conditions. J Clin Lab Anal 2021; 35:e23771. [PMID: 33792964 PMCID: PMC8183913 DOI: 10.1002/jcla.23771] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/16/2021] [Accepted: 03/16/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Several pre-analytical factors can affect the measurement of intact Parathyroid Hormone (IPTH). In this study, we have investigated the effects of using different types of tubes, time elapsed before separation, and storage conditions over time on the measured values of IPTH. METHOD Blood samples from 30 subjects were collected into plain, SST, and EDTA tubes. All serum and plasma were separated immediately (first set) and after 2 hrs delay (second set). The first set of samples were aliquoted and stored at RT (25°C), at fridge (4°C), and freezer (-20°C). IPTH was measured in all the stored aliquots at 2,4, and 8 days after collection using Architect analyzer. RESULTS Paired T test and ANOVA repeated measures showed no significant difference between IPTH levels in all tubes. The second set of serum and plasma were significantly lower (3.8% and 7.4%, p < 0.001, respectively) when compared to samples measured initially. Serum samples stored at RT were significantly lower (by 45%,59%, and 77%) on days 2,4, and 8 when compared to the initial time (p < 0.001 in all cases). Plasma samples stored at RT, were significantly lower on day 8 after collection, by 30.8% (p < 0.001). These differences would be clinically important. CONCLUSION Plasma IPTH can be stored at RT for up to four days. Both plasma and serum IPTH are not affected by a delay in the separation of up to two h and they can be stored for up to 8 days in a fridge or freezer without any clinically significant changes in their values.
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Affiliation(s)
- Haitham Khalil
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Pathology, King Abdulaziz Medical City, Jeddah, Saudi Arabia.,Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Anwar Borai
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Pathology, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Mohammed Dakhakhni
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Pathology, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Suhad Bahijri
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hala Faizo
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fawzi F Bokhari
- Academic Affairs, Armed Forces Hospital Administration, Taif, Saudi Arabia
| | - Gordon Ferns
- Division of Medical Education, Brighton and Sussex Medical School, Mayfield House, Brighton, United Kingdom
| | - Ahmed A Mirza
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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9
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Ding F, Nie X, Li X, He Y, Li G. Data mining: Biological and temporal factors associated with blood parathyroid hormone, vitamin D, and calcium concentrations in the Southwestern Chinese population. Clin Biochem 2021; 90:50-57. [PMID: 33539806 DOI: 10.1016/j.clinbiochem.2021.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/19/2021] [Accepted: 01/24/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Parathyroid hormone (PTH) and vitamin D plays a major role in calcium (Ca) homeostasis and bone turnover. The purpose of this study was to assess which factors (sex, age, time of blood sampling, season of the year, temperature and sunshine hours (SHH)) had the greatest impact on plasma PTH, 25-OH-VitD, and Ca levels, and then whether these effects were clinically acceptable in a large number of Southwestern Chinese subjects. METHOD The data was from West China Hospital Health Examination Center, Sichuan University from April 1, 2018 to June 30, 2019. A total of 18,664 physical examination subjects were included. PTH and 25-OH-VitD were measured by a Roche Cobas e 601, and Ca was measured by a Roche Cobas 8000. Linear regression models were used to assess correlations between PTH, 25-OH-VitD, Ca and the above factors. RESULTS The concentrations of serum PTH in females were significantly higher than those in males, while the 25-OH-VitD and Ca were opposite. The concentration of PTH in data collection decreased in summer and increased in spring. The concentration of 25-OH-VitD decreases in spring and increases in autumn. PTH concentrations were negatively correlated with last month temperature and SHH, while 25-OH-VitD were opposite. Linear regression showed that season may be the main factor affecting serum PTH and 25-OH-VitD levels, and these effects were not clinically acceptable. CONCLUSION In order to avoid influencing clinicians' investigation of suspected hyperparathyroidism and hypovitaminosis, reference intervals for PTH, 25-OH-VitD, and Ca should be established, taking into account sex, age and the season.
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Affiliation(s)
- Fei Ding
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xin Nie
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiaoling Li
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yong He
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
| | - Guixing Li
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China.
