Comparison of parathyroid hormone assays with bone histomorphometry in renal osteodystrophy.
Comparison of parathyroid hormone assays with bone histomorphometry in renal osteodystrophy.
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DOI：
10.1210/jcem-63-5-1163
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发表时间：
1986-11
期刊：
影响因子：
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通讯作者：
D. Andress;D. Endres;N. Maloney;J. Kopp;J. Coburn;D. Sherrard
中科院分区：
文献类型：
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作者：
D. Andress;D. Endres;N. Maloney;J. Kopp;J. Coburn;D. Sherrard
对67例透析患者的骨活检进行了研究，以确定与测量无活性羧基末端/中段血浆PTH片段的RIA相比，针对完整血浆PTH的PTH RIA是否是纤维性骨炎的更好预测因子。在比较中使用了与完整PTH交叉反应但不与中间区或羧基末端片段交叉反应的氨基末端特异性抗血清，以及与PTH分子的44-68区交叉反应并测量完整和中间区/羧基末端PTH片段的抗血清。血浆PTH浓度与骨形成率、骨沉积率、成骨细胞类骨质、破骨细胞数量和骨髓纤维化呈正相关。氨基端甲状旁腺素测定对纤维性骨炎的最佳预测值为88%，而中段甲状旁腺素测定为74%。这种预测值的差异可归因于骨髓纤维化与血浆氨基末端PTH的高度显著相关性。总之，这些数据表明，甲状旁腺素放射免疫分析，使用氨基末端特异性抗血清可能是一个更好的预测纤维性骨炎患者进行维持性血液透析。
Bone biopsies were studied in 67 dialysis patients to determine if a PTH RIA specific for intact plasma PTH is a better predictor of osteitis fibrosa than a RIA that measures inactive carboxy-terminal/midregion plasma PTH fragments. An amino-terminal-specific antiserum that cross-reacts with intact PTH, but not midregion or carboxy-terminal fragments, and an antiserum that cross-reacts with the 44-68 region of the PTH molecule and measures both intact and midregion/carboxy-terminal PTH fragments were used in the comparisons. Plasma PTH concentrations measured by both assays correlated positively with bone formation rate, bone apposition rate, osteoblastic osteoid, osteoclast number, and marrow fibrosis. The optimum predictive value of the amino-terminal PTH assay for osteitis fibrosa was 88%, compared to 74% for the midregion PTH assay. This difference in predictive value could be attributed to the highly significant correlation of marrow fibrosis with plasma amino-terminal PTH. In conclusion, these data suggest that a PTH RIA that uses an amino-terminal-specific antiserum may be a better predictor of osteitis fibrosa in patients undergoing maintenance hemodialysis.