Influence of PTH assay methodology on differential diagnosis of renal bone disease
Influence of PTH assay methodology on differential diagnosis of renal bone disease
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DOI：
10.1093/ndt/gfg144
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发表时间：
2003-04-01
影响因子：
6.1
通讯作者：
Schmidt-Gayk, H
中科院分区：
文献类型：
--
作者：
Reichel, H;Esser, A;Schmidt-Gayk, H
背景血浆甲状旁腺激素（PTH）的测定是诊断和监测肾性骨病的常规方法。最近，已经引入了使用特异性针对PTH（1-4）的抗体的新的PTH测定（“全PTH”）。本研究的目的是评价肾性骨病患者的全甲状旁腺素及其相关参数。对141例血液透析患者的血液样本进行了以下测量：三种完整的PTH测定（Nichols，Roche Elecsys（（R）），总的Severity小体）;全PTH（Severity小体）;骨特异性碱性磷酸酶（W）;抗酒石酸酸性磷酸酶5 b（TRAP 5 b）;骨钙素，25-羟基维生素D。来自全PTH的参数为：（i）非PTH（1-84），完整PTH（分泌体测定）和全PTH之间的差异;（ii）全PTH/非PTH（1-84）比值。通过完整PTH测定产生的值相当。平均全PTH浓度低于平均完整PTH浓度（16.9 +/- 18.1 vs 26.4 +/- 30.5 pmol/l，Nichols，P < 0.05）。所有四种PTH测定之间的相关系数相当，并且非常高（r > 0.96，ns）。整个PTH测定产生的值的等级顺序与Nichols完整PTH测定产生的等级顺序在统计学上无显著差异。中位非PTH（1-84）浓度为5.2 pmol/l（范围0-49.4）。所有PTH测定与非PTH（1-84）高度显著相关（相关系数0.83-0.92）。校正血清钙也与非PTH（1-84）相关，但相关性较弱（r = 0.28）。回归分析表明，非PTH（1-84）的浓度可以预测76.6%-84.6%的现行完整的PTH浓度。其他参数对非PTH的预测贡献很小（1-84）。在整个患者组中，整个PTH/非PTA（1-84）比值与任何PTH测定或生化骨标志物之间无统计学显著相关性。141例患者中有8例的PTH/非PTH比值为1-84
Background. Determination of plasma parathyroid hormone (PTH) is routinely performed to diagnose and monitor renal bone disease. Recently, a new PTH assay ('whole PTH') using an antibody directed specifically against PTH(1-4) has been introduced. It was the aim of the current study to evaluate whole PTH and parameters derived from whole PTH in renal bone disease.Methods. The following measurements were carried out in blood samples from 141 unselected haemodialysis patients: three intact PTH assays (Nichols, Roche Elecsys((R)), Scantibodies total); whole PTH (Scantibodies); bone-specific alkaline phosphatase (W); tartrate-resistant acid-phosphatase 5b (TRAP 5b); osteocalcin, 25-hydroxyvitamin D. Parameters derived from whole PTH were: (i) non-PTH(1-84), difference between intact PTH (Scantibodies assay) and whole PTH; (ii) whole PTH/non-PTH(1-84) ratio.Results. The values generated by the intact PTH assays were comparable. The mean whole PTH concentration was lower than mean intact PTH concentrations (16.9 +/- 18.1 vs 26.4 +/- 30.5 pmol/l, Nichols, P < 0.05). The correlation coefficients between all four PTH assays were comparable and were very high (r > 0.96, ns). The rank order of values generated by the whole PTH assay was statistically not significantly different from the rank order generated by the Nichols intact PTH assay. The median non-PTH(1-84) concentration was 5.2 pmol/l (range 0-49.4). All PTH assays correlated highly significantly with non-PTH (1-84) (correlation coefficients 0.83-0.92). Corrected serum calcium was also associated with non-PTH (1-84) but the correlation was weaker (r = 0.28). Regression analysis indicated that the non-PTH(1-84) concentration could be predicted by 76.6-84.6% by the prevailing intact PTH concentrations. Other parameters contributed only marginally to prediction of non-PTH(1-84). In the entire patient group, there was no statistically significant correlation between the whole PTH/non-PTA(1-84) ratio and any of the PTH assays or biochemical bone markers. Eight of 141 patients had a whole PTH/non-PTH(1-84) ratio