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10
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Farré-Segura J, Fabregat-Cabello N, Calaprice C, Nyssen L, Peeters S, Le Goff C, Cavalier E. Development and validation of a fast and reliable method for the quantification of glucagon by liquid chromatography and tandem mass spectrometry. Clin Chim Acta 2020; 512:156-165. [PMID: 33181149 DOI: 10.1016/j.cca.2020.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/03/2020] [Accepted: 11/03/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The quantitation of glucagon remains a challenging immunoassay, mainly due to cross-reactivity. A sensitive, rapid and specific intact glucagon method is therefore necessary for quality routine analysis. A tandem mass spectrometry method to fulfill this objective is described in this work. METHODS Glucagon was extracted from plasma employing a mixed-mode anion exchange solid-phase extraction. Sample stability was assessed in K2-EDTA and P800 tubes at different temperatures. We compared our method to two different immunoassays. FDA and EMA guidelines were followed for validation. An external quality control program served for comparison with other laboratories. RESULTS Assay imprecision was below 4%. Recoveries were within 95-103%. LoQ was 8.75 pg/mL. Total analytical CV was 2.91%. Samples were found stable at 4 °C for less than 4 h. Diasource® RIA disagreed with our method. Mercodia® ELISA provided a closer agreement, also proven by external quality control samples. CONCLUSIONS A rapid and specific LC-MS/MS method for glucagon quantitation has been developed, validated and is suitable to routine care. The simplicity and the good performances in terms of time and specificity, could open the possibility to establish a standardized method for glucagon.
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Affiliation(s)
- Jordi Farré-Segura
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Belgium
| | | | - Chiara Calaprice
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Belgium
| | - Laurent Nyssen
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Belgium
| | - Stéphanie Peeters
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Belgium
| | - Caroline Le Goff
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Belgium
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Belgium.
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11
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Gannagé-Yared MH, Kallas-Chémaly MN, Sleilaty G. Parathormone Levels in a Middle-Eastern Healthy Population Using 2 nd and 3 rd Generation PTH Assays. Int J Endocrinol 2020; 2020:6302861. [PMID: 32148490 PMCID: PMC7054794 DOI: 10.1155/2020/6302861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/15/2019] [Accepted: 01/23/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The purpose of the current study is to determine PTH reference values in vitamin-D-replete Lebanese adults using 2nd and 3rd generation PTH assays and to look at the factors that affect PTH variations. METHODS Fasting PTH was measured using 2nd and 3rd generation Diasorin PTH assays in 339 vitamin-D-replete healthy subjects aged 18 to 63 years (230 men and 109 women) who have normal calcium levels and an eGFR ≥60 ml/mn. 25-OH vitamin D (25(OH)D) was measured using the Diasorin assay. RESULTS For the 2nd PTH generation, median (IQR) levels were 48.9 (34.9-66.0) pg/ml, and its 2.5th-97.5th percentile values were 19.7-110.5 pg/ml for 25(OH)D values between 20 and 30 ng/ml, and 19.7-110.7 pg/ml for 25(OH)D values ≥30 ng/ml. For the 3rd PTH generation, the median (IQR) values were 23.9 (17.7-30.5) pg/ml, and its 2.5th-97.5th percentile values were, respectively, 9.2 and 50.2 pg/ml for 25(OH)D values between 20 and 30 ng/ml, and 8.4 and 45.4 pg/ml for 25(OH)D values ≥30 ng/ml. The median (IQR) serum 25(OH)D levels were 27.5 (23.8-32.7) ng/ml. 2nd and 3rd generation PTH values are strongly correlated (r = 0.96, p < 0.0001), but poorly concordant (Lin's concordance coefficient 0.365, 95% CI: 0.328-0.401) with observations beyond the 95% Bland-Altman limits of agreement. 2nd and 3rd generation PTH levels did not differ according to gender and were significantly correlated with age but not with 25(OH)D and serum calcium levels. CONCLUSION Lebanese adult healthy subjects have higher 2nd and 3rd generation PTH levels compared with the reference range provided by the manufacturer. The reference range was not influenced by changing the 25(OH)D cutoff. The clinical significance of the higher PTH levels in our population should be investigated.
