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Serum PTH reference values in an adult Brazilian population: implications for the diagnosis of hyperparathyroidism
Rosario, Pedro Weslley; Calsolari, Maria Regina.
  • Rosario, Pedro Weslley; Santa Casa de Belo Horizonte. Belo Horizonte. BR
  • Calsolari, Maria Regina; Santa Casa de Belo Horizonte. Belo Horizonte. BR
Arch. endocrinol. metab. (Online) ; 63(2): 182-185, Mar.-Apr. 2019. tab
Article in English | LILACS | ID: biblio-1038494
ABSTRACT
ABSTRACT

Objective:

To define serum parathyroid hormone (PTH) reference values in carefully selected subjects following the recommended pre-analytical guidelines. Subjects and

methods:

First, 676 adults who would be submitted to thyroidectomy were evaluated. Patients using interfering medications or with malabsorption syndrome, hypomagnesemia, hyper- or hypophosphatemia, hypo- or hypercalcemia, 25-hydroxyvitamin D < 30 ng/dL, estimated glomerular filtration rate < 60 mL/min/1.73 m2, urinary calcium/creatinine ratio ≥ 0.25, thyroid dysfunction, parathyroid adenoma detected during surgery were excluded. The sample consisted of 312 subjects.

Results:

The median, minimum, maximum, and 2.5th and 97.5th percentiles of the PTH values obtained were 30, 7.2, 78, 10.1, and 52 pg/mL, respectively. Thus, the reference range was 10 to 52 pg/mL. PTH > 65 pg/mL, the upper limit of normal according to the manufacturer of the kit, was observed in only one subject (0.3%). Considering the upper limit proposed by the kit's manufacturer, 1/6 hypercalcemic patients and 4/8 normocalcemic patients with PHPT had normal PTH. Using the upper limit established in this study, only one normocalcemic patient had normal PTH. Thus, the sensitivity of PTH in detecting asymptomatic primary hyperparathyroidism (PHPT) using the values recommended by the kit and established in this study was 64% and 93%, respectively (50% versus 87.5% for normocalcemic PHPT).

Conclusion:

The upper reference limit of PTH obtained for a rigorously selected sample was 20% lower than that provided by the assay, which increased its sensitivity in detecting PHPT.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Parathyroid Hormone / Thyroid Nodule / Hyperparathyroidism Type of study: Diagnostic study / Observational study Limits: Adolescent / Adult / Aged / Female / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Arch. endocrinol. metab. (Online) Journal subject: Endocrinology / Metabolism Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Santa Casa de Belo Horizonte/BR

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Full text: Available Index: LILACS (Americas) Main subject: Parathyroid Hormone / Thyroid Nodule / Hyperparathyroidism Type of study: Diagnostic study / Observational study Limits: Adolescent / Adult / Aged / Female / Humans / Male Country/Region as subject: South America / Brazil Language: English Journal: Arch. endocrinol. metab. (Online) Journal subject: Endocrinology / Metabolism Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Santa Casa de Belo Horizonte/BR