Improved assessment of bone turnover by the PTH-(1-84) large C-PTH fragments ratio in ESRD patients
Improved assessment of bone turnover by the PTH-(1-84) large C-PTH fragments ratio in ESRD patients
复制标题
DOI：
10.1046/j.1523-1755.2001.00949.x
复制
发表时间：
2001-10-01
影响因子：
19.6
通讯作者：
Malluche, HH
中科院分区：
文献类型：
--
作者：
Monier-Faugere, MC;Geng, ZP;Malluche, HH
背景“完整”甲状旁腺激素（PTH）检测识别PTH-（1-84）以及氨基末端截短的PTH片段。即大的羧基末端PTH片段（C-PTH片段）。本研究调查了血浆PTH-（1-84）/C-PTH片段比率的使用是否增强了透析患者骨转换的无创评估。对51例未接受影响骨的药物（如维生素D或皮质类固醇）治疗的透析成人患者进行骨活检和血液样本，以测定骨转换和PTH肽的常规指标。通过从“完整”PTH中减去PTH-（1-84）来计算大C-PTH片段的血液水平。根据组织形态学获得的激活频率结果，根据骨转换水平对患者进行分类。采用适当的统计方法，通过各种血液指标预测boc周转率。此外，高钙血症诱导葡萄糖酸钙输注在一个子集的患者，PTH-（1-84），“完整的”PTH的水平。测定PTH（1-84）/C-PTH片段比值。PTH-（1-84）/C-PTH片段比是骨转换的最佳预测因子。比值>1预示骨转换高或正常（灵敏度100%），而比值> 1则预示骨转换高或正常（灵敏度100%）。
Background. The "intact" parathyroid hormone (PTH) assay recognizes PTH-(1-84) as well as amino terminally truncated PTH fragments. that is, large carboxyterminal PTH fragments (C-PTH fragments). The present study investigated whether the use of the plasma PTH-(1-84)/C-PTH fragment ratio enhances the noninvasive assessment of bone turnover in patients on dialysis.Methods. Bone biopsies and blood samples for determinations of routine indices of bone turnover and PTH peptides were obtained in 51 adult patients on dialysis not treated with drugs affecting bone such as vitamin D or corticosteroids. Blood levels of large C-PTH fragments were calculated by subtracting PTH-(1-84) from "intact" PTH. Patients were classified according to their levels of bone turnover based on histomorphometrically obtained results of activation frequency. Prediction of bo c turnover by the various blood indices was done by using proper statistical methods. In addition, hypercalcemia was induced by calcium gluconate infusion in a subset of patients, and levels of PTH-(1-84), "intact" PTH. and PTH(1-84)/C-PTH fragment ratio were determined.Results. The PTH-(1-84)/C-PTH fragment ratio was the best predictor of bone turnover. A ratio >1 predicted high or normal bone turnover (sensitivity 100%), whereas a ratio