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Affiliation(s)
| | | | - Ghassan Sleilaty
- Department of Biostatistics, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Clinical Research Center, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
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12
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Cavalier E, Souberbielle JC, Delanaye P. PTH determination in hemodialyzed patients-A laboratory perspective. Semin Dial 2019; 32:490-492. [PMID: 31631422 DOI: 10.1111/sdi.12844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Parathyroid hormone (PTH) is a key player of bone remodelling in patients suffering from Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Serum PTH concentrations are thus frequently measured in CKD patients. Nevertheless, this determination is far from simple. PTH stability can be an issue and degradation of the peptide can be important if storage is not properly done. Biologically active PTH circulates together with fragments, which can be detected by some immunoassays. There is, up to now, no standardization of the assays available on the market, which can lead to some confusion when patients are followed with different methods. The upper end of the reference ranges provided by some manufacturers have not been properly established and are sometimes far too high. Finally, PTH can be oxidized in vivo and thus become inactive, while still quantified by immunoassays. In this Editorial, we will try to highlight some of these issues on PTH measurement.
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Affiliation(s)
- Etienne Cavalier
- Department of Clinical chemistry, CHU de Liège, University of Liège, Liège, Belgium.,CKD-MBD Working group of the European Renal Association - European Dialysis and Transplant Association (ERA-EDTA).,International Federation of Clinical Chemistry (IFCC) Committee for Bone Metabolism (IFCC C-BM)
| | - Jean-Claude Souberbielle
- Laboratoire d'Explorations Fonctionnelles, INSERM U1151, Hôpital Necker-Enfant Malades, Paris, France
| | - Pierre Delanaye
- Department of Nephrology, Dialysis and Transplantation, CHU de Liège, University of Liège, Liège, Belgium
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13
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Ercan M, Akbulut ED, Avcı E, Yücel Ç, Oğuz EF, Turhan T, Serdar M. Determining biological variation of serum parathyroid hormone in healthy adults. Biochem Med (Zagreb) 2019; 29:030702. [PMID: 31379460 PMCID: PMC6610671 DOI: 10.11613/bm.2019.030702] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 05/24/2019] [Indexed: 11/21/2022] Open
Abstract
Introduction Measurement of parathyroid hormone (PTH) is essential in the investigation and management of calcium metabolism disorders. To assess the significance of any assay result when clinical decision making biological variation (BV) of the measurand must be taken into consideration. The aim of the present study is determining the BV parameters for serum PTH. Materials and methods Blood samples were taken at weekly intervals from 20 healthy subjects for ten weeks in this prospective BV study. Serum “intact PTH” concentrations were measured with electrochemiluminescence method. Biological variation parameters were estimated using the approach proposed by Fraser. Results The values of within-subject biological variation (CVI), between-subject biological variation (CVG), analytical variation (CVA), reference change value (RCV) and individuality index (II) for serum PTH were 21.1%, 24.9%, 3.8%, 59.4% and 0.8%, respectively. Within-subject biological variation and CVG were also determined according to gender separately; 18.5% and 24.0%; 26.2% and 18.6% for male and female, respectively. Calculated desirable precision and bias goals were < 10.6% and < 6.3%, respectively. Conclusion This study may contribute to BV data on serum PTH as it includes a sufficient number of volunteers from both genders over an acceptable period of time. We do not recommend the usage of population-based reference intervals for serum PTH concentrations. Reference change value may be helpful for the evaluation of serial serum PTH results. Nonetheless, evaluation of data according to gender is necessary when setting analytical performance specifications.
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Affiliation(s)
- Müjgan Ercan
- Faculty of Medicine, Department of Biochemistry, Harran University, Şanlıurfa, Turkey
| | - Emiş Deniz Akbulut
- Biochemistry Laboratory, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey
| | - Esin Avcı
- Faculty of Medicine, Department of Biochemistry, Pamukkale University, Denizli, Turkey
| | - Çiğdem Yücel
- Biochemistry Laboratory, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Esra Fırat Oğuz
- Biochemistry Laboratory, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Turan Turhan
- Biochemistry Laboratory, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Muhittin Serdar
- Faculty of Medicine, Department of Biochemistry, Acıbadem University, İstanbul, Turkey
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14
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Sharma-Ghimire P, Chen Z, Sherk V, Bemben M, Bemben D. Sclerostin and parathyroid hormone responses to acute whole-body vibration and resistance exercise in young women. J Bone Miner Metab 2019; 37:358-367. [PMID: 29956019 DOI: 10.1007/s00774-018-0933-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 04/29/2018] [Indexed: 01/18/2023]
Abstract
Whole-body vibration (WBV) has been shown to improve bone mineral density, and muscle strength and power. No studies to date have examined sclerostin and parathyroid hormone (PTH) responses to WBV combined with resistance exercise (RE). This randomized crossover study compared acute serum sclerostin and PTH responses to RE and WBV + RE in young women (n = 9) taking oral contraceptives. Participants were exposed to 5 1-min bouts of vibration (20 Hz, 3.38 peak-peak displacement, separated by 1 min of rest) before high intensity resistance exercise. Fasting blood samples were obtained before (PRE), immediately after WBV (POSTWBV), immediately post RE (IP) and 30 min post RE (30P). Pre-exercise sclerostin and PTH levels were not significantly different between conditions. Sclerostin levels significantly (p < 0.05) increased from PRE to IP for the WBV + RE condition, then decreased back to the pre-exercise level. PTH significantly decreased from PRE to 30P (p < 0.05) and IP to 30P (p < 0.01) for both conditions. Correcting for hemoconcentration eliminated the significant sclerostin responses, but the significant decrease in PTH remained (p < 0.05). There were no significant relationships found between sclerostin and PTH. In conclusion, sclerostin concentrations increased in response to the WBV + RE condition, which may have been mediated by plasma volume shifts. There was no transient PTH increase, but it showed a large decrease at 30P for both conditions. Based on these findings, the addition of WBV exposures prior to high intensity RE did not alter sclerostin and PTH responses to RE in young women.
