Cargando…
The whole-PTH/intact-PTH ratio is a useful predictor of severity of secondary hyperparathyroidism
Background. The newer parathyroid hormone (PTH) assay, whole-PTH, uses an antibody that binds the region harbouring the first amino acid, making it specific for the complete molecule, 1–84-PTH. Especially among dialysis patients, it has been reported that the level of whole-PTH can be calculated as...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2008
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4421130/ https://www.ncbi.nlm.nih.gov/pubmed/25983976 http://dx.doi.org/10.1093/ndtplus/sfn089 |
_version_ | 1782369798634602496 |
---|---|
author | Tanaka, Motoko Komaba, Hirotaka Itoh, Kazuko Matsushita, Kazunori Matshushita, Kazutaka Hamada, Yasuhiro Fujii, Hideki Fukagawa, Masafumi |
author_facet | Tanaka, Motoko Komaba, Hirotaka Itoh, Kazuko Matsushita, Kazunori Matshushita, Kazutaka Hamada, Yasuhiro Fujii, Hideki Fukagawa, Masafumi |
author_sort | Tanaka, Motoko |
collection | PubMed |
description | Background. The newer parathyroid hormone (PTH) assay, whole-PTH, uses an antibody that binds the region harbouring the first amino acid, making it specific for the complete molecule, 1–84-PTH. Especially among dialysis patients, it has been reported that the level of whole-PTH can be calculated as ∼60% of their intact-PTH value. In addition, since 1–84-PTH is part of intact-PTH, the whole-PTH/intact-PTH ratio should not theoretically exceed 1. However, an abnormally high 1–84-PTH/intact-PTH ratio is reported in a few patients with parathyroid carcinoma, primary hyperparathyroidism and secondary hyperparathyroidism. In this study, we examined the correlation between the 1–84-PTH/intact-PTH ratio and the severity of hyperparathyroidism in patients on haemodialysis (HD). Patients and methods. The study population comprised 196 HD patients (males 113, females 83, age 67.4 ± 13.6 years, HD period 8.1 ± 7.3 years; mean ± SD). The whole-PTH/intact-PTH ratio was compared in patients with high PTH levels (intact-PTH ≥300 pg/ ml; high PTH group, n = 32), moderate PTH levels (intact-PTH >150–<300 pg/ml; moderate PTH group, n = 50) and low PTH levels (intact-PTH <150 pg/ml; low PTH group, n = 114). The ratio was also compared in 25 patients with at least one enlarged gland >0.5 cm(3) suggesting nodular hyperplasia, as determined by power Doppler ultrasonography (hyperplasia group) with seven patients without enlarged gland (non-hyperplasia group) and six patients who had undergone total parathyroidectomy (post-PTx group). Results. The whole-PTH/intact-PTH ratio of the high PTH group (0.68 ± 0.1) was significantly higher than those of the moderate (0.61 ± 0.1, P < 0.001) and low (0.52 ± 0.1, P < 0.001) groups. Moreover, the ratio was significantly higher in the hyperplasia group (0.70 ± 0.1) than those in the non-hyperplasia group (0.59 ± 0.1, P < 0.05) and post-PTx group (0.456 ± 0.12, P < 0.001). Conclusions. The whole-PTH/intact-PTH ratio correlated with the severity of hyperparathyroidism. Our results suggest that the ratio might be a useful predictor of severity of secondary hyperparathyroidism in HD patients. |
format | Online Article Text |
id | pubmed-4421130 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-44211302015-05-15 The whole-PTH/intact-PTH ratio is a useful predictor of severity of secondary hyperparathyroidism Tanaka, Motoko Komaba, Hirotaka Itoh, Kazuko Matsushita, Kazunori Matshushita, Kazutaka Hamada, Yasuhiro Fujii, Hideki Fukagawa, Masafumi NDT Plus Original Article Background. The newer parathyroid hormone (PTH) assay, whole-PTH, uses an antibody that binds the region harbouring the first amino acid, making it specific for the complete molecule, 1–84-PTH. Especially among dialysis patients, it has been reported that the level of whole-PTH can be calculated as ∼60% of their intact-PTH value. In addition, since 1–84-PTH is part of intact-PTH, the whole-PTH/intact-PTH ratio should not theoretically exceed 1. However, an abnormally high 1–84-PTH/intact-PTH ratio is reported in a few patients with parathyroid