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Interpretation of Plasma PTH Concentrations According to 25OHD Status, Gender, Age, Weight Status, and Calcium Intake: Importance of the Reference Values

Mathilde Touvier 1, 2 Mélanie Deschasaux 1 Marion Montourcy 1 Angela Sutton 3, 4 Nathalie Charnaux 5, 4 Emmanuelle Kesse-Guyot 1 Léopold Fezeu 4 Paule Latino-Martel 1 Nathalie Druesne-Pecollo 1 Denis Malvy 6 Pilar Galan 2 Serge Hercberg 2 Khaled Ezzedine 6, 1 Jean-Claude Souberbielle 7
1 CRESS (U1153 / UMR_A_1125 / UMR_S_1153) - Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité
2 UREN - Unité de Recherche en Epidémiologie Nutritionnelle
3 Hôpital Jean Verdier [AP-HP]
4 CRESS - U1153 - Equipe 3: EREN- Equipe de Recherche en Epidémiologie Nutritionnelle
UP13 - Université Paris 13, INRA - Institut National de la Recherche Agronomique, CNAM - Conservatoire National des Arts et Métiers [CNAM], CRESS (U1153 / UMR_A_1125 / UMR_S_1153) - Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité
5 UP13 - Université Paris 13
6 Service de dermatologie Hôpital Saint-André Bordeaux
7 AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
Abstract : Context: Reference values for plasma PTH assessment were generally established on small samples of apparently healthy subjects, without considering their 25-hydroxyvitamin D (25OHD) status or other potential modifiers of PTH concentration. Objective: Our objective was to assess ranges of plasma PTH concentration in a large sample of adults, stratifying by 25OHD status, age, gender, weight status, and calcium intake. Design, Setting, and Participants: This cross-sectional survey is based on 1824 middle-aged Caucasian adults from the Supplementation en Vitamines et Mineraux Antioxydants study (1994). Main Outcome Measures: Plasma PTH and 25OHD concentrations were measured by an electro-chemoluminescent immunoassay. Extreme percentiles of plasma PTH concentrations were assessed specifically in subjects who had plasmatic values of 25OHD of 20 ng/mL or greater and 30 ng/mL or greater. Results: Among subjects with 25OHD status of 20ng/mL or greater, the 97.5th percentile of plasma PTH concentration was 45.5 ng/L. By using this value as a reference, 5% of the subjects with plasma 25OHD less than 20 nmol/L had a high plasma PTH level, reflecting secondary hyperparathyroidism. Among vitamin D-replete subjects (25OHD status of 20 ng/mL or greater), the 97.5th percentile of plasma PTH was higher in overweight/obese subjects (51.9 vs 43.5 ng/L among normal weight subjects). Conclusions: The reference value for plasma PTH defined in this vitamin D-replete population was far below the value currently provided by the manufacturer (65 ng/L) and varied according to overweight status. These results may contribute to improve the diagnosis of primary and secondary hyperparathyroidism and subsequent therapeutic indication.
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https://hal-univ-paris13.archives-ouvertes.fr/hal-02061577
Contributeur : Karim Boualem <>
Soumis le : vendredi 8 mars 2019 - 11:21:17
Dernière modification le : mardi 29 juin 2021 - 17:12:03

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UNIV-PARIS13 | INRA | CNAM | USPC | UNIV-PARIS5 | EREN | UNIV-HESAM | INSERM | UNIV-PARIS7 | SORBONNE-PARIS-NORD | INRAE | UNIV-PARIS | UP-SANTE | SUVIMAX

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Mathilde Touvier, Mélanie Deschasaux, Marion Montourcy, Angela Sutton, Nathalie Charnaux, et al.. Interpretation of Plasma PTH Concentrations According to 25OHD Status, Gender, Age, Weight Status, and Calcium Intake: Importance of the Reference Values. Journal of Clinical Endocrinology and Metabolism, Endocrine Society, 2014, 99 (4), pp.1196-1203. ⟨10.1210/jc.2013-3349⟩. ⟨hal-02061577⟩

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