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Affiliation(s)
- Pragya Sharma-Ghimire
- Bone Density Research Laboratory, Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK, 73019, USA
| | - Zhaojing Chen
- Bone Density Research Laboratory, Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK, 73019, USA
| | - Vanessa Sherk
- Department of Medicine, Division of Endocrinology, Metabolism and Diabetes, University of Colorado at Denver Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Michael Bemben
- Bone Density Research Laboratory, Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK, 73019, USA
| | - Debra Bemben
- Bone Density Research Laboratory, Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK, 73019, USA.
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15
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Chen H, Han X, Cui Y, Ye Y, Purrunsing Y, Wang N. Parathyroid Hormone Fragments: New Targets for the Diagnosis and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9619253. [PMID: 30627584 PMCID: PMC6304519 DOI: 10.1155/2018/9619253] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/22/2018] [Accepted: 10/28/2018] [Indexed: 12/28/2022]
Abstract
As a common disorder, chronic kidney disease (CKD) poses a great threat to human health. Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a complication of CKD characterized by disturbances in the levels of calcium, phosphorus, parathyroid hormone (PTH), and vitamin D; abnormal bone formation affecting the mineralization and linear growth of bone; and vascular and soft tissue calcification. PTH reflects the function of the parathyroid gland and also takes part in the metabolism of minerals. The accurate measurement of PTH plays a vital role in the clinical diagnosis, treatment, and prognosis of patients with secondary hyperparathyroidism (SHPT). Previous studies have shown that there are different fragments of PTH in the body's circulation, causing antagonistic effects on bone and the kidney. Here we review the metabolism of PTH fragments; the progress being made in PTH measurement assays; the effects of PTH fragments on bone, kidney, and the cardiovascular system in CKD; and the predictive value of PTH measurement in assessing the effectiveness of parathyroidectomy (PTX). We hope that this review will help to clarify the value of accurate PTH measurements in CKD-MBD and promote the further development of multidisciplinary diagnosis and treatment.
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Affiliation(s)
- Huimin Chen
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu Province 210029, China
| | - Xiaxia Han
- Nanjing Medical University, Nanjing, Jiangsu Province 211166, China
| | - Ying Cui
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu Province 210029, China
| | - Yangfan Ye
- Nanjing Medical University, Nanjing, Jiangsu Province 211166, China
| | - Yogendranath Purrunsing
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu Province 210029, China
| | - Ningning Wang
- Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu Province 210029, China
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16
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Valcour A, Zierold C, Blocki FA, Hawkins DM, Martin KJ, Rao SD, Bonelli F. Trueness, precision and stability of the LIAISON 1-84 parathyroid hormone (PTH) third-generation assay: comparison to existing intact PTH assays. Clin Chem Lab Med 2018; 56:1476-1482. [PMID: 29750642 DOI: 10.1515/cclm-2018-0217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 03/07/2018] [Indexed: 11/15/2022]
Abstract
BACKGROUND Over the past few decades, parathyroid hormone (PTH) immunoassays have progressed through successive generations resulting in increased specificity and accuracy for detecting circulating PTH. With the introduction of third-generation assays, in which the biologically active PTH(1-84) is specifically targeted, the PTH(7-84) and other fragments are not detected. The specific recognition of only PTH(1-84) whole molecule allows for more reliable standardization and calibration than with the existing assays. METHODS Samples from patients on hemodialysis or with primary hyperparathyroidism and apparently healthy subjects were examined in different collection matrices (EDTA plasma, unspun EDTA plasma and SST) stored for 0, 24 or 72 h at room temperature to reflect the prevailing sample collection methods, shipping and processing conditions of centralized labs in the United States. Samples were analyzed by the LIAISON 1-84 PTH and N-TACT assays, and by three additional commercially available intact PTH assays. RESULTS Defined samples, prepared using two different standards (WHO 95/646 international standard and the synthetic Bachem PTH(1-84)), show little bias with the LIAISON 1-84 PTH assay, but not with the other intact PTH assays. Furthermore, PTH is stable for up to 72 h in plasma, but less stable in serum beyond 24 h. CONCLUSIONS The FDA-approved LIAISON 1-84 PTH assay is accurate and reliably measures the biologically active PTH molecule in plasma or serum stored at room temperature for up 72 and 24 h, respectively.
