首页 | 本学科首页   官方微博 | 高级检索  
检索        


Inter-relations between the calcium set-points of Parfitt and Brown in primary hyperparathyroidism: a sequential citrate and calcium clamp study
Authors:P SCHWARZ  H A SØRENSEN  I TRANSBØL  Mineral Metabolic Research Group
Institution:*Department of Clinical Chemistry 339, Hvidovre Hospital, University of Copenhagen, DK–2650 Hvidovre, Denmark.;†Division of Endocrinology, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
Abstract:Abstract. The objective of the present study was to compare the calcium set-points of E. M. Brown and A. M. Parfitt obtained by sequential citrate and calcium clamp in patients with primary hyperparathyroidism and healthy controls. Twenty-six patients with primary hyperparathyroidism were investigated and compared to 22 healthy volunteers. All participants were investigated by sequential calcium lowering and raising comprising the following four phases: Phase (1) blood ionized calcium lowering of about 0·20 mmol l-1; phase (2) steady-state (relative) hypocalcaemia of blood ionized calcium 0·20 mmol l-1 below baseline; phase (3) blood ionized calcium is raised to about 0·20 mmol l-1 above baseline; and phase (4) (relative) hypercalcaemia of blood ionized calcium 0·20 mmol l-1 above baseline. Serum parathyroid hormone (1–84) was measured by an immunoradiometric assay. Blood ionized calcium was measured by a calcium selective electrode. We found the calcium set-points of Parfitt to be 1·42 mmol l-1 (SD 0·12, n= 52) vs. 1·25 mmol l-1 (SD 0·04, n= 44) in patients and controls, respectively (P < 0·001). The calcium set-points of Brown were 1·32 mmol l-1 (SD 0·10, n= 26) vs. 1·13 mmol l-1 (SD 0·04, n= 22), respectively (P < 0·001). By comparing the calcium set-points of Parfitt and Brown, a strikingly good correlation was observed, in patients (r= 0·91, P < 0·001) and in controls (r= 0·85, P < 0·001). We demonstrate in this paper in vivo that Brown's and Parfitt's calcium set-points are raised in primary hyperparathyroidism and return to normal following parathyroidectomy. The values for Brown's and Parfitt's calcium set-points are significantly different, but strikingly well correlated, supporting the view that Brown and Parfitt describe two different points on the same sigmoidal curve, corresponding to 50% and about 85% inhibition of PTH maximum, respectively. The mathematical form of the sigmoidal curve between blood ionized calcium and parathyroid hormone is very similar in primary hyperparathyroidism and normal humans.
Keywords:Clamp technique  ionized calcium  PTH  
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号