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New parathyroid function index for the differentiation of primary and secondary hyperparathyroidism: a case-control study
- Source :
- BMC Endocrine Disorders, Vol 20, Iss 1, Pp 1-5 (2020), BMC Endocrine Disorders
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- Background Patients with primary hyperparathyroidism (PHPT) may be asymptomatic, and some may present with normocalcemic PHPT (NPHPT). Patients with vitamin D deficiency may also be asymptomatic, with normal calcium and elevated PTH concentrations. These latter patients are usually diagnosed with vitamin D deficiency-induced secondary hyperparathyroidism (VD-SHPT). Therefore, it is very difficult to distinguish PHPT and NPHPT from VD-SHPT based on calcium or PTH concentrations in clinical settings. In this case-control study, we aimed to verify the diagnostic power of a new parathyroid function index (PFindex = Ca*PTH/P). Methods This study enrolled 128 patients with surgically and pathologically confirmed PHPT, including 36 with NPHPT, at a hospital in West China between January 2009 and September 2017. Thirty-seven patients with VD-SHPT and 45 healthy controls were selected from the population of a cross-sectional epidemiological study as the SHPT and healthy groups, respectively. We used the PFindex to describe the characteristics of PHPT, NPHPT, and VD-SHPT.. Differences between the four groups were compared, and a receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic power of PFindex. Results The PHPT group had the highest PFindex (454 ± 430), compared to the other three groups (NPHPT: 101 ± 111; SHPT: 21.7 ± 6.38; healthy: 12.2 ± 2.98, all p 34 to differentiate NPHPT from VD-SHPT yielded the highest positive likelihood ratio and lowest negative likelihood ratio. Conclusion The PFindex provided excellent diagnostic power for the differentiation of NPHPT from VD-SHPT. This simple tool may be useful for guiding timely decision-making processes regarding the initiation of vitamin D treatment or surgery for PHPT.
- Subjects :
- Male
endocrine system diseases
Endocrinology, Diabetes and Metabolism
lcsh:Diseases of the endocrine glands. Clinical endocrinology
Likelihood ratios in diagnostic testing
Gastroenterology
0302 clinical medicine
030212 general & internal medicine
Vitamin D
Parathyroid function index
education.field_of_study
Incidence
Hyperparathyroidism
Cell Differentiation
General Medicine
Middle Aged
Hyperparathyroidism, Primary
Prognosis
Parathyroid Hormone
Female
Secondary hyperparathyroidism
medicine.symptom
Research Article
China
medicine.medical_specialty
Population
030209 endocrinology & metabolism
Asymptomatic
vitamin D deficiency
Parathyroid Glands
03 medical and health sciences
Internal medicine
medicine
Vitamin D and neurology
Humans
education
Retrospective Studies
Vitamin D deficiency
lcsh:RC648-665
business.industry
medicine.disease
Cross-Sectional Studies
ROC Curve
Case-Control Studies
Calcium
Hyperparathyroidism, Secondary
business
Biomarkers
Primary hyperparathyroidism
Follow-Up Studies
Subjects
Details
- ISSN :
- 14726823
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- BMC Endocrine Disorders
- Accession number :
- edsair.doi.dedup.....35a117965fcc968f8fd5c61a50619737