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Affiliation(s)
- Andre Valcour
- LabCorp, Center for Esoteric Testing, 1447 York Court, Burlington, NC 27215, USA, Phone: +(336) 436-3854, Fax: +(336) 436-0618
| | | | | | | | - Kevin J Martin
- Division of Nephrology, Saint Louis University, St. Louis, MO, USA
| | - Sudhaker D Rao
- Division of Endocrinology, Diabetes, Bone and Mineral Metabolism, Henry Ford Health System, Detroit, MI, USA
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17
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Hocher B, Zeng S. Clear the Fog around Parathyroid Hormone Assays: What Do iPTH Assays Really Measure? Clin J Am Soc Nephrol 2018; 13:524-526. [PMID: 29507007 PMCID: PMC5969453 DOI: 10.2215/cjn.01730218] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Berthold Hocher
- Institute of Nutritional Science, University of Potsdam, Potsdam-Rehbrucke, Germany
- Department of Nephrology, the First Affiliated Hospital of Jinan University, Guangzhou, China
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China; and
| | - Shufei Zeng
- Institute of Nutritional Science, University of Potsdam, Potsdam-Rehbrucke, Germany
- Department of Nephrology, Charité Universitätsmedizin Berlin, Berlin, Germany
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18
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Sturgeon CM, Sprague S, Almond A, Cavalier E, Fraser WD, Algeciras-Schimnich A, Singh R, Souberbielle JC, Vesper HW. Perspective and priorities for improvement of parathyroid hormone (PTH) measurement - A view from the IFCC Working Group for PTH. Clin Chim Acta 2016; 467:42-47. [PMID: 27746210 DOI: 10.1016/j.cca.2016.10.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 10/11/2016] [Accepted: 10/12/2016] [Indexed: 11/15/2022]
Abstract
Parathyroid hormone (PTH) measurement in serum or plasma is a necessary tool for the exploration of calcium/phosphate disorders, and is widely used as a surrogate marker to assess skeletal and mineral disorders associated with chronic kidney disease (CKD), referred to as CKD-bone mineral disorders (CKD-MBD). CKD currently affects >10% of the adult population in the United States and represents a major health issue worldwide. Disturbances in mineral metabolism and fractures in CKD patients are associated with increased morbidity and mortality. Appropriate identification and management of CKD-MBD is therefore critical to improving clinical outcome. Recent increases in understanding of the complex pathophysiology of CKD, which involves calcium, phosphate and magnesium balance, and is also influenced by vitamin D status and fibroblast growth factor (FGF)-23 production, should facilitate such improvement. Development of evidence-based recommendations about how best to use PTH is limited by considerable method-related variation in results, of up to 5-fold, as well as by lack of clarity about which PTH metabolites these methods recognise. This makes it difficult to compare PTH results from different studies and to develop common reference intervals and/or decision levels for treatment. The implications of these method-related differences for current clinical practice are reviewed here. Work being undertaken by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) to improve the comparability of PTH measurements worldwide is also described.
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Affiliation(s)
- Catharine M Sturgeon
- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK.
| | - Stuart Sprague
- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Alison Almond
- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Etienne Cavalier
- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - William D Fraser
- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | | | - Ravinder Singh
- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | | | - Hubert W Vesper
- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
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- C/o Department of Laboratory Medicine, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
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