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      Effects of Minor Increase in Serum Calcium on the Immunoheterogeneity of Parathyroid Hormone in Healthy Subjects and in Patients with Primary Hyperparathyroidism

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          Abstract

          To study possible influences of a mild increase in serum-ionized calcium concentration that is seen during daily life on circulating parathyroid hormone (PTH) immunoheterogeneity, we used sequence-specific PTH assays to determine serum intact PTH, C-terminal PTH and N-terminal PTH following oral calcium (1.5 g) in healthy subjects (n = 7). This was also performed in patients with primary hyperparathyroidism (pHPT; n = 10) to see if their regulation of circulating PTH molecular forms is normal. Compared to healthy subjects, the patients were hypercalcemic (p < 0.05) and had higher levels of PTH in all three assays (p < 0.001). Following the oral calcium load, serum-ionized calcium increased by 0.08 ± 0.03 mmol/l in the patients and by 0.07 ± 0.03 mmol/l in the healthy subjects after 90 min, whereas serum intact PTH, C-terminal PTH and N-terminal PTH were reduced, both in the healthy subjects and in the patients. Suppression by calcium of both intact PTH and C-terminal PTH were impaired in the patients (p < 0.05 and p < 0.001), whereas suppression of N-terminal PTH was normal. Furthermore, the C/i and N/i ratios were higher at the highest calcium concentration achieved after calcium intake in the healthy subjects than in the basal state in the patients (p < 0.05), in spite of the larger degree of hypercalcemia in the latter (1.40 ± 0.06 vs. 1.31 ± 0.02 mmol/l; p < 0.05). Thus, (1) a minor increase in serum-ionized calcium that is seen during daily life alters the relative circulating concentrations of PTH versus its fragments; (2) the impaired sensitivity to calcium in pHPT is not evident for the suppression of N-terminal PTH, and (3) pHPT is accompanied by altered immunoheterogeneity of circulating PTH.

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          Author and article information

          Journal
          HRE
          Horm Res Paediatr
          10.1159/issn.1663-2818
          Hormone Research in Paediatrics
          S. Karger AG
          1663-2818
          1663-2826
          1995
          1995
          05 December 2008
          : 43
          : 6
          : 294-299
          Affiliations
          Department of Medicine, Lund University, Malmö and Department of Surgery, Lund University, Lund, Sweden
          Article
          184315 Horm Res 1995;43:294–299
          10.1159/000184315
          7607615
          76a7c829-10b0-4f41-8dd4-92968bc2a10a
          © 1995 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          History
          : 31 March 1994
          : 29 November 1994
          Page count
          Pages: 6
          Categories
          Original Paper

          Endocrinology & Diabetes,Neurology,Nutrition & Dietetics,Sexual medicine,Internal medicine,Pharmacology & Pharmaceutical medicine
          Primary hyperparathyroidism,Calcium,Suppression,Immunoheterogeneity,Parathyroid hormone,Healthy subjects

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