carcinoma, primary hyperparathyroidism and secondary hyperparathyroidism. In this study, we examined the correlation between the 1–84-PTH/intact-PTH ratio and the severity of hyperparathyroidism in patients on haemodialysis (HD). Patients and methods. The study population comprised 196 HD patients (males 113, females 83, age 67.4 ± 13.6 years, HD period 8.1 ± 7.3 years; mean ± SD). The whole-PTH/intact-PTH ratio was compared in patients with high PTH levels (intact-PTH ≥300 pg/ ml; high PTH group, n = 32), moderate PTH levels (intact-PTH >150–<300 pg/ml; moderate PTH group, n = 50) and low PTH levels (intact-PTH <150 pg/ml; low PTH group, n = 114). The ratio was also compared in 25 patients with at least one enlarged gland >0.5 cm(3) suggesting nodular hyperplasia, as determined by power Doppler ultrasonography (hyperplasia group) with seven patients without enlarged gland (non-hyperplasia group) and six patients who had undergone total parathyroidectomy (post-PTx group). Results. The whole-PTH/intact-PTH ratio of the high PTH group (0.68 ± 0.1) was significantly higher than those of the moderate (0.61 ± 0.1, P < 0.001) and low (0.52 ± 0.1, P < 0.001) groups. Moreover, the ratio was significantly higher in the hyperplasia group (0.70 ± 0.1) than those in the non-hyperplasia group (0.59 ± 0.1, P < 0.05) and post-PTx group (0.456 ± 0.12, P < 0.001). Conclusions. The whole-PTH/intact-PTH ratio correlated with the severity of hyperparathyroidism. Our results suggest that the ratio might be a useful predictor of severity of secondary hyperparathyroidism in HD patients. Oxford University Press 2008-08 /pmc/articles/PMC4421130/ /pubmed/25983976 http://dx.doi.org/10.1093/ndtplus/sfn089 Text en © The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Original Article Tanaka, Motoko Komaba, Hirotaka Itoh, Kazuko Matsushita, Kazunori Matshushita, Kazutaka Hamada, Yasuhiro Fujii, Hideki Fukagawa, Masafumi The whole-PTH/intact-PTH ratio is a useful predictor of severity of secondary hyperparathyroidism |
title | The whole-PTH/intact-PTH ratio is a useful predictor of severity of secondary hyperparathyroidism |
title_full | The whole-PTH/intact-PTH ratio is a useful predictor of severity of secondary hyperparathyroidism |
title_fullStr | The whole-PTH/intact-PTH ratio is a useful predictor of severity of secondary hyperparathyroidism |
title_full_unstemmed | The whole-PTH/intact-PTH ratio is a useful predictor of severity of secondary hyperparathyroidism |
title_short | The whole-PTH/intact-PTH ratio is a useful predictor of severity of secondary hyperparathyroidism |
title_sort | whole-pth/intact-pth ratio is a useful predictor of severity of secondary hyperparathyroidism |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4421130/ https://www.ncbi.nlm.nih.gov/pubmed/25983976 http://dx.doi.org/10.1093/ndtplus/sfn089 |
work_keys_str_mv | AT tanakamotoko thewholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT komabahirotaka thewholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT itohkazuko thewholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT matsushitakazunori thewholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT matshushitakazutaka thewholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT hamadayasuhiro thewholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT fujiihideki thewholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT fukagawamasafumi thewholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT tanakamotoko wholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT komabahirotaka wholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT itohkazuko wholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT matsushitakazunori wholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT matshushitakazutaka wholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT hamadayasuhiro wholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT fujiihideki wholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism AT fukagawamasafumi wholepthintactpthratioisausefulpredictorofseverityofsecondaryhyperparathyroidism |